The following symptoms and complaints may indicate burns:
The depth of a burn is described as follows:
| Grade | Clinical picture | Burn depth |
| 1 | Redness, edema (combustio erythematosa). | Superficial epithelial damage |
| 2a | Blistering on reddened skin (combustio bullosa); very painful | Epidermis (cuticle) and superficial portions of dermis (dermis) with sequestration |
| 2b | Blistering on light background; painful | Dermis; hair follicles and glandular appendages preserved |
| 3 | Epidermal shreds, necrosis (tissue damage resulting from death of cells), eschar (combustio eschariotica); tissue white; no pain | Epidermis and dermis completely destroyed |
| 4 | Charring lysis (in case of chemical damage). | Additional subcutaneous fat, muscles, tendons, bones, joints affected if necessary |
Note
- Superficial injuries are usually more painful than deep injuries.
- The severity of burns must be reassessed as they progress.
The extent of burns is described according to Wallace’s so-called rule of nine:
| Body part | Adult | Children | 0-1-year |
| Head/neck | 9 % | 16 % | 20 % |
| Hull | 36 % | 32 % | 30 % |
| Poor | 18 % | 18 % | 18 % |
| Hand | 1 % | 1 % | 1 % |
| Genital | 1 % | 1 % | 1 % |
| Thigh | 18 % | 16 % | 15 % |
| Lower leg/foot | 18 % | 16 % | 15 % |
Furthermore, the burn can be assessed according to the palm rule. One palm is equal to one percent body surface area (KOF).
Extent of burns according to the Lund-Browder scheme:
| Combustion % | 1-4 years | 5-9 years | 10-14 years | 15 years | Adults |
| Head | 17 | 13 | 11 | 9 | 7 |
| Neck | 2 | 2 | 2 | 2 | 2 |
| Hull front | 13 | 13 | 13 | 13 | 13 |
| Hull rear | 13 | 13 | 13 | 13 | 13 |
| Buttock half | 2,5 | 2,5 | 2,5 | 2,5 | 2,5 |
| Genitals | 1 | 1 | 1 | 1 | 1 |
| Upper arm | 4 | 4 | 4 | 4 | 4 |
| Forearm | 3 | 3 | 3 | 3 | 3 |
| Hand | 2,5 | 2,5 | 2,5 | 2,5 | 2,5 |
| Thigh | 6,5 | 8 | 8,5 | 9 | 9,5 |
| Lower leg | 5 | 5,5 | 6 | 6,5 | 7 |
| Foot | 3,5 | 3,5 | 3,5 | 3,5 | 3,5 |
There is a risk of shock:
- In adults from a burnt KOF of > 10%.
- In children from a burnt KOF of > 5 %.
The critical burn area is:
- Children at 60-80% of the KOF
- Adults at about 50-70% of the KOF
- Persons over 65 years at 30-40% of the KOF
To the combustion area are added together:
- 3rd and 4th degree burns
- Burns 2nd degree half
Indications of inhalation trauma may include:
- Loss of consciousness
- Dyspnea (shortness of breath)
- Tachypnea – breathing too fast.
- Burns on the face/burnt hair
- Hoarse voice
- Sooty sputum (sputum)
- Confusion / aggressiveness
Warning signs (red flags)
- Infection-free wound that has not healed on its own after a week → think of: deep-dermal injury.
