By the end of this chapter, you will be able to:
Mastering these skills will help you provide vital nutrition care that supports healing and recovery for burn patients in your community.
Compiled by: Winnie Achieng
Nutrition management in burn patients is a critical component of dietetic operations, given the complex metabolic and physiological changes that occur after burn injuries. In Kenya, where burn injuries contribute significantly to morbidity in both urban and rural settings, dietetic professionals must understand how to assess burn severity and tailor nutritional interventions accordingly. Effective nutrition support promotes wound healing, preserves lean body mass, and reduces complications such as infections. This chapter focuses on defining key terms related to burns and nutrition and provides a framework for comprehensive assessment of burn injuries and nutritional status.
Understanding the terminology related to burns and nutrition is essential for dietitians working in clinical and community settings. Precise definitions ensure clear communication among multidisciplinary teams and improve patient outcomes. The following subtopics clarify fundamental concepts relevant to nutrition management in burn care.
A burn injury refers to damage to the skin or other tissues caused by heat, chemicals, electricity, radiation, or friction. It can range from superficial damage affecting only the epidermis to full-thickness injuries involving deeper tissues. In Kenya, common causes include domestic accidents with hot liquids, fire outbreaks, and electrical burns. The extent and depth of the burn influence metabolic response and nutritional needs.
Total body surface area is the percentage of the body affected by burns. Accurate estimation of TBSA is crucial for determining fluid resuscitation needs and calculating energy and protein requirements. The "Rule of Nines" and Lund-Browder chart are common methods to estimate TBSA. For example, a burn covering both legs and the anterior torso would approximate 45% TBSA, indicating a severe injury demanding aggressive nutritional support.
Hypermetabolism describes the increased metabolic rate following a burn injury-driven by inflammatory mediators and stress hormones. This condition leads to elevated energy expenditure, muscle protein breakdown, and increased nutrient demands. In Kenyan hospitals like Kenyatta National Hospital, managing hypermetabolism through tailored nutrition plans is vital to improve recovery and reduce length of hospital stay.
Nutritional support encompasses dietary interventions aimed at meeting the increased nutritional needs of burn patients. This may include oral supplementation, enteral feeding, or parenteral nutrition depending on the patient’s condition. Adequate nutritional support helps maintain immune function, promotes wound healing, and prevents complications such as sepsis.
Wound healing is the biological process by which the skin and tissues repair after injury. Nutrition plays a key role in all phases of healing, including inflammation, proliferation, and remodeling. Deficiencies in protein, vitamins, and minerals can delay healing and increase the risk of infection, which is a major concern in burn units at county hospitals.
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Create a free accountThis chapter began by defining key terms related to burns and nutrition to establish a clear understanding of the subject matter. It proceeded to detail the assessment of burn injuries, explaining the nature and severity of burns as well as the critical role nutrition plays in patient recovery. The development of a specific diet plan followed, focusing on calculating nutrient requirements tailored to the individual’s condition, with particular attention to the Rule of Nines and the Curreri formula for estimating energy needs. Implementation of the diet plan was then discussed, emphasizing practical steps to ensure the patient receives appropriate nutritional support. Finally, the chapter highlighted the importance of monitoring and documenting the progress of nutrition interventions, alongside evaluating their outcomes to adjust care plans effectively and promote optimal healing.
Type: Individual
| Tools & Equipment | Materials |
|---|---|
| Pen | Patient clinic card |
| Chair | Foolscap paper |
| Table |
| S/N | Item | Quantity |
|---|---|---|
| 1 | Patient clinic card | 1 Pc per Candidate |
| 2 | Pen | 1 Pc per Candidate |
| 3 | Foolscap paper | 2 Sheets per Candidate |
| 4 | Chair | 1 Pc per Candidate |
| 5 | Table | 1 Pc per Candidate |
| Items to be Evaluated | Marks Available | Marks Obtained | Comments |
|---|---|---|---|
| TASK 1: Define key burn and nutrition terms | |||
| Donned appropriate personal protective equipment: lab coat and closed flat shoes (Award 1 mark each) | 2 | ||
| Prepared counselling area: arranged seating, ensured adequate lighting and ventilation (Award 1 mark each) | 3 | ||
| Created rapport: greeted assessor, introduced self, stated objectives of the session (Award 1 mark each) | 3 | ||
| Defined the following key terms clearly and accurately: (Award 2 marks for each correctly defined term, maximum 10 terms) | 20 | ||
| Terms to be defined include: Total Body Surface Area (TBSA), Partial Thickness Burn, Full Thickness Burn, Hypermetabolism, Enteral Nutrition, Catabolism, Anabolism, Fluid Resuscitation, Nutritional Support, and Protein-Energy Malnutrition (No marks, terms listed for assessor reference) | 0 | ||
| Used clear language and examples relevant to burn nutrition management (Award 1 mark each) | 4 | ||
| Answered assessor questions confidently and clarified any doubts (Award 1 mark each) | 3 | ||
| Maintained hygiene and safety throughout the session (Award 1 mark each) | 3 | ||
| Concluded session by summarizing key points and thanking assessor (Award 2 marks) | 2 | ||
| Sub-Total | 40 | ||
| PRODUCT CHECKLIST | |||
| Accurate verbal definitions and explanations of 10 key burn and nutrition terms (Award 2 marks for each correct and complete term definition, maximum 10 terms) | 20 | ||
| Sub-Total | 20 | ||
| GRAND TOTAL | 60 | ||
Type: Individual
| Tools & Equipment | Materials |
|---|---|
| Simulated burn injury model (full thickness and partial thickness areas) | Patient clinic card (pre-printed with patient details) |
| Measuring tape (metric) | Sterile gloves |
| Pen | Alcohol-based hand sanitizer |
| Reference chart for burn classification and Lund-Browder chart | Foolscap sheets (for notes and calculations) |
| S/N | Item | Quantity |
|---|---|---|
| 1 | Simulated burn injury model (full thickness and partial thickness areas) | 1 Pc per Candidate |
| 2 | Patient clinic card (pre-printed with patient details) | 1 Pc per Candidate |
| 3 | Measuring tape (metric) | 1 Pc per Candidate |
| 4 | Pen | 1 Pc per Candidate |
| 5 | Sterile gloves | 1 Pair per Candidate |
| 6 | Alcohol-based hand sanitizer | 1 Bottle shared |
| 7 | Reference chart for burn classification and Lund-Browder chart | 1 Pc per Candidate |
| 8 | Foolscap sheets (for notes and calculations) | 2 Sheets per Candidate |
| Items to be Evaluated | Marks Available | Marks Obtained | Comments |
|---|---|---|---|
| TASK 1: Perform Burn Injury Assessment | |||
| Donned personal protective equipment; gloves and sanitizer use (Award 1 mark each for gloves, hand sanitizing, and proper PPE use) | 3 | ||
| Prepared assessment area with all required equipment and materials (Award 1 mark for assembling equipment, 1 mark for organizing workspace) | 2 | ||
| Introduced self and explained the purpose of assessment to simulated patient (Award 1 mark each for greeting, introduction, and explanation) | 3 | ||
| Measured and identified burn wound areas accurately using measuring tape and Lund-Browder chart (Award 2 marks each for accurate measurement of burn areas, correct referencing of chart, and TBSA calculation) | 8 | ||
| Classified burn injury correctly into partial thickness and full thickness based on visual assessment and chart (Award 3 marks each for correct classification of partial and full thickness burns) | 6 | ||
| Recorded findings legibly and completely on patient clinic card and foolscap notes (Award 1 mark each for legibility, completeness, correct data, and neatness) | 4 | ||
| Demonstrated infection prevention measures throughout assessment (Award 1 mark each for hand hygiene before and after assessment) | 2 | ||
| Summarized assessment findings and stated nutritional implications clearly (Award 2 marks for summary, 2 marks for nutritional relevance) | 4 | ||
| Answered assessor’s questions confidently and accurately (Award 2 marks for clarity and correctness) | 2 | ||
| Sub-Total | 34 | ||
| PRODUCT CHECKLIST | |||
| Accurate burn surface area measurement matching 15% TBSA ±1% (Award 4 marks for measurement within tolerance) | 4 | ||
| Correct classification of burn depth (partial vs full thickness) on model (Award 4 marks for correct classification) | 4 | ||
| Complete and accurate recording on patient clinic card and notes (Award 4 marks for completeness and accuracy) | 4 | ||
| Clear summary statement of burn severity and nutritional management needs (Award 4 marks for clarity and relevance) | 4 | ||
| Sub-Total | 16 | ||
| GRAND TOTAL | 50 | ||
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