Medical burns

Burns are injuries caused by extremes of heat or cold, electricity, chemicals, light, radiation, or friction.

There is a high degree of variation in terms of the severity of burns, the type of tissue affected, and resulting complications. Damage from burns can occur in muscles, blood vessels, and on the skin. Burns may also be very painful, due to injury to the nerves. Based on the location and severity of the burn, a number of potentially fatal complications may happen. These include shock, infection, and respiratory distress. Unless treated by dermal regeneration, burns can result in scars and other deformities that may be psychologically damaging.

Burn Severity

Burns are classified to indicate their severity.

• First Degree:
  • Usually limited to redness and minor pain at the site of injury. These burns involve only the skin.
  • Minor radiation burns, such as sunburns, can be included as first-degree burns. These are easily remedied with dermal instruments, and biosynthetic ointments.

• Second Degree:
  • Superficial blistering of the skin, usually more pain than First Degree burns, and can damage the nerves, as well.
  • These wounds need to be cleaned carefully, as bacteria can get in more easily and cause life-threatening infections.

• Third Degree:
  • Both the top and inner layers of skin are damaged, and skin will appear "charred." Dead tissue will have to be gently scraped away, in a process known as "debriding" before the wound is really treated.
  • Scarring will undoubtedly occur, and skin and muscles will take a good deal of time to heal.

• Fourth Degree:
  • These burns go through all layers of the skin and any tissue underneath, possibly involving muscle and bone. There is no feeling in the area since the nerve endings are destroyed.
  • A condition called "compartment syndrome" usually occurs, where the muscles and such tighten so much that immediately releasing the pressure will be too much for the patient, and kill them in the process.
  • Extensive tissue regeneration must be performed as soon as possible, otherwise amputation is necessary if the patient doesn't succumb to their injuries.

• Fifth Degree:
  • A complete destruction of skin, fatty tissue, muscle and possibly bone. Any nerves are completely destroyed, so the patient may not experience pain.
    Death is imminent in most cases, unless the injury happens on an extremity such as a hand or foot.
  • Due to the severity of this type of injury, death usually comes quickly.

Types of Burns

Burns may occur from a wide range of causes, such as chemicals, electrical currents, radiation, combustion reactions, and hot fluids.

• Chemical
  • Most chemicals that cause severe chemical burns are strong acids or bases. Chemical burns are most often created by caustic substances such as sodium hydroxide and silver nitrate.
    More serious burns occur from sulfuric acid and nitric acid. Hydrofluoric acid can cause burns down to the bone. Such compounds are carefully monitored aboard Star Fleet vessels and outposts by the Science, Security, and Support departments.

• Electrical
  • Caused by an electric shock. Common causes of electrical burns include workplace injuries and electrical explosions. Any internal injuries may be disproportionate to the size of the burn mark(s) seen, and the extent of the damage is not always obvious.

• Radiation
  • Caused by exposure to plasma energy or ionizing radiation, the most common type of radiation burn is sunburn caused by UV radiation (such as by a sun). The skin develops a redness and tightness, and can cause cells to malform, becoming cancerous.
  • Certain medical instruments can be improperly used to create surface and internal burning.

• Scalding
  • Caused by hot liquids or gases, and commonly causes blisters. More damage can be caused if hot liquids enter an open wound.
  • Scalds are easily treated with dermal instruments and biosynthetic ointments.

Management

All burn wounds should be cleaned and debrided before dressings are applied. Debridement is the removal of dead tissue, debris and any contamination of the wound surface. No burn should be dressed until thorough cleaning and debridement has been performed. Chemical burns should be irrigated until the skin returns to normal. Biosynthetic dressings may speed healing tremendously.

If a burn patient was involved in a fire accident in an enclosed space, smoke inhalation is usually present as well, which can cause damage to the lungs. Burns can happen inside the throat and lungs as well, and is considered an emergency. The affected area should be rinsed thoroughly with a large amount of clean water or through sonic cleansing. Cold water should never be applied to a person with burns, as it will damage the area. Survival and outcome of severe burn injuries is remarkably improved if the patient is treated in a specialized burn center/unit rather than a standard biobed.

A number of different options are used for pain management, from medical painkillers to non-traditional alcoholic ingestion.