Treating Burn Patients In the Hospital
Treating burn injuries can be a difficult and lengthy process. Our inpatient care unit provides a team approach that includes physicians, nurses, counselors, and other caregivers committed to providing the best outcomes for our patients.
Patients and their families visiting the Burn Center have access to the latest treatments as well as a caring supportive staff that put the patient’s and their family’s needs first. We understand the impact that a traumatic burn injury can have and provide the resources and emotional support necessary to help our patients and their families start the road to recovery.
Where Are We Located?
We treat burn patients at University of Utah Hospital.
Find a Burn Specialist
What Kinds of Burn Patients Need Inpatient Therapy?
If you have been referred to a burn treatment inpatient unit, it's because you meet the American Burn Association's referral criteria and need specialized burn care only a verified burn center can provide. The 91Â鶹ÌìÃÀÖ±²¥ Burn Center covers Utah, Wyoming, Montana, Idaho, and Nevada.
If this is an emergency, or you want to speak to a burn professional regarding your injury, call 801-581-2700.
91Â鶹ÌìÃÀÖ±²¥'s Burn Center provides the most comprehensive care for burn patients in the Mountain West. Burn patients suffer not only from severe physical injuries, but also emotionally and spiritually as they work towards recovery.
Initial Treatment
Stabilizing Breathing
In an emergency situation, the most important aspect of care is not the burn, but the patient’s airway, breathing, and circulation. Patients with burns on their face, neck, or throat, and those with inhalation injury, may require a breathing tube. The breathing tube is placed into the patient’s nose or mouth and down the throat to the lungs.
The tube is attached to a machine, called a ventilator, and assists with breathing. Patients who do not require ventilator support may often need oxygen from a face mask or plastic nasal prongs that fit into the nostrils. A pulse oximeter is attached to the patient’s finger, toe, or ear, continually monitoring the amount of oxygen in the patient’s blood.
Placing an IV
After the patient’s breathing is under control, a small, flexible, plastic tube is placed in the patient’s veins. This is called an IV (intravenous) catheter. An IV delivers fluids and medicine into the patient’s body via the blood system. Many burn patients have more than one IV line.
Although burn patients may not appear dehydrated, they can go into shock if IV fluid is not given. Sometimes patients have tubes placed in an artery in their wrist or groin to transmit the patient’s blood pressure to a monitor. Blood samples can also be drawn from these lines for lab tests.
Monitoring the Heart
The patient will be attached to a heart (EKG or cardiac) monitor by leads (plastic covered wires that snap onto pads placed on the chest) so staff can observe the patient’s heart pattern at all times. Alarms on these machines are very sensitive and often go off due to movement of the patient rather than changes in the heart. The nurse will respond promptly to such alarms and monitors can be watched at the nurses’ station.
Inserting a Foley Catheter
A Foley catheter (a plastic tube) is placed in the urinary tract to the bladder. This allows hourly monitoring of urine output so IV fluids can be adjusted appropriately.
During the first 24–48 hours after a burn occurs, the patient often goes into burn shock and will require a large amount of IV fluid to keep vital signs within normal limits. A great deal of swelling is typical in the areas that are burned. This swelling should go away in a few days.
Eating and Drinking
During fluid resuscitation, patients are not given anything to drink or eat, because the stress to the body as a result of the burn affects the stomach’s ability to digest. If food or fluids are given before normal stomach activity returns, the patient may become sick and vomit.
Often a small tube called an NG (nasogastric tube) is placed in the patient’s nose and into the stomach. Through suction, it drains the stomach contents and helps prevent nausea and vomiting.
After two to three days, the body begins to use energy at a very rapid rate. This increased use of energy is characterized by an increase in heart rate, respiratory (breathing) rate, and in body temperature. Due to these changes, the body requires a large amount of calories and fluids to heal.
Because an IV no longer provides adequate nutrition a Dobhoff tube (small soft, pliable tube) is placed. This is inserted in the nose, past the stomach and into the intestines to provide high-calorie supplements to the patient’s regular diet. When the patients are able to eat enough on their own, the Dobhoff tube is removed. Patients are not allowed to drink water in the burn unit. Even though they are very thirsty, they are encouraged to drink fluids containing calories and protein.
Regulating Body Temperature
Because burn patients are unable to regulate their body temperature, heated blankets are used as needed to keep the patient warm. If the patient has a fever, fans may be used to cool them.
Controlling Pain
We understand that burns hurt. Every effort is made to relieve pain. A combination of IV and oral medications are used for pain management.
Why Did My Local Hospital Transfer Me to the 91Â鶹ÌìÃÀÖ±²¥ Burn Center?
You have been referred here because you meet the American Burn Association’s referral criteria and need specialized burn care only a verified burn center can provide. The 91Â鶹ÌìÃÀÖ±²¥ Burn Center is a verified burn center and covers a five state area, including Utah, Wyoming, Montana, Idaho, and Nevada.
You are here because you meet at least one of the following criteria:
- Second degree burns greater than 10 percent of the body
- Second degree burns to face, hands, feet, genitalia, perineum, major joints
- Third degree burns
- Complicated injuries
- Electrical burns
- Chemical burns
- Multiple trauma
- Inhalation injury
- Burns accompanied by preexisting medical conditions
- Burns to children in hospitals without pediatric services
- Patients with special social, emotional, or rehabilitative needs
Skin Itching, Scarring, & Compression Undergarments
Will my skin return to its natural color?
As the skin heals, it relearns its natural pigmentation, although it may never completely return to its original color. During this time, it is important to protect your skin from the sun (especially during the first year). If the skin is sunburned or tanned while healing, pigmentation can change permanently. As long as your skin is pink, red, or purple, you should use sunscreen and protect your skin with clothing or compression garments. It is very important that you protect your skin from the sun during the first year after your burn.
Why is my skin so dry?
Your oil glands, which provide natural oils to keep the skin moisturized, have been damaged as a result of injury. Frequent application of lotion can help keep skin hydrated and less dry.
What causes itching?
Your dry skin, combined with sensory nerves growing back, causes dry skin. Although very uncomfortable at times, it will lessen over the next few months. Talk to your care provider about medications that may ease itching.
My sleep patterns have changed since my injury. Is this normal?
Changes in sleep patterns following a traumatic injury and hospitalization are very common. Your sleep cycle takes time to reset. To reset your sleep cycle, try:
- Sleeping and waking up at your normal pre-burn schedule.
- Avoiding stimulants late in the day, such as coffee and caffeinated soda.
- Staying active during the day.
- Exercising at least three times a week for 45 minutes.
- Talking about your anxieties, which may help ease stress.
How long until I will be able to return to school or work?
You may return when your wounds are healed. Going to work or school prior to this puts you at risk for infection.
My skin is so tight and tough. Will it feel this way forever?
Continue with therapy, including stretching, and it will soften over time.
Do I need to wear pressure garments in the summer?
Pressure garments help control and prevent hypertrophic scarring. Collagen is a body protein in the skin. During the healing process, an overgrowth of collagen causes hypertrophic scarring. These scars are wavy and thick. In order to avoid hypertrophic scarring, you should wear your pressure garments 23 hours a day until the therapy team determines it is time to stop wearing them.
Talking to Others About Your Burns, Dealing With Staring, & Anxiety and Frustration
How should I respond if people ask how I was burned?
Rehearse Your Responses.
Memorize three sentences to use when people ask questions:
- How/when you were injured.
- How you are doing.
- Thank them for asking.
Example: I was burned in a gas accident. It’s been hard work but I’m getting better. Thank you for asking.
What should I do if I notice people staring?
Use your rehearsed response (above) and follow STEPS:
S – Smile
T – Tone of voice
E – Eye contact
P – Posture
S – Self-talk
How do I deal with anxiety and frustration when I first get home?
The routine of burn care requires patients and families to create a new normal. Many people think that when they get back home, things will be the same. This can lead to frustration and anxiety. It is important to deliberately think about a new routine that incorporates wound care, rest, and burn therapy.
Find a way to move emotions out of your body. This can be done through writing, talking, art, exercise, meditation, or other creative means. The burn support group offered on Wednesdays can be helpful.
Resources for Our Patients
Verified Burn Center Experts
Why does it matter that we are a verified burn center? The American Burn Association and the American College of Surgeons designed a rigorous review program that ensures verified centers offer the best care for their patients. This includes the whole patient experience from the time of injury through rehabilitation.
It also means we meet the highest quality of care available because we meet these high quality standards. The standards are for personnel qualifications, facilities resources, organizational structure, and medical care services.
