The document provides information about burns (quemaduras), including their causes, pathophysiology, assessment, and complications. It discusses the priorities in the initial assessment of a burn patient, which are the airway, stopping the burning process, and establishing intravenous access. It also covers burn classification based on extent, depth, location, and severity. The pathophysiology of burns includes local alterations like the zones of Jackson and systemic alterations. Complications mentioned include circulatory issues in burned areas that can lead to compartment syndrome.

1. QUEMADURAS
Stephanie Y. Ponce
20151030974

2. Las quemaduras son lesiones de piel y/o
mucosas provocadas por agentes físicos,
químicos o biológicos; dependiendo de sus
características será el manejo brindado.
¿Qué es una
Quemadura?

4. FUNCIONES DE LA PIEL
PROTECCIÓN TERMORREGULACIÓN
BALANCE
HIDROELECTROLÍTICO
SENSORIAL
01
03
02
04

5. PRINCIPIOS BÁSICOS DE LA
REANIMACIÓN INICIAL
VÍA AÉREA
Sospecha de compromiso de
la V.A x inhalación de humo +
edema x quemadura
LESIONES MX
Identificarlas y manejarlas
CONTROLAR T° AMBIENTE
Alejar al px de ambiente
perjudicial
ESTABILIDAD
HEMODINÁMICA
Con volumen

6. > SUPERFICIE = > INFLAMACIÓN
> PROFUNDIDAD

7. REVISIÓN PRIMARIA
03

8. ¿Cuál es la
Prioridad?

9. PRIMERA PRIORIDAD
Vía aérea Acceso
intravenoso
Detener el
proceso de
quemadura

10. 1. VÍA AÉREA
Las quemaduras pueden producir
edema (por quemadura) de la vía
superior o causar lesión directa
(inhalación), causando un riesgo de
obstruir.

11. REVISIÓN PRIMARIA
1.a Vía aérea
Asegurar la vía aérea de forma temprana.
1.b Ventilación:
● Hipoxia
● Envenenamiento por monóxido de
carbono
● Daño por inhalación de humo

12. Factores que ↑ el riesgo de obstrucción
de la VAS:
1.
Aumento de tamaño y
profundidad de las
quemaduras.
2.
Quemaduras de cabeza y
cuello, boca
3.
Trauma asociado

13. INDICACIONES CLÍNICAS DE LESIÓN POR
INHALACIÓN
● Antecedentes de confusión mental y/o encierro en un ambiente en llamas
● Quemaduras faciales o en el cuello
● Quemaduras de las cejas y vibrisas nasales
● Depósitos carbonáceos y cambios inflamatorios agudos en la orofaringe
● Dificultad para deglutir
● Signos de compromiso respiratorio (esputo carbonáceo, fatiga respiratoria,
oxigenación/ventilación deficientes)
● Signos de obstrucción de la VA (ronquera, estridor, uso de m. accesorios)
● SCQT >40-50%
● Explosión con quemaduras en la cabeza y en el torso
● Niveles de carboxihemoglobina >10% en un paciente víctima de un incendio

15. VENTILACIÓN INADECUADA:
HIPOXIA INHALACIÓN X
HUMO
MONOXIDO DE
CARBONO

16. ¿Cómo solucionarlo?
 flujo alto de O2: la vida ½ de HbCO es de 4h en promedio, pero con O2 a alto
flujo de 4-6h se reduce a +/- 40 min
 Colocar tubo endotraqueal de grosor adecuado
• 7.5mm en adultos
• 4.5mm en niños
 Gases arteriales: estarán alterados, por eso se obtienen primero niveles
basales de HbCO y administrar O2 al 100%

17. INTOXICACIÓN POR MONÓXIDO DE CARBONO
Cefalea y náuseas
(20-30%)
Confusión
(30-40%)
Coma
(40-60%)
Muerte
(> 60%)
01
03
02
04

19. 2. DETENER EL PROCESO DE
LA QUEMADA
• Se debe quitar toda la ropa.
• Se debe lavar las aéreas superficiales del
cuerpo con abúndate agua tibia o SSN
tibia
• Cubrir al paciente con cobertores limpios
y secos

20. 3. ACCESO INTRAVENOSO
• Se deben reemplazar las pérdidas continuas
de fuga capilar por la inflamación
• Mas del 20% de SCQ requiere reanimación
con volumen.
• Vía IV de grueso calibre.
• Utilizar miembros superiores.
• Lactato Ringer

21. ¿Cómo solucionarlo?
 Canalizar 2 venas perifericas con cateter corto y grueso (>18 gauge)
 Si no se puede en piel no quemada, intentar en piel Quemada
 Se prefiere las extremidades superiores a las inferiores (↑ riesgo de flebitis y
flebitis séptica)
 Si no se puede con venas periféricas, intentar con acceso venoso central o IO
 Usar lactate de ringer
 Monitorizar con sonda vesical el gasto urinario en px quemados

22. REVISIÓN PRIMARIA
3. Circulación
● Se deben administrar líquidos
● Medición de la diuresis
● Colocación de sonda vesical
● Lactato de ringer
2-4ml de LR x Kg x %SCQ
* Iniciar con 2 ml

23. REVISIÓN PRIMARIA
2-4ml de LR x Kg x %SCQ
• Iniciar con 2 ml
• ½ en primeras 8h a 1000ml x h
• ½ en las siguientes 16h
• Diuresis: 0.5ml/kg/h

28. EVALUACIÓN DEL PACIENTE
HISTORIA
• AMPLiA
PROFUNDIDAD
DE
QUEMADURAS
SCQT

30. CAUSAS DE QUEMADURAS
LLAMA ESCALDADURA
CONTACTO ELECTRICIDAD
QUÍMICA
A B
D C
E

32. FISIOPATOLOGÍA
01

33. FISIOPATOLOGÍA
ALTERACIONES
LOCALES
ALTERACIONES
SISTÉMICAS

34. ZONAS DE JACKSON
CENTRAL
O
COAGULACIÓN
• Células se dañan y
producen necrosis
tisular
PERIFÉRICA
O
HIPEREMIA
• Vasodilatación
arteriolar secundaria
INTERMEDIA
O
ESTASIS
• Lesión vascular
• Extravasación de sangre
• Isquemia por
vasoconstricción arteriolar

38. EDADES IMPORTANTES
<5 AÑOS >60 AÑOS

39. CLASIFICACIÓN SEGÚN:
EXTENSIÓN
Determinación del tamaño de la
quemadura.
PROFUNDIDAD
Relacionado al alcance de la
lesión.
LOCALIZACIÓN
Considerar el compromiso de
unidades estético funcionales o
especiales.
GRAVEDAD
Funcional, estética, psiquíca o
vital.
01
03
02
04

40. 2. EXTENSIÓN

41. El cuerpo se puede dividir en 9 partes o en
múltiplos de 9 y a partir de ahí se puede calcular
el porcentaje de quemadura, por ello conocida
también como la regla de los 9.
REGLA DE
WALLACE

44. ÁREA DE LA
MANO

45. PROFUNDIDAD

46. PRIMER GRADO
● Dolorosas
● Eritematosas
● palidecen al contacto
● con una barrera epidérmica intacta
● No forman vesículas.
Ej: quemaduras solares o pequeñas escaldaduras.

47. SEGUNDO GRADO
B1 Superficiales:
● Eritematosas
● Dolorosas
● palidecen al contacto
● forman ampollas.
● Se reepitelizan de manera espontánea en 1-2sem. Ej:
agua demasiado caliente de la bañera y las quemaduras
por llamas súbitas.

48. SEGUNDO GRADO
B2 Profundas:
● alcanzan la dermis reticular
● son blanquecinas
● Moteadas
● no palidecen al contacto
● conservan la sensibilidad dolorosa al explorarlas con
aguja.
● Curan en 2-5sem.

49. TERCER GRADO
● escara dura
● coriácea
● Indolora
● color negro, blanco o rojo intenso
● No queda ningún apéndice dérmico ni epidérmico
● cicatrizan por reepitelización procedente de los bordes de
la herida.

50. CUARTO GRADO
● Afecta a otros órganos además de la piel,
como músculo, hueso o cerebro.

52. QUEMADURAS QUÍMICAS QUEMADURAS ELÉCTRICAS
• Son causadas por exposición a ácidos,
a álcalis y a derivados del petróleo.
• Remover la sustancia química
rápidamente y dar atención inmediata
a la herida.
• Dependen de:
a) La duración del contacto .
b) La concentración de la sustancia
química.
c) La cantidad del agente.
• El cuerpo puede servir como volumen
conductor de energía.
• Necrosis muscular profunda
• Arritmias

53. REVISIÓN
SECUNDARIA
04

54. REVISIÓN SECUNDARIA
● Examen físico
● Documentación
● Determinaciones basales
● Circulación periférica en quemaduras
●Colocación de sonda nasogástrica
●Narcóticos analgésicos y sedantes
●Cuidados de herida
●Antibióticos
●Tetanos

55. COMPLICACIONES
04

56. Circulación periférica en quemaduras:
1. Desarrollar síndrome compartimental.
Signos:
a)Incremento del dolor con los movimientos pasivos
b) Tensión
c) Entumecimiento
d) Disminución del pulso distal

57. TABLE OF CONTENTS
INTRODUCTION
You can describe the topic of the
section here
ABOUT THE DAY
You can describe the topic of the
section here
FIREFIGHTER’S WORK
You can describe the topic of the
section here
INFORMATION EXTRA
You can describe the topic of the
section here
01
03
02
04

58. You can enter a subtitle here if you need it
INTRODUCTION
01

59. You can give a brief description of the topic you
want to talk about here. For example, if you want
to talk about Mercury, you can say that it’s the
smallest planet in the entire Solar System
¿Qué es una
Quemadura?

60. This can be the part of the presentation where
you introduce yourself, write your email…
WHOA!

61. —SOMEONE FAMOUS
“This is a quote, words full of wisdom
that someone important said and
can make the reader get inspired.”

62. 4TH MAY
Firefighters’ day celebration!

63. You can enter a subtitle here if you need it
ABOUT THE DAY
02

64. HISTORY OF THIS DAY
2010 2015 2020 2022
VENUS
Venus is the second
planet from the Sun
SATURN
Saturn is composed
of hydrogen gas
MARS
Despite being red,
Mars is actually cold
NEPTUNE
Neptune is very far
from the Sun

65. HOW DID IT START?
Do you know what helps you make your point
crystal clear?
Lists like this one:
● They’re simple
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● You’ll never forget to buy milk!
And the most important thing: the audience won’t
miss the point of your presentation

66. HOW IS IT CELEBRATED?
MERCURY
It’s the closest planet to the Sun and the
smallest in the Solar System
MARS
Despite being red, Mars is actually a cold
place. It’s full of iron oxide dust
VENUS
Venus has a beautiful name and is the
second planet from the Sun

67. AWESOME
WORDS

68. A PICTURE IS
WORTH A
THOUSAND WORDS

69. A PICTURE ALWAYS
REINFORCES
THE CONCEPT
Images reveal large amounts of data, so
remember: use an image instead of a long
text. Your audience will appreciate it

70. You can enter a subtitle here if you need it
FIREFIGHTERS’ WORK
03

71. Jupiter is the biggest planet
in the Solar System
FIREFIGHTER DUTIES
RESCUE
Mercury is the smallest
planet in the Solar System
FIRE
SUPPRESSION
Venus is the second planet
from the Sun
FIRE PREVENTION MEDICAL CARE
Saturn is composed of
hydrogen and helium
EMERGENCY
Despite being red, Mars is
actually a cold place
MENTORING
Neptune is the farthest planet
from the Sun

72. FISIOPATOLOGÍA
ALTERACIONES
LOCALES
ALTERACIONES
SISTÉMICAS

73. Jupiter is the biggest
planet in the Solar System
TYPES OF FIRE
MERCURY
Mercury is the smallest
planet in the Solar System
VENUS
Venus is the second planet
from the Sun
JUPITER MARS
Despite being red, Mars is
actually a cold place
NEPTUNE
Neptune is the farthest
planet from the Sun
A B
D C
E

74. LIST OF THEIR EQUIPMENT
EQUIPMENT DESCRIPTION WHAT IS IT FOR
HYDRAULIC TOOLS
Mercury is the smallest
planet in the Solar System
Rescue
HALLIGAN BAR
Jupiter is the biggest planet
in the Solar System
Firefighting
BUNKER GEAR
Despite being red, Mars is
actually a cold place
Medical attention
HELMET
Saturn is composed of
hydrogen and helium
Rescue

75. UTILITY OF THEIR EQUIPMENT
Jupiter is the biggest
planet of them all
JUPITER
SATURN
Saturn is composed
of hydrogen gas
MARS
Mars is actually a
very cold place
03
02
01
SATURN
Saturn is composed of
hydrogen and helium
VENUS
Venus has a beautiful
name but it’s very hot
NEPTUNE
Neptune is the farthest
planet from the Sun
06
05
04

76. HOW TO BECOME A FIGHTER?
JUPITER
Jupiter is the biggest planet
in the Solar System
MARS
Despite being red, Mars is
actually a cold place
NEPTUNE
Neptune is the farthest
planet from the Sun

77. 333,000
The Sun’s mass compared to Earth’s
386,000 km
Distance between Earth and the Moon

78. You can enter a subtitle here if you need it
EXTRA
INFORMATION
04

79. Jupiter is the biggest planet in
the Solar System
FIREFIGHTERS LONG TERM HEALTH RISKS
CARDIO DISEASE
Mercury is the smallest planet
in the Solar System
CANCER
Venus is the second planet
from the Sun
MENTAL STRESS HEARING LOSS
Saturn is composed of
hydrogen and helium

80. THIS IS A GRAPH
SATURN
Saturn is composed of
hydrogen and helium
MARS
Despite being red, Mars is
actually a cold place
NEPTUNE
Neptune is the farthest
planet from the Sun
Follow the link in the graph to modify its data and then
paste the new one here. For more info, click here
50%
10%
40%

81. FIREFIGHTERS’ RANKS
Mars is full of
iron oxide
dust clouds
Venus is the
second planet
in the system
Saturn is the
planet with
many rings
VENUS
SATURN MARS
FIREFIGHTERS
Despite being
red, Mars is a
cold planet
Venus is hot,
even hotter
than Mercury
Saturn is
made of
hydrogen gas

82. THIS IS A MAP
It’s the closest
planet to the Sun
MERCURY
Venus is the second
planet from the Sun
VENUS
Saturn is the planet
with rings
SATURN

83. 20%
Despite being red, Mars is
very cold
40%
Mercury is a very small
planet in the system
30%
Saturn is the planet with
many rings
10%
Jupiter is the biggest
planet of all

84. OUR TEAM
PETER DOE
You can speak a bit about
this person here
SARAH BONES
You can speak a bit about
this person here
TIMMY JIMMY
You can speak a bit about
this person here

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