Burns - Initial Management

Definition

Burns are injuries to the skin and underlying tissues caused by heat, chemicals, electricity, or radiation. Initial management focuses on stabilizing the patient, preventing further tissue damage, and minimizing complications.

Epidemiology

• Burn injuries affect millions worldwide annually, with higher incidence in low- and middle-income countries
• Most common in children and young adults
• Domestic burns (hot liquids, kitchen accidents) are frequent in children
• Occupational burns common in adults working with heat, chemicals, or electricity
• Mortality depends on burn extent, depth, age, and comorbidities

Etiology

• Thermal: flame, scalds (hot liquids), contact burns
• Chemical: acids, alkalis, oxidizers
• Electrical: high-voltage or low-voltage injuries
• Radiation: sunburn, radiation therapy
• Risk factors: age extremes, impaired mobility, poor supervision, unsafe working conditions

Pathophysiology

• Immediate tissue damage due to thermal, chemical, or electrical insult
• Cell death triggers inflammatory response and increased vascular permeability
• Fluid loss from capillary leakage leads to hypovolemia in extensive burns
• Edema formation contributes to compartment syndromes
• Risk of infection due to skin barrier disruption
• Systemic response in major burns: hypermetabolic state, immune dysregulation, multi-organ involvement