Severe burns, often classified as third-degree or advanced second-degree (IIb) burns, can happen under dramatic circumstances that radically upset us while calling for immediate action. After the victim’s initial ride to the local emergency department, doctors and other medical personnel must make a number of decisions quickly that will ease pain, reduce the possibilities of scarring, balance the levels of fluids in the body, and prevent infections. If the burns are serious enough, it must also be determined whether the patient should be sent to a specialized burn care center. Usually this is done within the first 24 hours.
What Can Go Wrong After a Severe Burn?
Third degree burns are marked by injury to all layers of the skin, meaning the epidermis (top layer), dermis, and underlying tissue, which may also mean damage to muscles. Advanced second degree burns injure more than the outer layer of skin as well.
Severe burns leave the body wide open to a number of medical complications, such as:
- Our skin is primarily meant to be a barrier against infectious agents. When the barrier is broken down or no longer exists, pathogens of many kinds can enter the body and wreak havoc. Infections are a common complication of serious burns. If an infection becomes established, septicemia (blood poisoning) and septic shock are real possibilities because pathogens may enter the bloodstream. Both septicemia and septic shock can lead to multiple-organ failure and, eventually, death.
- Hypovolemia (low blood volume) and fluid loss. When a burn injures blood vessels, it can cause fluid loss and mean a lowered amount of blood in the body. A lack of sufficient bodily fluids and blood volume can create an electrolyte imbalance (levels of elements such as potassium, magnesium, calcium, and sodium) that lead to heart irregularities and hypovolemic shock. Managing fluid volumes and electrolytes are critical to burn care.
- Pulmonary embolism and deep vein thrombosis (DVT). With severe burns that are classified as third degree, burn victims often need to remain bedridden. Extended periods of bed rest can increase the risk of blood clots because blood collects in veins due to the lack of bodily mobility. Both DVT, which often occurs in leg veins, and pulmonary embolisms (clots in the lungs that often arise from DVT clots that travel through the body) are risks arising from the lack of mobility. Pulmonary embolisms in particular can kill. Treatments to prevent clots include blood thinners and compression devices placed on the limbs to keep blood moving.
- Compartment syndrome. A bodily compartment is an enclosed space containing nerves, blood vessels, and muscles, surrounded by a layer of tissue called fascia. Fascia does not stretch, so if pressure increases inside the compartment (perhaps from swelling and other fluid problems), the nerves, blood vessels, and muscles inside the compartment may become compressed. Such compression can mean a lack of oxygen due to decreased blood flow, damaging muscles and nerves. Compartment syndrome occurs most often in forearms and lower legs. It is a medical emergency with immediate surgery required.
- Breathing problems. If the burn situation involved breathing smoke, hot air, or caustic chemicals, damage to the lungs and airways can result in respiratory failure.
- Critically low body temperature (hypothermia). If a large portion of skin is damaged, the body loses heat because our skin helps control our body’s temperature. If hypothermia is serious enough and lasts for an extended period of time, death can be the result.
- Seizures are a secondary result of the following problems: low levels of oxygen in the blood, electrolyte imbalances, and the accumulation of toxins in the body, especially from septicemia and septic shock.
- Psychological problems and PTSD. A serious burn can be emotionally devastating as well as physically difficult. Post-traumatic stress disorder (PTSD) can arise from memories of the burn experience and the pain. Anxiety and depression resulting from scarring and disfigurement can also occur. Psychological therapy is usually needed alongside physical therapy to bring a person back to wholeness after a severe burn.
Burn Care Center Criteria
Moving the patient to a burn care center is essential for serious burns because such care centers have the knowledge and capabilities to best prevent complications from arising.
Some of the criteria used to determine whether a burn victim should be sent to a burn care center are:
- Burns greater than IIb (advanced second-degree burns, which are marked by blistering and tissue damage beyond the top layer of the skin)
- Less severe burns on more than 20 percent of the body’s surface (more than 10 percent of the body’s surface if the patient is older than 50)
- Burn victims less than 10 years old
- Burns on the face, extremities, breasts, or genitals
- Electrical and chemical burns
- Burns involving trauma to airways
- Burns in patients with other health problems that may cause treatment difficulties
- Patients with multiple traumatic injuries along with burns.
If you or someone you care about experiences more than a first-degree burn—meaning something more than mildly reddened skin—seek medical attention immediately, especially if the face, hands, feet, breasts, or genital areas are injured or if a large area of the body is burned. If you have any doubt about the burn’s severity, it is better to visit your doctor or local emergency department as soon as possible rather than second-guess the situation. Time is of the essence when preventing burn complications.
When something goes wrong, we are left to wonder.
If someone else’s negligence caused or contributed to the situation which made you suffer a burn injury, they and not you should have to bear the costs associated with your treatment and recovery. This could include both economic and non-economic damages. “Economic damages” are things such as past and future medical bills; the cost of rehabilitation; assistive devices and prostheses; and lost wages. Typical “non-economic” damages are compensation for pain and suffering, and for mental anguish resulting from the injury.
Let our Indianapolis burn injuries lawyers fight for you. The experience of Mike Stephenson and the resources of McNeely Stephenson can be your means of achieving justice when you are the victim of someone’s negligence or recklessness. Call 1-317-825-5200 or use our online contact form for a free evaluation of your claim.