Burns
Heat, chemicals or electricity destroy skin and drive an inflammatory capillary leak, so a burn threatens the airway, the circulating volume and, when circumferential, ventilation and limb perfusion.
Definition
A burn is tissue injury caused by the transfer of thermal, chemical, electrical, frictional, cold or radiation energy. Severity is defined by depth, by the proportion of the total body surface area involved, by anatomical site, by mechanism, and by patient factors and associated injuries. Depth is classified as epidermal, superficial partial thickness, deep partial thickness or full thickness, a British Burn Association scheme that has replaced the older first, second and third degree terms.
First principles
Extent decides the fluid, depth decides the referral
Total body surface area (TBSA) sets the resuscitation volume, which is why simple erythema is excluded from it. Depth decides referral and surgery. For an emergency practitioner only two distinctions change what you do: is any of it full thickness, and is any of it merely epidermal. Separating superficial from deep partial thickness does not.
This page is exam revision material, not medical advice, and must not be used for patient care. Always check drug doses against the BNF and current guidance. Full disclaimer.