According to the American Burn Association (ABA), there were over 486,000 injuries in the United States and 3,500 deaths due to the different types of burns in 2019. Severe burns can affect a patient’s quality of life, and it is crucial to properly assess and manage burn injuries to ensure that the patient achieves their highest functional level.

Ehline Law and our burn injury attorneys have worked with victims since 2005, protecting their rights and getting them the compensation they deserve. We understand the impact of burn injuries on victims and their lives, which is why we’ve put together this guide on burn injury assessment and management information for patients to help them with their recovery journey.

Groups of People Who Are Vulnerable to Burn Injuries

Several groups of people have a higher risk of burn injury mortality, including:

1. Elderly individuals: As people age, their skin becomes thinner and more fragile, making them more susceptible to burns. Elderly individuals may also have underlying medical conditions that can complicate burn injuries and increase mortality risk.
2. Children: Children have thinner skin than adults, making them more susceptible to burns. Additionally, children may be unable to communicate their pain or discomfort effectively, which can delay treatment and increase the risk of complications.
3. Individuals with pre-existing medical conditions: People with pre-existing medical conditions, such as diabetes or heart disease, may be at higher risk for burn-related complications. These conditions can interfere with the body’s ability to heal and may increase the risk of infection or other complications.
4. Individuals in certain occupations: People who work in certain professions, such as firefighters, may be at higher risk for burn injuries due to their exposure to fire, heat, and other hazards. These individuals may also be more likely to experience smoke inhalation, which can be life-threatening.

Assessing Burn Injuries

Burn specialists typically carry out a thorough burn assessment, which involves the following steps:

1. Assess the extent of the burn injury: The burn specialist will assess the size of the burn injury and the percentage of body surface area affected. This is typically done using the “Rule of Nines,” explained in the later section.
2. Determine the depth of the burn injury: Burn injuries are typically classified as first-degree, second-degree, third-degree, and fourth-degree burns. Assessing the depth can help burn specialists take the necessary action to minimize medical complications.
3. Assess the location of the burn injury: The area of the burn injury can provide important information about the severity of the damage and the potential for complications. Burns to the face, hands, feet, and genitals are often considered high-risk areas.
4. Evaluate associated injuries: Burn specialists will also assess for any associated injuries, such as inhalation injury, bacterial infection, or others.
5. Assess pain and functional status: The burn specialist will assess the patient’s pain level and functional status, which can impact their overall prognosis and recovery.
6. Determine the need for surgery: If the burn injury is severe or complicated, the patient may require surgery. The burn specialist will evaluate the need for surgical intervention and coordinate with other medical professionals as needed.

A comprehensive burn assessment is essential for determining the appropriate treatment plan and optimizing the patient’s recovery.

Symptoms of Different Categories of Burn Injuries

There are different categories of burn injuries, and assessing the symptoms can help determine the type of burn injury and the right burn care management plan for the victim. 

Let’s review the symptoms of the four main categories of burn injuries.

First-degree Burns (Also Called Superficial Burns)

These are minor burns that affect only the outermost layer of skin. Symptoms of superficial burns may include:

• Redness and mild pain
• Swelling
• Dry, peeling skin

Second-degree Burns (Also Called Partial Thickness)

These burns affect the outer layer and the layer underneath the skin. Symptoms may include:

• Redness and blistering
• Swelling
• Severe pain
• Weeping or oozing skin

Third-degree Burns (Also Called Full-thickness Burns)

These burns affect all skin layers and damage the underlying tissues, muscles, and bones. Symptoms may include:

• White or blackened, charred skin
• Numbness or loss of sensation in the affected area
• Severe pain or little to no pain (depending on the severity of the injury)
• Difficulty breathing or respiratory distress (if the burn occurs in the chest area)

Fourth-degree Burns

These are the most severe type of burns and can cause damage to bones, muscles, and internal organs. Symptoms may include:

• Blackened or charred skin
• Loss of sensation in the affected area
• Difficulty breathing or respiratory distress
• Shock (pale, clammy skin, rapid heartbeat, and shallow breathing)
• Cardiac arrest or other life-threatening complications

It’s essential to seek immediate medical attention for all types of burns, especially third- and fourth-degree burns, as they can lead to severe complications and even death if left untreated.

Explaining the Rule of Nines: Calculating Total Body Surface Area (TBSA)

The Rule of Nines is a method used to estimate the percentage of total body surface area (TBSA) burned. It is a quick and straightforward way to assess the severity of a burn injury, and medical professionals commonly use it to determine the appropriate treatment.

The Rule of Nines splits the body into different regions, each representing 9% (or a multiple of 9%) of the total body surface area. The areas of the body included in the rule of nines are:

• Head and neck: 9%
• Each arm (front and back): 9%
• Chest and abdomen: 18%
• Upper back and lower back: 18%
• Each leg (front and back): 18%
• Genital area: 1%

Burn specialists add the percentages to assess how much of the total body has burn injuries, which can help determine the right treatment.

Severe Burns That Can Be Life-threatening

All types of burns have the potential to be life-threatening, depending on their severity, location, and extent. However, certain types of burns are more dangerous and have a higher risk of causing severe complications or death. These include the following:

1. Full-thickness burns: These burns penetrate all layers of the skin and can cause extensive tissue damage. They may also affect the underlying tissues, muscles, and bones, leading to permanent disability or disfigurement. Third-degree burns are a medical emergency and require immediate medical attention.
2. Fourth-degree burns: These burns are even more severe than third-degree burns and can cause damage to internal organs, bones, and nerves. They are typically caused by high-voltage electrical shocks or exposure to extreme heat sources and may require surgical intervention.
3. Burns that affect the airway: Facial burns, or burns to the airway, caused by inhaling smoke or hot gases, can be life-threatening. They can cause swelling and inflammation of the airway, leading to breathing difficulties and even respiratory failure.
4. Burns that cover a large percentage of the body: Burns that cover a significant portion of the body can cause dehydration, infection, and shock. They may also interfere with the body’s ability to regulate temperature, leading to hypothermia or hyperthermia.
5. Chemical burns: Chemical burns can cause extensive tissue damage and may also enter the bloodstream, leading to systemic toxicity. They require immediate medical attention and may require specialized treatment.

Burn Management for Inhalation Injuries

Inhalation injury occurs when a person inhales smoke, hot gases, or other toxic substances during a fire or other hazardous event. Inhalation injury can cause damage to the airway, lungs, and other vital organs, and it can be life-threatening if left untreated.

Identifying Inhalation Injuries from Thermal Burns

Inhalation injury from smoke or carbon monoxide poisoning is a major cause of death in burn patients from fire accidents. Inhalation injuries can lead to acute respiratory distress syndrome and cytokine storm syndrome, which can be fatal.

Clinical indications of inhalation injury include:

1. Difficulty breathing or shortness of breath
2. Coughing or wheezing
3. Hoarseness or difficulty speaking
4. Burns or discoloration around the mouth or nose
5. Soot or debris in the sputum
6. Chest pain or tightness
7. Low oxygen saturation levels

Treatment and Medical Care for Burn Patients with Inhalation Injuries

Burn specialists manage acute inhalation injury through supportive care, airway management, and specialized treatments. The specific treatment approach will depend on the severity of the injury and the patient’s needs.

Supportive care may include oxygen therapy, fluid resuscitation, and pain management to support the patient’s overall health and prevent further complications. Airway management may involve intubation or other measures to ensure adequate ventilation and oxygen.

Specialized treatments for inhalation injury may include:

1. Nebulized medications: Medications delivered via a nebulizer can help reduce airway inflammation and improve breathing.
2. Bronchoscopy: This procedure involves inserting a flexible scope into the airway to remove any debris or blockages causing breathing difficulties.
3. Hyperbaric oxygen therapy: This treatment involves exposing the patient to high oxygen levels in a pressurized chamber. It can help improve oxygen delivery to the tissues and promote healing.
4. Mechanical ventilation: In some cases, patients with inhalation injuries may require mechanical ventilation to support their breathing and ensure adequate oxygenation.

For a major burn injury, the burn specialists may also work closely with other medical professionals, such as pulmonologists and critical care physicians, to provide comprehensive care for patients with inhalation injuries. Early recognition and treatment of an inhalation injury are essential to prevent further complications and improve outcomes for burn patients.

Immediate Burn Management

Whether the patient suffers from partial thickness burns or other classes of burn injury, it is crucial to administer the critical steps to burn management and treatment, which includes the following.

Stopping the Burning Process

If possible, remove the victim from the source of the burn, or extinguish any flames. Remove any clothing or jewelry unless it is sticking to the skin. 

Initiate the Cooling Process

Use saline or tap water to cool the tissues. It is essential to exercise extreme care during the cooling process, especially in patients with extensive burns, as it can lead to hypothermia or shock.

Assessing the Victim

Quickly assess the extent and severity of the burn injury, including the location and depth of the burn, the size of the affected area, and whether the victim is experiencing pain or other symptoms.

Establishing and Maintaining the Airway

If the victim suffers from an inhalation injury, ensure the airway is open and adequately supported. Administer supplemental oxygen if necessary.

Fluid Resuscitation

Depending on the severity of the burn injury, the victim may require fluid resuscitation to prevent shock, replenish lost fluids, and maintain vital organ function.

Wound Care

Clean and dress the burn wound appropriately. Burn wounds should be kept clean and dry, with routine changing of the dressing.

Pain Management and Medication

Administer appropriate pain medication, such as over-the-counter painkillers or morphine, to help manage the pain associated with burn injuries. Ensure the victim’s tetanus vaccination is up-to-date, and administer a booster if necessary.

Transfer to a Burn Center

Consider transferring the patient to a specialized burns unit, where they can receive more specialized care and treatment.

Whether the patient suffers from electrical burns or other types of burns, the goal of burn management and treatment is to stabilize the patient, prevent complications, and promote healing. It involves a multidisciplinary approach that may include coordinating with medical professionals from various specialties, including burn surgeons, nurses, respiratory therapists, and physical therapists.

Regular monitoring and assessment of the patient’s condition are also essential to ensure that they are receiving appropriate care and treatment.

Schedule a Free Consultation with Ehline Law

If you’ve suffered burn injuries due to another’s negligence, contact us at (833) LETS-SUE for a free consultation to discuss your case, as you may be able to seek compensation.