![]() First- and second-degree burns can be treated with antiseptic ointment and dressings. Escharotomy should be performed to treat compartment syndrome and prevent acute limb ischemia. In circumferential burns around limbs, peripheral pulses and capillary refill can be used to assess perfusion. Blood oxygen, arterial blood gas, electrolyte, and creatinine levels should be monitored closely in patients with third- and fourth-degree burns. Various formulas exist to calculate initial fluid requirement, but fluids should be adjusted to maintain clinical stability and appropriate urine output. Patients with severe burns may require intubation, supplemental oxygen, and resuscitation with IV fluids. Massive tissue necrosis, which occurs with severe burns, may result in sepsis, shock, and sequential organ failure (see “ SOFA score” for details). The TBSA is calculated using Lund-Browder charts. The current classification of burns is based on burn depth and recognizes four degrees: first degree ( superficial), second degree ( superficial partial-thickness and deep partial-thickness), third degree (full-thickness), and fourth degree (deeper-injury burn). The two factors that influence the severity of a burn are its depth and the total body surface area ( TBSA) involved. Move a burned leg or arm normally to keep the burned skin from healing too tightly, which can limit movement.Burns are injuries to tissue caused by heat, chemicals, electricity, friction, and/or radiation. If the burn is on a leg or an arm, keep the limb raised as much as possible for the first 24 to 48 hours to decrease swelling. Do not use aspirin, because it can make bleeding in the burned area worse. Read and follow all instructions on the label. Take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve), as needed. ![]() Be sure to follow the instructions included in the package. There are many nonprescription burn dressings available. (Some dressings shouldn't be changed every day.) Until the burn heals, wash the burn every day with a mild soap and water, unless your doctor says otherwise. If a bandage is stuck to a burn, soak it in warm water to make the bandage easier to remove.
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