Summer Skin Burns, Bites & Abrasions Alexa Colgrove Curtis PhD, FNP-BC Associate Professor SONHP Director, Nurse Practitioner Programs.

Summer SkinBurns, Bites & Abrasions

Alexa Colgrove Curtis PhD, FNP-BCAssociate Professor SONHP

Director, Nurse Practitioner Programs

Summer Skin

• Burns– Sunburns & Skin Cancer– Burn First Aid– Poison Oak

• Bites– Mosquitos– Ticks

• Abrasions– Cuts & Scrapes

Burns

Burns

Burns

Burns Severity

Minor Moderate MajorAdult <10% TBSA Adult 10-20% TBSA Adult >20% TBSAYoung or old < 5% TBSA Young or old 5-10% TBSA Young or old >10% TBSA<2% full thickness burn 2-5% full thickness burn >5% full thickness burn

High voltage injury High voltage burnPossible inhalation injury Known inhalation injury

Circumferential burn Significant burn to face, joints, hands or feet

Other health problems Associated injuries

Sunburn Prevention

• Avoid sun exposure between 10 am & 4 pm– Seek shade– UV index 0-11+

• Risk of sunburn• http://www.epa.gov/sunwise/uvindex.html

• Sunscreen– SPF 30 or greater– UVA/UVB– Apply generously 15-30 minutes before exposure– Reapply every two hours

Sunburn Treatment

• Take a cool shower/bath or use cool compresses

• Liberal use of moisturizer• Hydrate • Anti-inflammatory– Ibuprofen– 1% Hydrocortisone

Burn First Aid for Minor Burns

• Cool the burn– Don’t use ice

• Apply a sterile bandage– Observe for infection

• Hydrate• Take an anti-inflammatory– Ibuprofen

Poison Oak

Poison Oak Prevention

• Learn to spot poison oak in all seasons• Wear protective clothing when exposed to brush• If exposed scrub with soap and water, or rubbing

alcohol, within 10 minutes.• Scrub under your nails, plant oil can be spread by oil on

your fingers• If your pet has been exposed wash in shampoo and

water, wear rubber gloves• Wash exposed equipment with soap and water, the oil

can stay potent for as long as five years.

Poison Oak Identification

Poison Oak Treatment

• Cool compresses• Calamine lotion• Hydrocortisone cream• Steroids– Cream– Pills– Injectable

Skin Cancer

• http://www.webmd.com/melanoma-skin-cancer/ss/slideshow-skin-lesions-and-cancer

• ABCDE– Asymmetry– Border– Color– Diameter– Evolving

Bites

• Mosquitos

West Nile Virus

• Spread by infected mosquitos• Can cause encephalitis (inflammation of the

brain) or meningitis (inflammation around the brain and spinal column)

• People over 60 and the chronically ill are most at risk

• Incubation period is generally 2-6 days• Most people are infected June – September

West Nile Virus Symptoms

• 70-80% of people exposed to West Nile Virus do not develop symptoms

• About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash. Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.

West Nile Virus Symptoms

• Less than 1% of people who are infected will develop a serious neurologic illness such as encephalitis or meningitis. The symptoms of neurologic illness can include headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.

• Recovery from severe disease may take several weeks or months. Some of the neurologic effects may be permanent. About 10 percent of people who develop neurologic infection due to West Nile virus will die.

West Nile VIrus Activity

West Nile Virus Prevention

• Avoid mosquito infected areas• Reduce mosquito breeding grounds• Wear protective clothing• Use mosquito repellant– Of the products registered with the EPA, those

containing DEET, picaridin, IR3535, and some oil of lemon eucalyptus and para-menthane-diol products provide longer-lasting protection.

• Report dead birds to the local health department

Bites

• Ticks

Lyme Disease

• Caused by the bacterium Borrelia burgdorferi • transmitted to humans through the bite of

infected blacklegged ticks

Early Lyme Disease Symptoms

• “Bull’s-eye” rash: Erythema Migrans (EM)

• Fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes

• 3-30 days post-tick bite

Lyme DiseaseEarly Disseminated Stage

• Additional EM lesions in other areas of the body

• Facial or Bell's palsy

• Severe headaches and neck stiffness due to meningitis

Lyme DiseaseEarly Disseminated Stage

• Pain and swelling in the large joints (such as knees)

• Shooting pains that may interfere with sleep• Heart palpitations and dizziness due to

changes in heartbeat

Lyme DiseaseLate Disseminated Stage

• Approximately 60% of patients with untreated infection may begin to have intermittent bouts of arthritis, with severe joint pain and swelling.

• Large joints are most often affected, particularly the knees.

Lyme DiseaseLate Disseminated Stage

• Up to 5% of untreated patients may develop chronic neurological complaints months to years after infection– shooting pains– numbness or tingling in the hands or feet– problems with short-term memory.

Lyme DiseaseReported Cases in the U.S.

Lyme Disease Prevention

• Be extra vigilant in warmer months (April-September) when ticks are most active.

• Avoid wooded and bushy areas with high grass and leaf litter.

• Wear protective clothing.• Use repellents that contain 20% or more DEET

on the exposed skin.• Use products that contain permethrin on

clothing.

Lyme Disease Prevention• Find and remove ticks from your body.• Pull upward with steady, even pressure. Don't twist or jerk the tick

• After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

Lyme Disease Testing & Treatment

• Testing blood for evidence of antibodies against the Lyme disease bacteria

• Antibiotics for 2-3 weeks• Symptom management

Abrasions

• Use soap and water to cleanthe wound.– Irrigate as needed

• Apply pressure to stop the bleeding• Apply topical antibiotic cream– Bacitracin not Neosporin due to skin allergies

• Apply a sterile dressing• Observe for infection

AbrasionsWhen to Seek Medical Attention

• If you are unable to control the bleeding.• Wound edges of the cut are jagged or gape open• The cut is deep (1/4 inch or more), or you can see fat or

muscle.• You can't get all of the dirt or debris out of the wound, or

the wound was caused by something very dirty or rusty.• You have a puncture wound or a deep cut and haven't had

a tetanus shot in the past 5 years.• The wound is from an animal or human bite.• You have numbness, loss of sensation, or loss of movement.

Minor LacerationsGlue Me

• Dermabond• Clean and irrigate wound• Approximate wound edges• Gently apply adhesive to the external skin surface• Wipe off excess adhesive immediately• Hold wound edges together for 30 seconds• Adhesive acts as its own water-resistant bandage, and

no added coverings are needed. • No ointment, it will cause adhesive to fail.• Adhesive will spontaneously peel off in five to 10 days.

Have a Wonderful Summer