Burn Depth
Superficial burns affect only the epidermis and appear red and painful without blisters. Partial-thickness burns involve the dermis, producing blisters and severe pain. Full-thickness burns destroy all skin layers and may look white, leathery, or charred with little pain because nerve endings are destroyed.
Rule of Nines
For adults, the head and each arm are 9 percent, each leg is 18 percent, and the anterior and posterior trunk are 18 percent each. The genitalia count as 1 percent. Children have proportionally larger heads, so the rule is adjusted, and the palm of the patient's hand is roughly 1 percent.
Referral to a Burn Center
Burns involving the face, hands, feet, genitalia, or major joints warrant burn center consideration. So do circumferential burns, chemical or electrical burns, inhalation injury, and large partial-thickness burns. Cool small burns briefly, cover with dry sterile dressings, and keep the patient warm to prevent hypothermia.