Aging Begins at 30

Burns Should Be Avoided But Can be Treated

Your skin holds in the good stuff and keeps out the bad. If badly burned, the essential fluids of the body leak and infection invades.

Protect your skin. Keep your medicines at minimum so you are clear-headed. Avoid carelessness, do not smoke in bed, have an anti-scald device (less than 125° F) on your hot water line, wear flame resistant clothing, use an electric heat (not a flame) stove or a microwave oven, have smoke alarms and fire extinguishers in your home. The elderly have a lower burn incidence than younger adults, but a higher mortality rate and length of hospital stay. Clothing burns are twice as common in the elderly. Elder patients may suffer a severe burn if unattended and faint or strokeagainst a hot register when unattended.

At least 2 million burns occur yearly, about 130,000 are admitted and 10,000 die. About 9% of burn victims are elderly. Survival rates from burns have been improving since hospital burn units were set up in the 1960's. However, many die before they reach the hospital from inhalation burns.

If you are elderly and lucky you will burn 30% or less of your skin surface and you will recover after 40 days in the hospital. If a burn is less than 15% and partial thickness it may not require hospitalization. The palm of your hand is 1% of your body surface, an arm 9%, a leg, a back, or a front is 18%. If you are elderly and unlucky enough to burn 40% or more of your body, the humane and rational treatment is to turn off the IV's and turn on the morphine so you can spend time with your kids and die in peace. Three times as many elderly are delayed in getting treatment as are young adults. If survivable, the elderly deserve aggressive treatment. Fifty percent survival rates in young adults have risen from a 43% to a 78% area of burn and in the elders from 9% to 30% between 1950 and 1990.

The two factors that influence survival most are age and burn size. The elderly get deeper burns.

Early treatment concentrates on resuscitation, support, and careful monitoring of routine vital signs. Whether your lungs sound wet or not is important. If no hair follicles, sweat glands, and sebaceous glands are left, then that skin is not going to heal without a graft. A 65 year old 190 lb farmer with a 40% burn will need 16 liters of fluid in his first burn day; eight liters in the first 8 hours after the burn counting the time to find him and get him to the hospital. Without this amount of fluid his kidneys will die, then he will die. Most cells in the burn area secrete histamine like substances which circulate all over and make the capillaries leak like a sieve. In 1971, it was found that replacement of large amounts of fluids was critical to survival.

As well as histamine like substances factors are released from the burn that suppress cellular and serum soluble infection fighting cells and chemicals.

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See related Patient Topics Burns, Fire Safety, Injuries and Wounds, Safety or Safety--General.

See related Provider Topics Burns, Injuries and Wounds or Safety.

All contents copyright © 1992-2004 the Author(s) and The University of Iowa. All rights reserved.

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