Burns are the most common and devastating form of trauma. Our skin is vital for our bodies to maintain internal/external equilibrium and for protection against infection. When you suffer from a burn the important skin barrier is weakened and a myriad of complications can occur. Moderate to severe burns can require extensive hospitalization and medical treatment in order to prevent burn wound infection and immunosuppression issues resulting from the burn. Below are some of the most common complications that can result from a burn injury.
Sepsis is the leading cause of most burn related deaths. Bloodstream infection and the subsequent development of sepsis are the most common types of burn-related complications in burn intensive care units. Burn sepsis occurs after the patient develops an infection. When your body is fighting a disease it naturally releases chemicals into the bloodstream to fight off the infection. Sepsis develops when your body has an inflammatory response to its own infection fighting chemicals.
Burns leave patients at an increased risk to develop an infection because the open wounds can become a breeding ground for bacteria. Because of the high mortality rates associated with sepsis and the difficulty of properly diagnosing it, medical professionals have developed burn-specific sepsis criteria to look for. While there are six variables to consider, a patient is diagnosed with sepsis after exhibiting 3 of the following variables coupled with a documented infection.
- Temperature greater than 101.3 or below 95 degrees
- A rapid heart rate greater than 110 beats per minute.
- Breathing rate of more than 25 breathes per minute without assisted ventilation.
- Low blood platelet count.
- Inability to continue enteral feedings for more than 24 hours (delivery of food directly to the stomach through a feeding tube.)
If left untreated, the patient may go into septic shock. Septic shock is characterized by an extreme drop in blood pressure that can lead to organ failure or death.
In order to have the greatest chances of survival, sepsis needs to be diagnosed and treated right away. Intensive inpatient monitoring is required to ensure stabilization.
Burns create an open, dirty wound leaving burn patients at an increased risk of developing tetanus. Burn injuries, however small, leave the patient susceptible to infection. Because the burn wound is considered the central problem in the burn patient, successful treatment and timely closure of the wound is essential for survival. Thus, the immunization status of all burn patients should be determined on admission and a booster and/or tetanus immune globulin given. Sometimes burn treatment centers will re-administer a tetanus vaccine regardless of past immunization records.
Hypothermia is a condition where the body loses heat faster than it can produce it. Effectively monitoring and controlling a burn victim’s body temperature is one of the major challenges facing critical care personnel. Because the skin regulates body temperature, when a significant portion of the skin is burned, the body loses its ability to effectively regulate heat. To prevent hypothermia, burn units will cover burn wounds to exclude air and prevent cooling, use warm intravenous fluids, heat the room, and use warming blankets to keep the patient warm. A good motto to follow is “cool the burn, not the patient.” Cool water can act as an evaporative mechanism that can assist with the onset of hypothermia. Convective cooling, on the other hand, has shown to maintain a warm environment in and around the burn and assist in maintaining the core temperature.
The hypothermic response can start within the first five days and last up to a year, depending on the severity of the burn. Close monitoring of the patient’s temperature is required to insure that body temperature remains stable.
It is important to note that ice should never be used to treat a burn. Ice can damage the wound and increase the risk of hypothermia.
Ventilator-associated pneumonia (VAP) is extremely common in burn patients. VAP is defined as pneumonia that develops after intubation in a ventilated patient that showed no signs of pneumonia at the time the tube was inserted. Burn patients are constantly at risk for infectious complications. Bacteria take advantage of the easy access to the lower airways from the breathing tube and VAP is the result from the invasion of the lower respiratory tract and lungs by microorganisms. The combination of severe thermal injury and inhalation injury create an ideal environment for the development of VAP.
Because burn patients will commonly experience a variety of symptoms that are associated with VAP it is hard to accurately diagnose. The American Burn Association recommends that if VAP is suspected, then cultures of the lower airways should be tested to confirm the diagnosis. Once VAP is diagnosed, antibiotics should be administered right away to avoid increased morbidity and mortality rates.
Urinary Tract Infection
Most patients with small to medium sized burns will not need a catheter; however, if the nature of the burn is severe enough to cover more than 20% of the body surface area, then a catheter may be inserted. Prolonged catheterization can lead to the development of a urinary tract infection (UTI). After 72 hours of catheterization, increased levels of bacteria start to develop in a patient’s urine. Urine samples should be routinely collected in order to monitor the development of an infection and the catheter should be removed after the patient is stabilized.
Let Us Help You
Burns are one of the most complicated and severe forms of trauma. Treatment of a burn will depend of the severity and size of the burn. If your burn was caused because of someone’s carelessness or negligence, you may be able to receive compensation for your suffering and other losses.
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