Burn Injuries

An experienced trial lawyer should have a basic understanding of burn injuries. Burn injuries can be catastrophic and can lead to death, significant pain, mental anguish and costs and expenses beyond normal medical care. Generally speaking, the younger the burn victim, the more expensive the treatment is. Burn injuries can take several operations before the best possible results are obtained and then the results are not perfect. The most frequent cause of burn injuries to children result from bathing, or pulling hot items off a stove. Flammable fabric also can cause significant burn injuries. Often a burn injured client needs the assistance not only of an expert medical team for the treatment and/or surgery, but also the skill and treatment of an expert rehabilitation team to attempt to restore some normalcy to the person's life. Clearly, a driver or passenger in an automobile accident can also have significant burn injuries if the vehicle catches fire as a result of the collision.

Depending on the surface area of the body that is burned, the chances of survival decrease the more area burned. In addition, it is important for the medical provider to attempt to keep body temperature within a very narrow range to avoid significant damage. If the body temperature exceeds certain parameters, more tissue can be destroyed as a result of a burn. Most burns are broken into three areas, first degree, second degree and third degree. These are also known as superficial, partial thickness and full thickness. The depth of the burn is also an important factor in any diagnosis. If the depth is only to the outer skin it is considered epidermis. If it goes to the layer inside it is called dermis. Inside the dermis is called the subcutaneous. Superficial or first degree burns involve the outer layer of skin, the epidermis. This type of burn can cause tingling, pain, redness, peeling of skin as well as other symptoms. This type of burn usually takes one week to heal. Partial thickness burns or second degree burns involve the epidermis and parts of the dermis. They cause significant pain, sensitivity to cold air, blistering, mottling and other symptoms. These burns take a couple of weeks to heal. Full thickness burns or third degree burns are the most significant burns. This type of burns involved the epidermis, dermis and subcutaneous tissue. This type of burn also leads to significant pain, shock, hematuria broken skin as well as many other symptoms. Physicians who specialize in treating burn victims frequently asses the percentage of burn by what is commonly called the rule of nines method. This rule divides the body surface into groups of 9% each. The head and neck comprise 9%, each arm is 9%, each leg is 18%, the front and back of the torso are each 18%, and the perineum is 1%. Life and/or death can hang in the balance depending on how much of the surface area of the body is burned. The treating physician will usually make an initial evaluation of the surface area burned and then recalculate it after a few days when the full extent of the burn can be observed better.

Most burns come from either thermal (heat or hot liquids), chemical acids, caustic soda, phosphorous, sodium and alkalis), electrical (depending on amperage and voltage) or irradiation (atomic radiation, x-rays, ultraviolet and other rays). Obviously if certain things are inhaled it can cause drastic consequences to internal organs.

It would be a mistake for the physician to only consider the area of the burn during initial observation. frequently, secondary effects to other systems must be considered as well since they can also cause serious and life threatening consequences. Burn victims are usually given high calorie and protein diets as well as blood transfusions where necessary. Generous fluid supply is important to decrease the chance permanent injury. Infection must be another major consideration which generally means closing off wounds with skin grafts. Serious concern is necessary where dead tissue is involved because they carry no blood supply. Antibiotics may not reach the infected areas so topical chemotherapy, excision and dressings may be required. If there is circular dysfunction, fluid and plasma replacement is required. Pulmonary complications are usually addressed by establishing an open airway and use of oxygen. If there are issues with contracture of muscles or tendons, physical therapy should be instituted. Other complications include hypertrophic scarring, pruritis (itching), psychological issues, ulceration, development of skin cancer and unusual sensitivity to sunlight, heat, cold and cloth, erythema, keloid scarring, perichondritis, maceration, and decubitis ulcers.

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