Don't Play with Hot Irons!

For the fourth day of trauma week 2023, Alicia Linter, CCRN, MSN, ACNP-BC, from the Arnold Luterman Regional Burn Center came to talk to us about burns. The burn center provides specialized burn care to the entire Gulf Coast. There are an estimated 400-600 admissions per year there and lots of faculty/staff, and even a therapy dog! To understand what severe burns are, we must know the anatomy of the skin. The epidermis is the nonvascular, stratified epithelial cells. The dermis is the thick layer of vascular tissue, containing nerve endings, oil/sweat glands, and lymph spaces. The subcutaneous tissue is the adipose tissue and fibrous. By definition, burns are injuries to the skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, and UV radiation. They are categorized into four depths: first, second, third, and fourth; the first being the most superficial, and the fourth being almost deadly. We can determine the severity of the burn by the source of burn injury(scald, hot water, fire), degree of heat, length of contact/exposure, age of the victim, anatomical location, pre-existing medical conditions, and associated injuries. The skin function also plays a part in this, like skin protection(sunscreen/gloves/coat), sensory in limbs, skin/wound temperature, amount of water the victim drinks, and how bad the injury looks. There are a variety of burns. One type of burn is thermal/flame burns. They have an irregular pattern, varying depth, radiating heat, and are the most common injury. Another type is scald burns. It's similar to thermal burn with an irregular pattern and mixed depth, but it is caused by hot steam/water. Other burns include contact burns(caused by irons/hot ash), chemical burns(chemicals/car fires/AC boxes), and electrical burns(voltage/associate injuries). When a burn injury happens, the medical professionals at the scene stop the burning process, move to a safe place, do their ABCs (airways, breathing, and circulation), keep the victim warm, check vital signs, give IV fluids, and transport them to the burn center. At the burn center, the doctors have many types of surgeries and recovery plans after they determine the type of burn using thermal imaging. They use excisional debridements, skin subs(xeno), and autografts to get the patient feeling better in no time. After the presentation, Linter showed us an inflatable body with red "burns" and how they found the percentage of the burned body by measure using their hands and counting. Today was very educational and I learned to not play with fire and hot irons. I liked learning about burns and how the burn center helped people. Yeah, it's kind of gruesome, but it's really cool stuff. Especially how you can add donor skin to the person's wound and that could be their new skin, and their original skin will develop around it. It's a career I would consider.