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This presentation is made by Dr Ashok Jaisingani for study purpose if any one like this than please give comments

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  1. 1. Dr. Ashok Jaisingani
  2. 2. Introduction The incidences of burns varies worldwide according to culture The majority of the burn in children are scaled & caused by accident with kettles, pans, hot drink and hot water. Among the adolescence the burns are usually caused by experiments with matches & flammable liquid Most electrical and chemical injuries occurs in adult Cold and radiation are also very rare cause of the burns.
  3. 3. Conditions Which Increase The Risk Of Burns In Adult Mental disease (Attempted suicide or assault) Epilepsy Alcohol or drug abuse These are the underlying factors in as many as 80% of pts with burn admitted to hospital in some population.
  4. 4. Prevention Of Burn Health promotion and appliance design have reduce the incidence of burns Regulation regarding flame retardant clothes & furniture The promotion of smoke alarm The almost universal use of cordless kettles and education to parents to keep their hot water thermostat at 600 Introducing of effective legislation
  5. 5. The Pathophysiology Of Burn By far the most common organ affected by the burn injury is skin. Burn can also damage the airway and lungs with life- threatening consequences Air-way injury occurs when face and neck are burned Respiratory system injury usually occurs if the person trapped in burning vehicle, house, car and aeroplane and forced to inhale the hot & poisonous gases
  6. 6. Injury To The Airway & Lungs Physical Burn Injury To Airway Above The Larynx: The hot gases can physically burn the nose, mouth, tongue, palate & larynx  lining of these structure start to swell  these may start to interfere with larynx and may complete block the airway if proper action not taken. Physical Burn Injury To Airway Below The Larynx: This is rare as heat exchange mechanism in supraglottic airway are usually able to absorb heat safely. Steam has large latent heat of evaporation & can cause thermal damage to lower airway  respiratory epithelium become swell & detach from bronchial tree  blockage of lower airway.
  7. 7. Symptoms Associated With Laryngeal Edema The symptoms of laryngeal edema are very late, are Change in voice Stridor Anxiety Difficulty in respiration After these symptoms intubation at this point is very difficult or even impossible. Because of this early intubation of suspected airway burn is treatment of choice.
  8. 8. Metabolic Poisoning Carbon monoxide is the most common poisonous gas that cause metabolic poisoning This is the usual cause of person being found with altered consciousness in enclosed fire space. Carbon monoxide block the transport of oxygen by binding to Hb, because it has 240 times greater affinity than oxygen. Level of carbon monoxide in the blood stream have importance, concentration above 10% are dangerous and should be treated with pure oxygen for more than 24 hours (conc. around 60% cause death) Hydrogen cyanide a toxin produce in house fire cause metabolic acidosis by interfering mitochondrial respiration
  9. 9. Inhalational Injury Minuet particle within thick smoke not filtered by upper airway & reach to lung parenchyma are responsible for the inhalational injury. These particle stick to the moist lung  Intense reaction within alveoli  chemical pneumonitis  edema of alveolar sac  decreasing gases exchange & often give rise to bacterial pneumonia. Bacterial pneumonia have significant effect on the mortality of burn pt
  10. 10. Mechanical Block On Rib Movement Burned skin is very thick and stiff and this can physically stop ribs movement in case of full- thickness burn across the chest.
  11. 11. Danger Of Smoke, Hot Gases & Steam Inhalation Inhaled hot gases can cause supraglottic airway burn and laryngeal edema. Inhaled steam can cause infraglottic burn and loss of respiratory epithelium Inhaled smoke particle can cause chemical alveoli and respiratory failure Metabolic poisoning caused by the inhaled carbon monoxide gas Metabolic acidosis caused by inhalation poisonous gas hydrogen cyanide Full thickness burn to the chest cause mechanical block of the rib movement