eMedicine Specialties > Emergency Medicine > Environmental

Burns, Thermal: Multimedia

Author: Jamie Goodis, MD, Emergency Medicine, Stanford University
Coauthor(s): Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Contributor Information and Disclosures

Updated: Dec 15, 2009

Multimedia

Partial- and full-thickness burns from a structur...Media file 1: Partial- and full-thickness burns from a structure fire. Note facial involvement.
Partial- and full-thickness burns from a structur...

Partial- and full-thickness burns from a structure fire. Note facial involvement.

Rule of nines for calculating burn area.Media file 2: Rule of nines for calculating burn area.
Rule of nines for calculating burn area.

Rule of nines for calculating burn area.

Lund and Browder chart illustrating the method fo...Media file 3: Lund and Browder chart illustrating the method for calculating the percentage of body surface area affected by burns in children.
Lund and Browder chart illustrating the method fo...

Lund and Browder chart illustrating the method for calculating the percentage of body surface area affected by burns in children.

Child with burns from a scald. Hot soup was spill...Media file 4: Child with burns from a scald. Hot soup was spilled when the child grabbed the handle of a pot. Note the full-thickness burn to left upper part of the chest. Edema of the lips and blisters on the face and nose indicate second-degree burns of the face.
Child with burns from a scald. Hot soup was spill...

Child with burns from a scald. Hot soup was spilled when the child grabbed the handle of a pot. Note the full-thickness burn to left upper part of the chest. Edema of the lips and blisters on the face and nose indicate second-degree burns of the face.

Escharotomy to release the chest wall and allow f...Media file 5: Escharotomy to release the chest wall and allow for ventilation of the patient.
Escharotomy to release the chest wall and allow f...

Escharotomy to release the chest wall and allow for ventilation of the patient.

59-year-old physician with deep-seated bulla on m...Media file 6: 59-year-old physician with deep-seated bulla on middle finger after burning himself taking a hot bun out of oven.
59-year-old physician with deep-seated bulla on m...

59-year-old physician with deep-seated bulla on middle finger after burning himself taking a hot bun out of oven.

The American Burn Association has developed a set...Media file 7: The American Burn Association has developed a set of criteria for burn center transfer. These criteria have been adopted by most emergency medical services.
The American Burn Association has developed a set...

The American Burn Association has developed a set of criteria for burn center transfer. These criteria have been adopted by most emergency medical services.

The size of the burn is best estimated by using a...Media file 8: The size of the burn is best estimated by using a chart that corrects for the changes in body proportions with aging.
The size of the burn is best estimated by using a...

The size of the burn is best estimated by using a chart that corrects for the changes in body proportions with aging.

Second-degree burns are often red, wet, and very ...Media file 9: Second-degree burns are often red, wet, and very painful. An enormous variability exists in their depth, their ability to heal, and their tendency to result in hypertrophic scar formation.
Second-degree burns are often red, wet, and very ...

Second-degree burns are often red, wet, and very painful. An enormous variability exists in their depth, their ability to heal, and their tendency to result in hypertrophic scar formation.

Third-degree burns are usually leathery, dry, ins...Media file 10: Third-degree burns are usually leathery, dry, insensate, and waxy. These wounds do not heal.
Third-degree burns are usually leathery, dry, ins...

Third-degree burns are usually leathery, dry, insensate, and waxy. These wounds do not heal.

Management of burn blisters is controversial. Man...Media file 11: Management of burn blisters is controversial. Many can be left intact to facilitate comfort, while the underlying wound heals. Sometimes, blisters obscure full-thickness wounds, as shown here, but, usually, wounds underlying blisters are partial thickness.
Management of burn blisters is controversial. Man...

Management of burn blisters is controversial. Many can be left intact to facilitate comfort, while the underlying wound heals. Sometimes, blisters obscure full-thickness wounds, as shown here, but, usually, wounds underlying blisters are partial thickness.

A clinically focused definition set describing bu...Media file 12: A clinically focused definition set describing burn wound infections.
A clinically focused definition set describing bu...

A clinically focused definition set describing burn wound infections.

Burn wound cellulitis presents with increasing er...Media file 13: Burn wound cellulitis presents with increasing erythema, swelling, and pain in the uninjured skin around the periphery of the wound.
Burn wound cellulitis presents with increasing er...

Burn wound cellulitis presents with increasing erythema, swelling, and pain in the uninjured skin around the periphery of the wound.

Invasive burn wound infection implies that bacter...Media file 14: Invasive burn wound infection implies that bacteria or fungi proliferating in burn eschar are invading the underlying viable tissues. These wounds display a change in color, new drainage, and, commonly, a foul odor. This infection can be life threatening.
Invasive burn wound infection implies that bacter...

Invasive burn wound infection implies that bacteria or fungi proliferating in burn eschar are invading the underlying viable tissues. These wounds display a change in color, new drainage, and, commonly, a foul odor. This infection can be life threatening.

A large (and increasing) number of medications an...Media file 15: A large (and increasing) number of medications and membranes have been selected for use in burn wound management.
A large (and increasing) number of medications an...

A large (and increasing) number of medications and membranes have been selected for use in burn wound management.

If hand positioning and therapy are ignored while...Media file 16: If hand positioning and therapy are ignored while overlying burns heal, long-term suboptimal function may result.
If hand positioning and therapy are ignored while...

If hand positioning and therapy are ignored while overlying burns heal, long-term suboptimal function may result.

The depth of partial-thickness burns is routinely...Media file 17: The depth of partial-thickness burns is routinely underestimated in the outpatient setting.
The depth of partial-thickness burns is routinely...

The depth of partial-thickness burns is routinely underestimated in the outpatient setting.

A 2-year-old child is brought to the office for e...Media file 18: A 2-year-old child is brought to the office for evaluation of a scald burn to the hand.
A 2-year-old child is brought to the office for e...

A 2-year-old child is brought to the office for evaluation of a scald burn to the hand.

Splinting a serious hand burn.Media file 19: Splinting a serious hand burn.
Splinting a serious hand burn.

Splinting a serious hand burn.

More on Burns, Thermal

Overview: Burns, Thermal
Differential Diagnoses & Workup: Burns, Thermal
Treatment & Medication: Burns, Thermal
Follow-up: Burns, Thermal
Multimedia: Burns, Thermal
References

References

  1. Sheridan RL. Burns. Crit Care Med. Nov 2002;30(11 Suppl):S500-14. [Medline].

  2. US Fire Administration. QuickStats: The Overall Fire Picture - 2007. US Fire Administration Web site. Available at http://www.usfa.fema.gov/statistics/quickstats/.

  3. World Fire Statistics Centre. Population Comparisons for Fire Deaths (2002-2004). The Geneva Association Web site. Available at http://www.genevaassociation.org/Affiliated_Organizations/WFSC.aspx. Accessed October 2007.

  4. D'Souza AL, Nelson NG, McKenzie LB. Pediatric burn injuries treated in us emergency departments between 1990 and 2006. Pediatrics. Nov 2009;124(5):1424-30. [Medline].

  5. Vassilia K, Eleni P, Dimitrios T. Firework-related childhood injuries in Greece: a national problem. Burns. Mar 2004;30(2):151-3. [Medline].

  6. Jones D, Lee W, Rea S, et al. Firework injuries presenting to a national burn's unit. Ir Med J. Sep 2004;97(8):244-5. [Medline].

  7. Fire Deaths and Injuries, Facts - NCIPC. Centers for Disease Control and Prevention. Available at http://www.cdc.gov/ncipc/factsheets/fire.htm. Accessed March 1, 2008.

  8. Consumer Product Safety Commission. Flammable Fabrics Act: Children's Sleepwear. vol 61(175). Federal Registrar Online via GPO access: Federal Registrar; September 1996. 47633-47649. [Full Text].

  9. Sheridan R. Outpatient burn care in the emergency department. Pediatr Emerg Care. Jul 2005;21(7):449-56; quiz 457-9. [Medline].

  10. Amirsheybani HR, Crecelius GM, Timothy NH, et al. The natural history of the growth of the hand: I. Hand area as a percentage of body surface area. Plast Reconstr Surg. Mar 2001;107(3):726-33. [Medline].

  11. Perry RJ, Moore CA, Morgan BD, Plummer DL. Determining the approximate area of a burn: an inconsistency investigated and re-evaluated. BMJ. May 25 1996;312(7042):1338. [Medline].

  12. Reed JL, Pomerantz WJ. Emergency management of pediatric burns. Pediatr Emerg Care. Feb 2005;21(2):118-29. [Medline].

  13. [Guideline] World Health Organization 2007. Management of Burns. World Health Organization. Available at http://www.who.int/surgery/publications/Burns_management.pdf. Accessed March 2, 2008.

  14. Choi M, Armstrong MB, Panthaki ZJ. Pediatric hand burns: thermal, electrical, chemical. J Craniofac Surg. Jul 2009;20(4):1045-8. [Medline].

  15. [Guideline] ABA. Burn Incidence and Treatment in the US: 2006 Fact Sheet. American Burn Association Web site. Available at http://www.ameriburn.org.

  16. Allison K, Porter K. Consensus on the prehospital approach to burns patient management. Emerg Med J. Jan 2004;21(1):112-4. [Medline].

  17. Bernard SJ, Paulozzi LJ, Wallace DL. Fatal injuries among children by race and ethnicity--United States, 1999-2002. MMWR Surveill Summ. May 18 2007;56(5):1-16. [Medline].

  18. Children's Hospital Boston. Fire Safety and Burns - Injury Statistics and Incidence Rates. Children's Hospital Boston Web site. Available at http://www.childrenshospital.org/az/Site903/mainpageS903P0.html. Accessed April 22, 2005.

  19. Edlich RF, Moghtader JC, Rosen P, et al, eds. Thermal burns. In: Emergency Medicine: Concepts and Clinical Practice. 4th ed. St Louis, Mo: Mosby; 1998:941-953.

  20. Fogarty BJ, Gordon DJ. Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland. Burns. Feb 1999;25(1):53-6. [Medline].

  21. Hove LM, Lindtjorn B. Epidemiology of burns in Bergen, Norway. Scand J Plast Reconstr Surg Hand Surg. Jun 1999;33(2):225-9. [Medline].

  22. Juma A. Bitumen burns and the use of baby oil. Burns. Aug 1994;20(4):363-4. [Medline].

  23. Monafo WW. Initial management of burns. N Engl J Med. Nov 21 1996;335(21):1581-6. [Medline].

  24. Monafo WW, Freedman B. Topical therapy for burns. Surg Clin North Am. Feb 1987;67(1):133-45. [Medline].

  25. Schwartz LR, Tintinalli JE, et al, eds. Thermal burns. In: Emergency Medicine: A Comprehensive Study Guide. 4th ed. Minneapolis: McGraw Hill; 1996:893-898.

  26. Shea PC, Fannon P. Mayonnaise and hot tar burns. J Med Assoc Ga. Sep 1981;70(9):659-60. [Medline].

  27. Stratta RJ, Saffle JR, Kravitz M, Warden GD. Management of tar and asphalt injuries. Am J Surg. Dec 1983;146(6):766-9. [Medline].

  28. Taylor KO, Goudie CM, Muller MJ. Evaluation of a pediatric scald burn clinical pathway. J Burn Care Rehabil. May-Jun 2004;25(3):256-61. [Medline].

  29. Tiernan E, Harris A. Butter in the initial treatment of hot tar burns. Burns. Oct 1993;19(5):437-8. [Medline].

  30. Turegun M, Ozturk S, Selmanpakoglu N. Sunflower oil in the treatment of hot tar burns. Burns. Aug 1997;23(5):442-5. [Medline].

  31. Wald DA. Burn management: Systematic patient evaluation, fluid resuscitation and wound management. Emerg Med Rep. 1998;19:45-52.

  32. Wibbenmeyer LA, Amelon MJ, Torner JC, et al. Population-based assessment of burn injury in southern Iowa: identification of children and young-adult at-risk groups and behaviors. J Burn Care Rehabil. Jul-Aug 2003;24(4):192-202. [Medline].

Further Reading

Keywords

burns, thermal burns, thermal injury, heat burn, scalds, burn injury, burn treatment, contact burns, firework burns, fire deaths, treatment, diagnosis, symptoms

Contributor Information and Disclosures

Author

Jamie Goodis, MD, Emergency Medicine, Stanford University
Jamie Goodis, MD is a member of the following medical societies: American College of Emergency Physicians, Emergency Medicine Residents Association, International Society for Mountain Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Coauthor(s)

Erik D Schraga, MD, Consulting Staff, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates; Consulting Staff, Permanente Medical Group, Kaiser Permanente, Santa Clara Medical Center
Disclosure: Nothing to disclose.

Medical Editor

Debra Slapper, MD, Consulting Staff, Department of Emergency Medicine, St Anthony's Hospital
Debra Slapper, MD is a member of the following medical societies: American Academy of Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jon Mark Hirshon, MD, MPH, Associate Professor, Department of Emergency Medicine, University of Maryland School of Medicine
Jon Mark Hirshon, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Public Health Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Jonathan Adler, MD, Attending Physician, Department of Emergency Medicine, Massachusetts General Hospital; Division of Emergency Medicine, Harvard Medical School
Jonathan Adler, MD is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.