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Epidermis Layer of squamous epithelial cells that provides a protective barrier Dermis Layer composed of collagen, elastic fibers, blood, lymph, and nerves Subcutaneous tissue Fatty tissue which anchors skin to muscles and bones Partial thickness burns 1st and 2nd degree burns Full thickness burns 3rd and 4th degree burns 1st degree burns Mild to severe erythema, no blisters, skin blanches with pressure 2nd degree burns Large blisters, edema, mottled red, wet shiny skin, painful 3rd degree burns Deep red, black, dry skin, edema, little to no pain, tissue disrupted with fat exposed 4th degree burns Involves injury to muscle and bone, edema and pain absent, no blisters Burn shock Inability of circulation to meet needs of tissues for oxygen and nutrients Immediate Care Priority of airway, breathing, circulation, rehydration, pain management Electrolyte imbalance Within 1st 8 hours- increased potassium, decreased sodium Stabilize Care Promote healing, prevent complications/contractures, restore function Vancomycin Anti-infective given for potentially life threatening infections Autograft Own skin removed from non burned area Homograft Skin from cadaver Hetergraft Skin from animal Reason for skin grafts To prevent water, electrolyte, or protein loss Sulfamylon Topical agent that can be used to penetrate thick eschar Betadine Topical agent that may elevate iodine levels if applied to large areas of skin Nutrition for burns Protein increased 2-4 times normal, calories 2,000-4,000/day