PATHOPHYSIOLOGY

PRECIPITATING FACTORS: Chemicals Thermal Radiation Electrical

PREDISPOSING FACTORS: Age: affects all ages; more severe in infant & elderly Dementia Cigarette smoking & alcohol use.

Tissue destruction

Impaired skin integrity

Release of potassium from the damaged cell

Inflammatory response
Vasoconstriction Release of chemical mediators Capillary permeability

Adherence of Leukocytes in the injured area LOCAL MANIFESTATIONS: 1st degree: Pain, erythema, blanching & edema 2nd degree pain, oozing fluid-filled vesicles, erythema & shiny wet subcutaneous layer( ruptured vesicles) 3rd degree eschar formation, edema, little or no pain

Na & H20 and protein shift from intravascular to interstitial spaces

Circulating blood volume BP

SNS stimulation

Release of catecholamine & corticosteroids

Activation of renninangiotensinaldosterone system

Vasoconstriction & tachycardia Afterload

Na & H20 retention

Cardiac output

Tissue perfusion

SYSTEMIC MANIFESTATION

CNS: Anxiety Pain Restlessness

CV: Hypotension Tachycardia Prolonged capillary refill Dysrhythmias

METABOLIC: Hyperglycemia Hyponatremia Hyperkalemia Signs of dehydration

INTEGUMENTARY: Eschar formation Dry oral mucosa Dry skin Poor skin turgor Cool, clammy skin

RESPIRATORY: Tachypnea Adventitious breath sounds DOB Use of accessory muscles.

MUSCULOSKELETAL: Limited ROM Deeply charred subcutaneous tissue, muscle & bone tissue

GU: Oliguria