Premergency First Aid, CPR and AED Manual

7 Bleeding, Wound Care and Trauma

Full thickness (3rd degree) burns affect the entire thickness of the epidermis and dermis and may also affect tissue below the skin, in the subcutaneous layer, such as muscle, bone, and internal organs. The burned skin is dry and leathery and can appear white, dark brown, or charred black. Some full thickness burns can feel hard to the touch. Clotted blood vessels or burned tissue may be visible under the burned skin. A severely burned area may have no feeling if the nerve endings have been destroyed; however, the surrounding tissue will be extremely painful.

2. Extent Estimating the percentage of the skin surface that has been burned is done by one of two methods. Rule of Palm – This measurement involves using the patient palm size (excluding the fingers). The palm is approximately 1% of the body surface. Rule of Nines – Another measurement technique divides the body into sections each roughly equal to 9% of the total body surface area (BSA). Any airway burn is also serious. Signs of an airway burn injury include singed hair in the nose, soot around the nose and mouth, hoarseness, and difficulty breathing. A complete full thickness burn is unusual. Severe burns will typically be a mixture of superficial, partial thickness. and full thickness burns.

3rd Degree Burn

Superficial burns and small partial thickness burns heal well with no scarring. Deep partial thickness burns and all full thickness burns usually scar badly and often require surgery.

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