Nursing Management of Patients with Burns and Reconstructive Surgery
1. Burn Injury
Definition : Burn injury is damage to the skin and underlying tissues caused by heat, electricity, chemicals, radiation, or friction.
Causes of Burn Injury
* Thermal burns (fire, hot water, steam, oil)
* Chemical burns (acids, alkalis)
* Electrical burns (electric current)
* Radiation burns (X-rays, sunlight)
* Friction burns (road accidents, machinery)
Classification of Burns
Based on depth
* Superficial (first-degree): only epidermis affected
* Partial thickness (second-degree): epidermis and part of dermis
* Full thickness (third-degree): all layers of skin destroyed
Based on severity
* Minor burns
* Moderate burns
* Major or critical burns (large body surface area, face, airway involvement)
Based on cause
* Thermal
* Chemical
* Electrical
* Radiation
Management of Burn Injury
General Principles
* Maintain airway and breathing
* Prevent shock
* Control pain
* Prevent infection
* Promote wound healing
* Maintain fluid and electrolyte balance
Medical Management
* IV fluid replacement
* Pain relief with analgesics
* Antibiotics if infection present
* Tetanus prophylaxis
* Wound care with sterile dressings
* Skin grafting in severe cases
* Nutritional support (high protein, high calorie diet)
2. Nursing Management of Burn Patient
Assessment
* Check airway, breathing, circulation
* Assess burn area and depth
* Monitor vital signs
* Observe fluid loss and urine output
* Assess pain and psychological status
Nursing Interventions
* Maintain airway and give oxygen if needed
* Start IV fluids as prescribed
* Monitor intake and output strictly
* Maintain sterile wound care
* Administer prescribed analgesics
* Prevent infection using aseptic technique
* Position patient to prevent contractures
* Provide high protein, high calorie diet
* Assist in skin graft care if required
* Provide emotional and psychological support
* Educate patient and family
3. Emergency Care of Burn Patient
Immediate First Aid
* Remove patient from source of burn
* Stop burning process immediately
* Cool the burn with clean running water
* Remove tight clothing and jewelry
Airway and Breathing
* Assess airway for inhalation injury
* Give oxygen if required
* Prepare for intubation if airway is compromised
Circulation
* Start IV fluids immediately
* Monitor pulse and blood pressure
* Prevent and manage shock
Wound Care
* Cover burn with sterile clean cloth
* Do not apply creams or home remedies initially
* Maintain asepsis
Pain and Comfort
* Give analgesics as prescribed
* Keep patient warm to prevent hypothermia
Transport to Hospital
* Shift patient to burn unit or emergency department quickly
* Continue monitoring vital signs during transport
Previous Year Questions (INC & ANC)
1. Define Burn injury. Explain its causes, classification and management.
2. Describe the nursing management of a patient with burns.
3. Explain the emergency care of a burn patient.
4. Write short notes on fluid and electrolyte imbalance in burn patients.
5. Explain complications of burns and their prevention.
6. Describe the nursing care of a patient with extensive burns.
7. Write short notes on shock in burn patients.
8. Explain wound care management in burn patients.
9. Describe infection control measures in burn units.
10. Write short notes on skin grafting.
11. Explain preoperative nursing care of patients undergoing reconstructive surgery.
12. Describe postoperative nursing management of reconstructive surgery patients.
13. Write short notes on skin graft care.
14. Explain care of donor site and graft site.
15. Describe pain management in burn patients.
16. Write short notes on contractures and their prevention in burn patients.
17. Explain nutritional management of burn patients.
18. Describe psychological care of burn patients.
19. Write short notes on rehabilitation of burn patients.
20. Explain nursing care of patients after reconstructive surgery.
21. Describe physiotherapy in burn rehabilitation.
22. Write short notes on scar management and prevention.
23. Explain nursing responsibilities in plastic and reconstructive surgery ward.
24. Describe care of patients with electrical burns.
25. Write short notes on chemical burns and their management.
26. Explain role of nurse in prevention of complications in burn patients.
27. Describe discharge planning and home care of burn patients.
28. Write short notes on infection in burn wounds.
29. Explain emergency management of airway burns.
30. Describe rehabilitation goals in reconstructive surgery patients.
