CLINICAL FRATURES OF BURN INJURY

Pain

Pain is immediate, acute onset and intense with superficial burn . This is likely to persist until strong analgesia is administered .With deep burn there may be surprisingly little pain .

Acute anxiety

The patient is often severely distressed at the time of injury .

Fluid loss and dehydration

Fluid loss commences  immediately and if replacement is delayed or inadequate the patient may clinically dehydrated .There may be initially tachycardia due to anxiety and later tachycardia due to fluid loss .

Local tissue edema

Superficial burn will blister and deep burns develop edema in the subcutaneous space . This may be marked in head and neck with severe swelling which may obstruct the airway . Limb edema may compromise the circulation .

Special sites

Burn of eyes are uncommon in house fires as the eyes are tightly shut and relatively protected .The eyes may be involved in explosion injuries or chemical burn. Burns of nasal airways , the mouth and upper airways may occur in inhalation injuries .

Coma

Following house fires , the patient may be unconscious and the reason for this must be ascertained . Asphyxiation or head injury must be excluded .