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Practice Guidelines for the Management of Electrical Injuries 1. Fluid Resuscitation 5. These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. Burn patient management - evidence summary. Download the BBA Standards of Physiotherapy and Occupational Therapy Practice in the Management of Burn Injured Adults and Children Revised by the Burn Therapy Standards Working Group, 2022 Advanced Burn Life Support is designed to provide first responders, nurses, nurse practitioners, physician assistants, and physicians with the ability to assess and stabilize patients with burn injuries during the first critical hours post injury. 3. pdf), Text File (. org. Burns in pregnancy 13. 978-1-76000-785-0 (online) Produced by: NSW Statewide Burn Injury Service Further copies Due for further review: August 2022 Management of Burns o Percentage of burn: The larger the burn size, the more significant effect on the body, more procedures, more prone to infection & immunosupression and more lasting adverse effects for quality of life. metaDescription()}} Feb 20, 2024 · A combination of the burn mechanism, burn depth, extent, and anatomic location helps determine the overall severity of the burn injury (minor, moderate, severe), which provides general guidance for the preferred disposition ( table 1) and care of these patients. 77 management 12. 1 Many require a protracted stay in intensive care, numerous operative interventions and comprehensive rehabilitation. Feb 20, 2023 · Severe burn injury — Severe burn injury can be defined as burns that should be referred to, and treated at, a designated burn center . The Federal Ministry of Health of Ethiopia has developed this burn management guideline. cdr Author: Nitin Created Date: 11/16/2007 8:06:07 AM Adult Practice Management Guidelines. American Burn Association Burn Center Referral Criteria. These guidelines are a set of rules that have been developed to accompany and complement the First Aid, First Aid Guidelines, Guidelines, Pre-hospital Approach to Burns Patient Management Pre-Hospital Care (First Aid Clinical Practice Guidelines) BBA First Aid Clinical Practice Guideline – 24. Intervention/Treatment 2 IV. These injuries also decline the quality of life, especially when included in larger burns. Engagement of a multidisciplinary burns team is necessary to help maximise quality of life for survivors who may have profound physiological The American Burn Association Web site contains general information for burn care professionals and is not intended to be a substitute for professional medical advice or consultations with healthcare professionals. Nov 1, 2000 · Ulmer JF. Approximately 6. By defining standards, a governance framework is established Nov 18, 2019 · Thermal burns are skin injuries caused by excessive heat, typically from contact with hot surfaces, hot liquids, steam, or flame. Jun 19, 2023 · Extensive burns can cause considerable local damage, tissue injury, and a widespread inflammatory response affecting multiple organ systems. Sep 5, 2023 · The Emergency Management of Severe Burns course (EMSB) provides instruction on the assessment, stabilisation and transfer severely burned patients during the first 24 hours. ameriburn. The 2023 Burn Injury Summary Report contains data from participating ABA hospital burn centers and represents five years of cumulative data (2018-2022). Population 2 II. Pathophysiology of Burn shock 8. Burn wound care has also evolved as more patients have survived. Published: January 2018 (4 th ed). Most burns are due to heat from hot liquids (called scalding), solids, or fire. CPT codes 99151-99157 describe May 29, 2023 · Thermal burns are a significant cause of worldwide morbidity and mortality. After reviewing this article, the reader should be familiar with basic approaches to burn care, the underlying pathophysiology of Pediatric Burn Hypermetabolic Guideline: Pediatric Burn Hypermetabolic Management Revised Date: July 2022 Review Date: July 2024 Content Experts Ryan Stark, M. A MEDLINE search o … Aug 31, 2021 · The white paper with draft Guidelines text is available for free download at fgiguidelines. 5% of all trauma cases) are admitted for burns management. Nov 30, 2020 · The ABA pain guidelines were developed 14 years ago and have not been revised despite evolution in the practice of burn care. May 27, 2022 · Clinical guidelines on inpatient burn management (primarily for patients whose burns require that they be hospitalized for about 4 weeks post injury) were published in April 2022 by the Japanese Society for Burn Injuries (JSBI), in Acute Medicine & Surgery. Voluntary Smoke Management Guidelines 2022 1 If these guidelines are met, and no local ordinance or burning ban prohibits burning, a burn for a recognized forestry or agricultural practice may be carried out. Feb 8, 2022 · As a result of improvements in the care of patients with major burns, increasing numbers of patients are surviving more severe injuries. Assessment 2 III. Title: ONE PAGE - Guidelines for Burn Patient Referral Author: Lucy Rogan Keywords: DAFQ6ledl60,BACG5fKJTXI Created Date: 1/29/2024 5:05:25 PM Jan 23, 2023 · Most burns are small and are treated at home or by local providers as outpatients. 18: Download the BBA First Aid Clinical Practice Guidelines BBA Statement for the National Burns Awareness Day: Advice… . With an emphasis on presenting hands-on and relevant clinical information, it focuses on the evaluation and management of non-complex burn injuries n engl j med 380;24 nejm. ACI Statewide Burn Injury Service – Clinical Guidelines: Burn Patient Management Agency for Clinical Innovation 67 Albert Avenue Chatswood NSW 2067 PO Box 699 Chatswood NSW 2057 T +61 2 9464 4666 | F +61 2 9464 4728 E [email protected] | aci. Airway assessment, control of hemorrhage, and the advanced trauma life support guidelines must be followed. • Burn patients should be stabilized in terms of airway, breathing, circulation, and fluid resuscitation and burn size estimated using Rule of Nines or Palmar method. Most burns are minor and can be treated as outpatients or at local hospitals. The decision to transfer and treat at burn centers is based on the extent of body surface area Apr 15, 2020 · Superficial burns (Figure 1 7) are localized to the epidermal layer and are painful, erythematous, dry, and blanching. Changes across the Guidelines documents. Admission Discharge Criteria updated Dec 2022. Scenario: First aid and initial management: ; Covers first aid measures and initial management of a burn or scald in primary care. proactive, preemptive pain management rather than a reactive, “damage control” approach. Guidelines: Burn Patient Management, for tips on taking digital photographs. The update may also serve as Advanced Burn Life Support (ABLS) programs, ABLS Live and ABLS Now, provide knowledge for immediate care of the burn patient up to the first 24 hours post-injury. The Japanese Society for Burn Injuries (JSBI), led by its Scientific Committee, published the “Clinical Practice Guidelines for Management of Burn Care” 1 in March 2009. Title: Bookfinal. The burn units' criteria for transfer and admission are consistent with those of the Australian and New Zealand Burn Association and the International Society for Burn Injuries. org CARE RESEARCH PREVENTION REHABILITATION Sep 3, 2020 · The Guidelines on the Management of Acute Pain in the Adult Burn Patient are available online through the Journal of Burn Care and Research (JBCR). Management of Investigation Results in the ED (February 2023) Coronavirus Infection, Prevention and Control Guidance (October 2022) Procedural Sedation in the Emergency Department (August 2022) Discharge to General Practice (October 2022) Management of Controlled Energy Device Attendances (Taser) 2021; Emergency Department Care (November 2021) Fluid management in burns ≥10% TBSA. The BBA will review ‘National Standards for Provision and Outcomes in Adult and Paediatric Burn Care’ during the year 2027-2028. Pham, MD, Leopoldo C. Definition and classification of intestinal failure in adults Pironi L, Arends J, Baxter J, Bozzetti F, Peláez RB, Cuerda C, Forbes A, Gabe S, Gillanders L, Holst M, Jeppesen PB, Joly F, Kelly D, Klek S, Irtun Ø, Olde Damink SW, Panisic M, Rasmussen HH, Staun M, Szczepanek K, Van Gossum A, Wanten G, Schneider Aug 1, 2016 · The mission of the ISBI Practice Guidelines Committee is to create a set of clinical guidelines to improve the care of burn patients and reduce costs by outlining recommendations for management of specific medical problems encountered in burn care, recommendations which are supported by objective and comprehensive reviews of the literature as well as by expert opinion. For civilians, these injuries are typically sustained in house fires, motor vehicle crashes, and work-related accidents. Infection control in Burn patients 10. There is an extensive variety of pharmacologic and nonpharmacologic therapeutic options for the management of acute and chronic pain in cats and dogs. Next review: 2024. D. Parsons L. Burns occur mainly in the home or the workplace. orgJune 13, 2019 2351 Management of Burns the burn center, where the decision about intu-bation can be made. The guideline is not a May 31, 2022 · The American Burn Association (ABA) released the Clinical Practice Guideline: Early Mobilization and Rehabilitation of Critically Ill Burn Patients via publication in the Journal of Burn Care and Research (JBCR). This chapter will focus on the initial resuscitation and management of severe burns. These criteria are based on the Australian and New Zealand Burn Association guidelines for Burn Unit referral. New data regarding the potential for surgical and endoscopic interventions have Medical University of South Carolina ¹ European Burns Association guidelines for the management of burn mass casualty incidents within a European response plan Thomas Leclerc, Folke Sjöberg, Serge Jennes, José Ramón Martinez-Mendez, Mar 29, 2024 · Suspected Radio Frequency Electromagnetic Field Exposure Clinical Practice Guideline, 12 July 2024; Chemical, Biological, Radiological and Nuclear (CBRN) Injury Part I: Initial Response to CBRN Agents, 01 May 2018; Chemical, Biological, Radiological and Nuclear (CBRN) Injury Response Part 2: Medical Management of Chemical Agent Exposure, 23 Mar Dec 1, 2022 · The ABA recommends all pediatric burns may benefit from burn center referral due to pain, dressing change needs, rehabilitation, patient/caregiver needs, or non-accidental trauma. With proper treatment, successful functional and emotional recovery is possible. If possible, transport patients to a (verifi ed) burn center within 24 hours. 5. Burn injuries represent 5% to 10% of combat casualties in combat. Resident Burn Manual 2021; Nursing Resource Manual 2022; Trauma Team Activation Criteria; Checklist for Burn Admissions; Daily Expectations of the Residents on the Burn Service; Emergency Department/Trauma Adult Airway Management Protocol Clinical Nutrition 35 (2016) 247-307 Download file. The first PGs for burn care addressed the issues encountered in developed countries, lacking consideration for circumstances in resource-l … Jun 1, 2018 · Cancio LC. Guidelines for Burn Care Under Austere Conditions Airway & Ventilation Management 11 12 The assessment and management of airway injury from smoke inhalation is dealt with in the South West Burn Care Network document ‘Management of Smoke Inhalation and Airway Injury of the Burn Injured Patient’8. Carney N, Totten AM, O’Reilly C, et al. Until then, there were no guidelines for burn care in Japan, and the American Burn Association (ABA) guidelines were released internationally in 1998. 9 MB) The European Burns Association (EBA) serves as a resource to facilitate communication and collaboration between burn care specialists. ACI Statewide Burn Injury Service Clinical Guidelines: Burn Patient Management . This document is a practical guide to the management of burn injuries for healthcare professionals everywhere who are non-burns specialists. 1 To accomplish this, we review the principles of acute pain management in adult burn patients and present a reasonable approach to the management of the complex pain associated with burn injury based on a review of the literature and expert opinion. 1). 5% of all burned patients receive treatment in specialized burn centers. 9. Hospital (RNSH). They can lead to debilitating, lifelong injuries and have a serious psychological and economic impact. Hand burn injuries often result in limited hand function especially flexion/extension of fingers and present a major hindrance in rehabilitation. al. 3 This clinical practice guideline, like the previous one, addresses issues of prevention, risk assessment, monitoring, and treatment. Burn Wound Management for Out-patient Care Burn-patient-management-guidelines. This confirmation renders an invaluable part of patient management and should be considered in a timely schedule. Data Includes: 30,135 cases in 2022; 152,312 cases over 5 years; 109 burn data contributors from 39 states + DC; eBook $199 Non Member $99 Member Adult Specific Guidelines. 1, 3, 5, 6 We'd like to use cookies on this site to bring you the best experience. Burn wound management 12 Selecting an appropriate dressing – quick reference guide 16 The multidisciplinary team 24 Websites 25 Appendices 26. A sub-committee of the American Burn Association's Committee on the Organization and Delivery of Burn Care was created to revise the adult pain guidelines. Burn pain management: a guideline-based approach. This guideline is developed with close consideration and reference to relevant policies, strategies, guidelines and scientific evidences. health. The experts identified fields of interest, defined questions to be addressed, performed relevant literature searches, and added their expertise in burn disaster preparedness and response. Informed by the work of FGI topic groups on palliative care and inclusive environments, requirements and appendices have been Apr 27, 2022 · The Japanese Society for Burn Injuries (JSBI) published the third edition of guidelines to present the standard of care for inpatient treatment of burn injuries in Japan. Oct 21, 2022 · Pathophysiological changes of early burn wounds. Gibran, MD, FACS. Find out more It was published in 2012 by the National Network for Burn Care, an NHS body that includes representation from the four Burn Care Networks for England & Wales, NHS Specialised Commissioners, Patient Representatives and the British Burn Association. After the primary and secondary surveys are completed, early and aggressive Burn Care Services will need to be assessed for compliance with the standards set out in the document. Burn management notes clinical guidelines statewide burn injury service burn patient management 4th edition the agency for clinical innovation (aci) works with For initial fluid management see Burns Acute Management CPG Burn injuries greater than 10% TBSA and including the dermis result in circulatory compromise secondary to fluid loss via damaged tissue, widespread vasodilation as well as increase capillary permeability and fluid shifts (third spacing). He or she may recommend that you be transferred to a burn center if your burn covers more than 10 percent of your total body surface area, is very deep, is on the face, feet or groin, or meets other criteria established by the American Burn Association. Several CPT codes (01951-01999, excluding 01996) describe anesthesia services for burn excision/debridement, obstetrical, and other procedures. Less common injuries in children include electrical, chemical and radiation burns. In addition to the immediate coagulation and necrosis of the tissue in the coagulation zone of the skin wound after the burn, the zone of stasis also has a progressive damaging effect in the early stages, especially in the 12–24 h after the injury (). This will be the fifth time that such an intensive course is held and organised by the European Burns Association and supported by the local organising committee EBA2023 Dec 15, 2021 · The American Burn Association (ABA) estimates the level of care required for burns according to the location, depth, and percentage of total body surface area (TBSA) affected. Burns of Special type 12. Assistant Professor of Pediatrics Division of Critical Care Department of Pediatrics Table of Contents I. gov. Such injuries are likely to be associated with: Extremes of age (<5 or >60 years) Site of injury Face,hands, or perineum Any flexure including neck or axilla Circumferential dermal burns or full thickness burn of the limb, torso, or neck Sep 4, 2020 · PURPOSE. If there is any doubt, exami- Jul 27, 2021 · Released earlier than usual, the fiscal year (FY) 2022 ICD-10-CM Official Guidelines for Coding and Reporting became available online Monday, July 12, and include instructions for assigning novel code U09. nsw. If you go to a doctor for burn treatment, he or she will assess the severity of your burn by examining your skin. The ad hoc CPG committee developed a standardized, evidence-based process for CPG production, which is now in use by several Investigator Panels. An exchange of information between the various burn centres in Europe and verification of burn centres will help us to promote the goal of the EBA. This document provides a summary of the available evidence to support the Burn Patient Management and the Minor Burn Management guidelines. Ten Commandments of Burns Aug 13, 2022 · Diagnosis. 1998;19:151-9. ; Scenario: Managing non-complex burns: ; Covers the primary care management of non-complex burns. Burn injuries in hands are complex and the appearance of contractures is a common complication. Any other burn that the referring department is not happy about or confident to send home. The Lund-Browder chart is the most precise tool for estimating TBSA and should always be used for burns in children, because it takes into account the changes in body 1. {{configCtrl2. ESPEN Endorsed Recommendation. (See "Emergency care of moderate and severe thermal burns in adults" and "Overview of the management of the severely burned patient" and "Treatment of deep burn injury" . Local wound management-Skin substitutes, biological dressings, dressing techniques 9. Practice guidelines (PGs) are recommendations for diagnosis and treatment of diseases and injuries, and are designed to define optimal evaluation and management. 2,3 An estimated 11 million people worldwide sought medical care for burns in 7. Burn Wound Management for Out-patient Care Apr 1, 2022 · These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. o Depth of burn: The deeper the burn injury, the more significant the 2023 Annual Burn Injury Summary Report. 1. Antibiotic Stewardship added Jun 2020. Goals and Objectives of Burn Management Guideline Jun 12, 2019 · Burns are the fourth most common type of trauma worldwide, after traffic injuries, falls, and interpersonal violence. The most common wound infection in small outpatient burns is cellulitis, usually caused by Staphylococcus aureus. Initial assessment and fluid resuscitation of burn patients. ABLS programs also support emergency and mass casualty preparedness focusing on triage, burn survivability, patient transportation, and patient treatment. A common theme during the 2022 Guidelines revision cycle was person-centered care. Jun 20, 2023 · In the United States, approximately 500,000 people seek care for burn injuries yearly. Guidelines for the management of severe traumatic brain injury, fourth edition. European Practice Guidelines for Burn Care Guidelines for Burn Camp Leader Exchanges How to Organise Support Programmes for Burn Survivors Burn Centre Registration form Mass burn casualty incidents Documents accesible for national authorities around Europe when linked from the EU-plan. Mar 25, 2014 · It describes the types of burns, fluid resuscitation guidelines, signs of burn shock, management of electrical and chemical burns, and wound care. The Guidelines for Burn Patient Referral were developed by the Organization and Delivery of Burn Care Committee (ODBC) of the ABA and approved by the Board of Trustees. Scribd is the world's largest social reading and publishing site. Burn Wound assessment – history, size & depth 4. ; Burns may be the result of child abuse and neglect. Cleeland CS American Burn Association 311 South Wacker Drive, Suite 4150 Chicago, IL 60606 (312) 642-9260 www. These burns do not blister and take three to six days to heal. J Burn Care Rehabil. Page iii American Burn Association Practice Guidelines Burn Shock Resuscitation Tam N. Referral Guidelines & Documentation (incl. g. Nutrition in burns 13. C. Burn Wound Management Burn wounds should be cleaned with sterile water and Chlorhexidine (Hibiscrub) as soon as possible, to These recommendations are based on the International Society for Burn Injuries (ISBI) Practice guidelines for burn care, Part 2 and on expert opinion in review articles [White, 2012; BMJ Best Practice, 2022]. Obtain a burning permit from the Mississippi Forestry Commission. Burns of Special sites 11. The key points are initial stabilization of the patient and airway, rapid fluid resuscitation based on TBSA, and treatment specific to the causative agent for chemical or electrical burns. It is hoped that by doing so, equitable provision of burn care will be ensured for patients and their families. Burn Wound Management for Transfer 7. 1. Terry Swanson, Co-chair, Karen Ousey, Co-chair, Emily Haesler, Methodologist 01 Foreword Box 2 National burn injury guidelines for referral to a burns unit All complex injuries should be referred. Burn Center Practice Management Guidelines. Jun 30, 2022 · Current evidence regarding management of burn blisters is limited and controversial. The purpose of this guideline is to update the previous guideline by Drs Faucher and Furukawa. The guidelines discuss treat-ment options centered on preemptive, multimodal analgesic therapies. ### The American Burn Association dedicates their efforts and resources to promoting and supporting burn-related care, prevention, education, and research. 2014;20(4):396-401. Acute Burn Resuscitation updated May 2023; Adult VTE Prophylaxis updated Nov 2022; BICU Ventilator Weaning updated Aug 2022; Burn ICU Approach to Antifungals added Jan 2020; Burn Nutrition updated Jan 2024; Burn Palliation Guidelines added Feb 2023; Burn UTI Guideline updated Sep 2022; Central Line Management of simple and retained hemothorax: A practice management guideline from the Eastern Association for the Surgery of Trauma 2020; Management of the open abdomen: A systematic review with meta-analysis and practice management guideline from the Eastern Association for the Surgery of Trauma 2022 Mar 1, 2023 · Methods. au (ACI) 180009, ISBN 978-1-76000-786-7 (print). Management. Burn mechanisms are varied and include: flame, scald, explosion, contact, chemical, electrical, friction, reverse thermal (cold) and radiation. Lippincotts Prim Care Pract. Curr Opin Crit Care. 2014;94(4):741-754. Practice Guidelines for Burn Care, 2006 Nicole S. pdf - Free download as PDF File (. Download the Burn patient management evidence summary (PDF 2. Cancio, MD, and et. 2. In 2020, the American Burn Association (ABA) began a process to create new Clinical Practice Guidelines (CPGs). 9 Post COVID-19 condition (found under Section I. ABLS programs support emergency preparedness needs for disaster management. Burn Wound Infection updated Nov 2020. Emergency Assessment and Management of Burn Injuries 2. The European Burns Association’s disaster committee developed medical-organizational guidelines to support this European plan. Burn within the time limits specified by the Stagnation Indices The ‘National Standards for the Provision of Adult and Paediatric Burn Care’ covers the entire burn care pathway and aims to provide the means to measure the capability of individual burn services as a whole and the clinical network in which they operate. Office management of minor burns. Practice Guidelines for the Management of Pain Lee Faucher, MD, FACS and Kenneth Furukawa, MD. NBC direct referrals) 6. [1] All severely burned patients are trauma patients first, thus should always be handled systematically with an initial focus on the ABCs (airway, breathing, and circulation). (Also see Burns, Evaluation and Management and Burns, Thermal). Adequacy of resuscitation should be confirmed. Intravenous fluid choices in critically ill children. Jan 1, 2022 · These practice guidelines update the “Practice guidelines for management of the difficult airway: A report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway. 2 The majority of admissions result from scalds, followed by contact and flame burns. txt) or read online for free. First Aid and Early Management of Burn Injuries 3. ” These updated guidelines are intended for use by anesthesiologists and all other individuals who deliver or who are responsible for difficult airway management. Jan 28, 2020 · Approximately 6,600 (17. Jun 9, 2022 · Overview of surgical procedures used in the management of burn injuries; Overview of treatment of chronic wounds; Patient management following extremity fasciotomy; Skin autografting; Skin laceration repair with sutures; Skin substitutes; Society guideline links: Open wound management; Surgical management of severe lower extremity injury 2022 Clinical practice guidelines on the management of heart failure from the American College of Cardiology, American Heart Association, and Heart Failure Society of America (ACC/AHA/HFSA), published in the journal Circulation. ; The leading cause of burns in the majority is scalds (70–85%) followed by flame burns, electrical, and chemical burns. The goal is management of burns shock, through optimal replacement of fluid losses to maximise wound and body perfusion, and minimise wound and body oedema and associated adverse effects Calculate requirements from time of the burn, not time of presentation ing this time, scrutiny of proton pump inhibitors (PPIs) has increased considerably. Membership and access to the IWII is free. 1997;1:40-9. Additionally, the American Burn Association (ABA) guidelines mirror the ATLS. Carcillo JA. Management of Burn deformities 15. ) BURN MANAGEMENT Serious burns requiring hospitalization include the following: Adult: greater than 15% burn Pediatric: greater than 10% burn Any burn in the very young, elderly or the infirm Any full thickness burn Specific regions: face, ears, eyes, hands, feet, perineum Circumferential burns Aug 5, 2022 · This article updates and replaces the 2004 American Academy of Pediatrics (AAP) clinical practice guideline for the management and prevention of hyperbilirubinemia in the newborn infant ≥35 weeks’ gestation. Tips • Plan carefully prior to dressing application to ensure optimum wound care. [1] prevention and management. These text, graphic and multimedia resources will be updated regularly as a part of the IWII implementation plan for this 2022 edition of Wound Infection in Clinical Practice. These guidelines are a set of rules that have been developed to accompany and complement the Dec 5, 2023 · AMERICAN BURN ASSOCIATION CLINICAL PRACTICE GUIDELINES. Surg Clin North Am. Prevention of Deformities and Contractures 14. Although PPIs remain the medical treatment of choice for GERD, multiple publications have raised questions about adverse events, raising doubts about the safety of long-term use and increasing concern about overprescribing of PPIs. Scalds and Burns 1 Introduction; Burn is a leading cause of unintentional injury in children, second only to motor vehicle accidents. The ABA is unable to respond to requests regarding personal medical concerns related to burn injuries. 1,14 The last three decades have seen a remarkable evolution in burn management, which has resulted in a vast reduction in mortality; further, morbidity outcomes are significantly better. Delirium Management Guidelines 1 Guideline: RevisedDelirium Management Guidelines Date: September 2022 Review Date: September 2024 Content Experts Trauma PMG Reviewed by and adapted to Burn by: Anne Wagner, MD Table of Contents A burn is an injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or ultraviolet radiation (such as sunburn). gr pp lk oy rs xf ar te wd kw