Evaluation of the Patient
The first examination of the patient with burn injury has to be
complete and should focus on
-Airway, breathing and circulation.
-Evaluation are specific with regard to, inhalation injury to
lungs
-Burn injured patient may have multiple system injury and should
examined for these.
We shall deal primarily with recent thermal burns in this
post, since this occur frequently and in passing touch upon the
important features of chemical and electric burns in so far as
they affect the treatment.
Type of Injury
The patho-physiology involved in the wounds of a patient with a
burn injury is basically the same regardless of the cause.
In the superficial area of injury, coagulative necrosis occurs.
In this zone protein is irreversibly denatured and cellular integrity is
lost.
Adjacent to this zone is the zone of stasis in which tissue is
viable but subject to further necrosis as the wound evolves due
oedema and inflammation.
A third zone has been recognized below the zone of stasis and is
characterized as a zone of hyperemia.
The depth of the coagulative necrosis that occurs in burns which
are caused by scalding, flame, or contact with a hot object is
directly related to the temperature, duration of exposure,
thickness of the tissue, and state of the blood supply in the
tissue
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