SU4.1-4 | Burns — Glossary

The structured, empathic communication skill of delivering difficult information — preparing the setting, finding out what the patient knows, giving information in plain language, responding to emotion, and agreeing a plan.

The early circulatory failure after a major burn, caused by inflammatory mediators making capillaries leaky so plasma shifts into the interstitium, reducing circulating blood volume.

Of sound mind and mentally competent; the doctor must certify a patient is conscious and compos mentis before recording a dying declaration.

Shortening and tightening of skin, muscle or other tissue across a joint following a deep burn, restricting movement and prevented by early positioning, splinting and physiotherapy.

The Criminal Procedure Code provision governing police inquest into unnatural/suspicious deaths; an Executive Magistrate conducts the inquest for a married woman's death within 7 years of marriage.

Acute stress-related gastroduodenal ulceration occurring after major burns, prevented by early enteral feeding and acid suppression.

A burn into the deep dermis appearing blotchy red and white with reduced sensation and sluggish capillary refill, healing slowly with scarring and often requiring grafting.

A statement by a person who believes they are about to die concerning the cause and circumstances of their injury; ideally recorded by a Magistrate, but by a doctor when the patient is critical, after certifying mental fitness.

The dry, leathery, dead tissue of a full-thickness burn.

A surgical incision through the dead, leathery eschar of a circumferential full-thickness burn to relieve the tourniquet effect of rising oedema and restore distal perfusion or chest expansion.

A burn destroying the entire dermis, appearing dry, white or charred and leathery, and painless because nerve endings are destroyed; it cannot heal spontaneously and needs grafting.

A raised, red, often itchy scar confined to the original burn that forms during healing of deep burns and is managed with pressure garments, massage and silicone.

Damage to the airway and lungs from hot gases, smoke and toxins, suspected with facial burns, singed nasal hair, soot in sputum, hoarseness, or a fire in an enclosed space; it threatens the airway and warrants early intubation.

An official investigation into an unnatural or suspicious death; under CrPC 174 a burns death of a married woman within 7 years of marriage is inquired into by an Executive Magistrate.

The Indian Penal Code provision covering the death of a woman by burns or injury within 7 years of marriage where she had been subjected to cruelty for dowry.

The Indian Penal Code provision penalising the abetment of a person's suicide, relevant to suspected suicidal burns.

Indian Penal Code provisions covering voluntarily causing grievous hurt by acid (326A) and throwing or attempting to throw acid (326B).

The Indian Penal Code provision penalising cruelty, physical or mental, to a married woman by her husband or his relatives.

The three concentric zones of a burn wound: a central zone of coagulation (dead), a surrounding zone of stasis (salvageable), and an outer zone of hyperaemia (recovers).

An age-corrected chart for estimating %TBSA that is the most accurate method and is especially important in children, whose head is proportionally larger and limbs smaller than an adult's.

A case with legal implications that the doctor is duty-bound to register and report to the authorities, such as a suspected non-accidental, homicidal, suicidal or dowry-related burn.

Rehabilitation that helps a burn survivor regain the ability to perform everyday activities and return to work and social life.

Using the patient's whole palm including the fingers as approximately 1% of total body surface area to estimate small or scattered burns.

Burn fluid formula giving 4 mL of Ringer's lactate per kg per %TBSA in the first 24 hours, half in the first 8 hours from the time of the burn and half over the next 16 hours.

A psychological disorder of intrusive memories, avoidance and hyperarousal that may follow a major burn and is part of the psychological rehabilitation that requires support.

A tight, custom-fitted elastic garment worn for many months over a healed deep burn to reduce and flatten hypertrophic scarring during scar maturation.

The structured trauma assessment sequence — Airway, Breathing, Circulation, Disability, Exposure — applied to the burned patient to detect and treat life threats in order.

Holding a joint in an anti-contracture position with a splint, started early in rehabilitation to prevent the burned tissue from shortening across the joint.

A burn into the superficial dermis that is moist, pink, blistered and very painful with brisk capillary refill, typically healing in about two weeks with minimal scarring.

The percentage of the body's surface affected by partial-thickness or deeper burns, used to calculate fluid resuscitation; simple epidermal erythema is excluded.

The end-point used to titrate burn fluid resuscitation: 0.5-1 mL/kg/h in adults (about 1 mL/kg/h in children), monitored via a urinary catheter.

A rapid method of estimating adult burn extent by assigning body regions in multiples of nine percent (head 9, each arm 9, each leg 18, front trunk 18, back trunk 18, perineum 1).

The intermediate, injured-but-viable region of a burn whose tissue can be saved by good resuscitation or lost to necrosis if the patient becomes hypotensive or infected, deepening the burn.