Understanding the Degree of Burns and the Medical Phases

You have heard of first, second, and third degree burns but what exactly do those terms mean to you and how exactly are these types of burns treated? When exactly do you seek medical treatment? Possibly your burn is not hurting, does this mean you should skip medical treatment? This last question is possibly one of the most dangerous ones to keep you reading this article.

A first degree burn is a superficial burn, the surface is red, it blanches, think of sunburns, brief scalding and its painful. A second degree burn is partial thickness (epidermis and some of the dermis), it will blister, blanch, and it is very painful, think of scalds and flames. While a third degree burn is full thickness (all layers of skin), it will not blanch, its leathery, the skin will appear brown, tan, or black, there is little to no pain.

The reason behind the no pain in a third degree burn is the depth of a burn; you have burned down into the third layer of skin, burning through nerves once you have accomplished a burn this in depth this is considered a medical emergency and medical attention is needed quickly.

Emergent Phase: This is the phase when the initial burn causes damaged capillaries to dilate, the fluids leave the veins and go to the cells to try and repair the damage. Due to the fluid shift edema and blistering at burn site and dehydration at cells may cause hypovelemic shock and renal failure.

Main goal during the emergent phase is to prevent hypovolemic shock and maintain respiratory functions.

Major concern: dehydration

Intermediate Phase: This phase starts around 48 to 72 hours after a burn, it is also known as the diuretic or acute phase, this is when the fluids begin to shift back into the vascular compartment. The kidneys at this time will start to excrete large amounts of urine.

Major concern: circulatory overload

Rehabilitation Phase: Simply put this is when treatment begins. Goals should be staying infection free and having the patient / client start to return to a normal life style. Depending on the severity of the burns this can be a very long process from months to even years.

Major concern: infection control