Ice to a Burn Injury

Tuesday, August 19, 2008 by Renee Lierly, RN

Most laser based technology used in Dermatology creates a laser induced thermal injury by the absorption of electromagnetic energy by chromophores in the skin (melanin, hemaglobin and water). Thermal damage to structures of the skin is a combination of time and temperature, the temperature to which the cell is heated as well at the time period for which the temperature is sustained. The goal of controlling a thermal injury requires careful selection of wavelength, fluence, pulse duration and spot size. Skin color in addition to Cooling the epidermis before, during and after a laser pulse must be taken into consideration to prevent unwanted thermal injury to adjacent tissues. The failure to properly assess the client, select appropriate parameters and ineffective or improper cooling may all contribute to an unwanted adverse effect of a burn injury.

Laser hair removal, Laser vein treatment and the treatment of pigmented lesions can all result in a unwanted burn injury. The first objective in burn wound care is to dissipate the heat. Clinical evidence indicates a beneficial effect from immediate active cooling of a burn injury to dissipate the heat.
Cool tap water or saline compresses is an effective method of cooling. Colder substances such as ice can be detrimental by extending the zone of injury by constricting the blood vessels. The period of time that is required for active cooling is brief. Cooling stabilizes skin mast cells, decreasing histamine release, thereby, decreasing edema of the wound. Cooling is an effective way of controlling the pain of a partial-thickness burn. Cooling for pain control may be achieved by using moist cool compresses, not ice packs.

Treatment providers should not perform any procedure that produces a side effect that they are unable to recognize and treat. Treatment of a side effect must comply with the standard of care ordinarily used by other healthcare professionals practicing their profession in the same or similar locality and under the same or similar circumstances. The failure of a healthcare professional to observe the standard of care is negligence.
It does not matter if the burn injury was caused by an Aesthetic Laser system of some other heat source, the standard of care remains the same.
I have included several links for burn injury first aid to reference as the standard of care.
Mayo Clinic
Health Sciences Center, University of Utah
Burn Injury Lawyers
Massachusetts General Hospital

Total Burn Care

--- Renee Lierly, RN

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