Nursing Field Notes / Skin + Wound

Burns 🔥

NG-027 SKIN + WOUND ADHD-friendly visual edition

Burn injuries = direct tissue damage from exposure to sun ☀️, chemicals 🧪, thermal (boiling liquids) 🍲, or electricity ⚡ — how DEEP the damage goes decides the degree.

📄 Simple Nursing original — opens in Drive →

🧯 The 3 C'sCool water · Cover · Clothing removal.

🧊 Cool water — NEVER iceNo creams, no antibiotic ointment to open skin.

🛢️ Tar burn?Immediate action = cooling the injury with water.

💧 Big burn: Airway → IV fluidsFull thickness 20%: after a patent airway, fluids are priority.

🧨

CAUSE

STEP 1 · WHAT BURNED IT

Four ways to cook skin — then know the layers the heat digs through.

🔥 Types & causes — direct tissue damage from exposure to:

☀️ Sun

🧪 Chemicals

🍲 Thermal
boiling liquids

⚡ Electricity

🧠 “SCorched by The Elements” — Sun · Chemicals · Thermal · Electricity.

🧅 The skin is 3 layers

Epidermis — the surface
Dermis — the middle
Subcutaneous tissue — “that fatty bubble looking tissue”

Under the skin we find fascia, muscle, & bone — the deeper the burn digs, the higher the degree.

🔎

CLUES

STEP 2 · READ THE DEPTH

Degree = depth. Match what you SEE on the surface to how far down the damage goes.

🗺️ The depth map: degree by skin layer NCLEX TIP

🧾 What you see, degree by degree

Degree	Looks like
1° superficial	Dry with blanchable redness
2° partial thickness	“Red, moist, shiny fluid filled vesicles” — painful blisters
3° full-thickness	Dry waxy white, leathery, or charred black — non-blanchable
4° full-thickness	Deepest of all — past the skin itself

👆 The blanch check

✅ 1° blanches — press it, it whitens, color returns. Surface only.

❌ 3° does NOT blanch — waxy, leathery, charred tissue can't respond.

🧠 “If it blanches, skin still dances.” Blanchable = superficial. Non-blanchable + leathery = full-thickness trouble.

🩺

CARE

STEP 3 · COOL · COVER · CLOTHES

Minor burn prehospital care = the 3 C's — and the exam loves what you DON'T put on a burn.

✅ Prehospital care for minor burns — the 3 C's

💧 Cool water — briefly soak the area. NO ice, creams, antibiotic ointment to open skin

🩹 Cover the area — “clean dry cloth”

👕 Clothing & jewelry removal — only if not adhered

🧠 C · C · C = Cool it, Cover it, Cut the Clothes. Water is the only thing that touches a fresh burn.

⛔ Never-do list

❌ NO ice on the burn
❌ NO creams or antibiotic ointment to open skin
❌ Never rip off adhered clothing — HCP removes anything sticking to the skin

Cool water only — soak briefly, then cover with a clean dry cloth.

💧 Kaplan question: the big-burn priority NCLEX TIP

Client with full thickness burns covering 20% of the body. Priority of care after ensuring a patent airway:

➡️ IV fluids

🧠 A before F: secure the Airway, then pour the Fluids.

🎓 Saunders questions — tar & chemical burns

🛢️ Tar burn — the nurse instructs firefighters: the immediate action?
➡️ Cooling the injury with water

🧪 Chemical burn — the first consideration in immediate care?
➡️ REMOVING ALL clothing — including gloves, shoes, and any undergarments

🧠 Tar = water first 💧 · Chemicals = strip everything 👕. Cool the sticky, shed the soaked.

⚡

QUICK RECALL

SAY IT OUT LOUD

🧯 Cool · Cover · Clothes offThe 3 C's of minor burn care.

🫧 Blisters = 2° partial“Red, moist, shiny fluid filled vesicles.”

🖤 Waxy · leathery · charred= 3° full-thickness, non-blanchable.

💧 Airway ✔ → IV fluidsThe big-burn priority order.

🎯 Cover & check — 4 rapid-fire questions

Q1: Firefighter with a tar burn. Immediate action?

Cooling the injury with water.

Q2: Chemical burn at a factory. First consideration in immediate care?

Removing ALL clothing — including gloves, shoes, and any undergarments.

Q3: Full thickness burns over 20% of the body — priority after a patent airway?

IV fluids.

Q4: Minor burn — what NEVER goes on it?

No ice, no creams, no antibiotic ointment to open skin — cool water only, then cover with a clean dry cloth.