This document provides information on burn injuries and their management. It discusses the causes and types of burns, assessment of burn depth and severity, fluid shifts that occur after burns, and the emergent, acute, and rehabilitative phases of burn injury and treatment. Key aspects of burn management include wound care, infection prevention, fluid resuscitation based on burn size, nutritional support, and rehabilitation of mobility and body image.
This document provides information on burns, including definitions, types, classification, pathophysiology, assessment, and management. It defines burns as thermal injuries to the skin and tissues. Burns are classified based on depth and extent of damage. First and second degree burns involve the epidermis and dermis, while third degree burns extend deeper. Burn severity is also classified according to percentage of total body surface area affected. Management involves fluid resuscitation, wound care, pain control, and nutrition support. Complications can impact various organ systems. The goal is to prevent infection, contractures, and other issues through proper acute care and rehabilitation.
The document discusses burns, including definitions, causes, classifications, assessment, and management. Burns are injuries caused by heat, chemicals, electricity, or radiation. They can range from superficial to full thickness. Assessment involves determining burn severity and extent using methods like the Rule of Nine. Management consists of three phases - emergent, acute, and rehabilitation. The emergent phase focuses on fluid resuscitation to prevent shock based on established formulas.
This document discusses the pathophysiology and immediate care of burn injuries. It covers how burns damage the skin and can also affect the airway/lungs through inhalation of hot gases. Major metabolic effects include carbon monoxide poisoning and circulatory changes like fluid shifts from blood vessels into burned tissue. Immediate care focuses on airway control, respiratory support, fluid resuscitation based on burn size, and wound assessment to determine depth. Superficial and deep partial thickness burns may heal on their own while full thickness burns require skin grafts.
Smoke inhalation injury causes damage to the lungs and systemic toxicity. It occurs in 17% of burn patients and increases mortality up to 24%. Diagnosis is clinical with bronchoscopy and other tests. Treatment involves airway management, cardiovascular support, antibiotics, steroids, and treatments for carbon monoxide and cyanide poisoning. Complications include respiratory failure, infections, and long term lung damage. Prognosis depends on factors like burn severity and lung injury score. Close monitoring is needed due to the progressive nature of inhalation injury.
COPD is a chronic lung disease characterized by airflow limitation and breathing-related problems. It encompasses chronic bronchitis and emphysema. The main risk factor is cigarette smoking, which causes an inflammatory response and destruction of lung tissue over time. Symptoms include cough, sputum production, shortness of breath, and wheezing. Diagnosis involves pulmonary function tests and chest imaging. Treatment focuses on smoking cessation, bronchodilators, corticosteroids, oxygen therapy, breathing exercises, and managing exacerbations.
This document provides information on the management of patients with burns. It defines burns and classifies them based on etiology, depth and extent. It describes the epidemiology of burns in India. The pathophysiology of burns involves cell lysis, increased capillary permeability and systemic inflammatory response. Management involves three phases - emergent, acute and rehabilitative. The emergent phase focuses on airway protection, fluid resuscitation using Parkland formula and monitoring for adequacy. Wound care and prevention of infection are addressed in the acute phase.
This document discusses the classification, pathophysiology, and treatment of burn injuries. It classifies burns as superficial, partial thickness, or full thickness based on the depth of skin layer involvement. The major priorities in treatment are fluid resuscitation to prevent shock, wound management, infection prevention, and pain control. Treatment involves three stages - the emergent/resuscitative stage to restore circulating volume, the acute phase focusing on wound healing and nutrition, and the rehabilitative stage to prevent scarring and restore function. Infection is a leading cause of death, so careful monitoring for signs of infection is important.
The document discusses different types of burns including thermal, chemical, and electrical burns. It describes how burns are assessed based on depth and percentage of total body surface area affected. First, second, and third degree burns are defined based on the level of skin layers involved. Complications from burns can include fluid shifts causing hypovolemia, infection, and multi-organ dysfunction. Burn management involves wound assessment, fluid resuscitation to address fluid imbalances, and treatment depending on severity.
This document provides information on burns, including definitions, types, classification, pathophysiology, assessment, and management. It defines burns as thermal injuries to the skin and tissues. Burns are classified based on depth and extent of damage. First and second degree burns involve the epidermis and dermis, while third degree burns extend deeper. Burn severity is also classified according to percentage of total body surface area affected. Management involves fluid resuscitation, wound care, pain control, and nutrition support. Complications can impact various organ systems. The goal is to prevent infection, contractures, and other issues through proper acute care and rehabilitation.
The document discusses burns, including definitions, causes, classifications, assessment, and management. Burns are injuries caused by heat, chemicals, electricity, or radiation. They can range from superficial to full thickness. Assessment involves determining burn severity and extent using methods like the Rule of Nine. Management consists of three phases - emergent, acute, and rehabilitation. The emergent phase focuses on fluid resuscitation to prevent shock based on established formulas.
This document discusses the pathophysiology and immediate care of burn injuries. It covers how burns damage the skin and can also affect the airway/lungs through inhalation of hot gases. Major metabolic effects include carbon monoxide poisoning and circulatory changes like fluid shifts from blood vessels into burned tissue. Immediate care focuses on airway control, respiratory support, fluid resuscitation based on burn size, and wound assessment to determine depth. Superficial and deep partial thickness burns may heal on their own while full thickness burns require skin grafts.
Smoke inhalation injury causes damage to the lungs and systemic toxicity. It occurs in 17% of burn patients and increases mortality up to 24%. Diagnosis is clinical with bronchoscopy and other tests. Treatment involves airway management, cardiovascular support, antibiotics, steroids, and treatments for carbon monoxide and cyanide poisoning. Complications include respiratory failure, infections, and long term lung damage. Prognosis depends on factors like burn severity and lung injury score. Close monitoring is needed due to the progressive nature of inhalation injury.
COPD is a chronic lung disease characterized by airflow limitation and breathing-related problems. It encompasses chronic bronchitis and emphysema. The main risk factor is cigarette smoking, which causes an inflammatory response and destruction of lung tissue over time. Symptoms include cough, sputum production, shortness of breath, and wheezing. Diagnosis involves pulmonary function tests and chest imaging. Treatment focuses on smoking cessation, bronchodilators, corticosteroids, oxygen therapy, breathing exercises, and managing exacerbations.
This document provides information on the management of patients with burns. It defines burns and classifies them based on etiology, depth and extent. It describes the epidemiology of burns in India. The pathophysiology of burns involves cell lysis, increased capillary permeability and systemic inflammatory response. Management involves three phases - emergent, acute and rehabilitative. The emergent phase focuses on airway protection, fluid resuscitation using Parkland formula and monitoring for adequacy. Wound care and prevention of infection are addressed in the acute phase.
This document discusses the classification, pathophysiology, and treatment of burn injuries. It classifies burns as superficial, partial thickness, or full thickness based on the depth of skin layer involvement. The major priorities in treatment are fluid resuscitation to prevent shock, wound management, infection prevention, and pain control. Treatment involves three stages - the emergent/resuscitative stage to restore circulating volume, the acute phase focusing on wound healing and nutrition, and the rehabilitative stage to prevent scarring and restore function. Infection is a leading cause of death, so careful monitoring for signs of infection is important.
The document discusses different types of burns including thermal, chemical, and electrical burns. It describes how burns are assessed based on depth and percentage of total body surface area affected. First, second, and third degree burns are defined based on the level of skin layers involved. Complications from burns can include fluid shifts causing hypovolemia, infection, and multi-organ dysfunction. Burn management involves wound assessment, fluid resuscitation to address fluid imbalances, and treatment depending on severity.
The initial resuscitation of the burn patient in icuGhaleb Almekhlafi
This document discusses advances in burn care over the last 50 years that have improved survival rates and reduced morbidity and mortality. Key factors contributing to improved outcomes include developments in resuscitation protocols, respiratory support, infection control, early burn wound closure, and early enteral nutrition. The document then provides guidance on various aspects of burn patient management and treatment, including vascular access, monitoring, resuscitation formulas and endpoints, wound management, pain management, and nutrition.
The document discusses different types of burn injuries including thermal, chemical, smoke inhalation, and electrical burns. It describes the pathophysiology and clinical manifestations in the emergent and acute phases after a burn. Key aspects are fluid and electrolyte shifts leading to shock in the emergent phase and wound healing through debridement, grafting, and rehabilitation in the acute phase. Complications include infection and contractures.
Inhalation injury occurs when toxic gases or smoke are inhaled, potentially causing thermal or chemical damage to the upper and lower airways. This can lead to higher fluid needs, longer ventilation times, pneumonia risk, and acute respiratory distress syndrome. Diagnosis involves considering exposure history and examining for soot or burns, with tools like bronchoscopy and imaging. Management focuses on airway support through ventilation, suctioning, and bronchodilators to prevent obstruction. Targeted therapies aim to reduce inflammation and infection while systemic toxicology addresses issues like carbon monoxide poisoning.
The document discusses emergency management of burns. It provides information on common causes of burns, pathophysiology involving initial and secondary tissue damage, burn wound classification models, and initial management following the EMSB (airway, breathing, circulation, disability, exposure, fluids) protocol. Key points include fluid resuscitation using the Parkland formula, monitoring for signs of circulatory obstruction in limbs, considering escharotomy if needed, and criteria for burn patient transfer to a specialized burn unit.
This document provides information on burns, including:
- The definition and causes of burns including thermal, electrical, chemical and radiation burns.
- The degrees of burns from first to fourth degree based on depth of tissue damage.
- Methods for estimating the percentage of total body surface area burned including the Rule of Nines.
- Criteria for burn admission to hospital care based on factors like surface area, depth and location of burns.
- Complications that can result from severe burns like infection, shock and organ damage.
- The importance of first aid like cooling the burned area in water to minimize further tissue injury.
This document discusses different types of burns including thermal, chemical, electrical, and radiation burns. It describes how burns are assessed based on depth and extent of body surface area involved. First, second, and third degree burns are defined. Fluid imbalances that can occur with burns are also outlined. The phases of burn injuries - emergent, acute, and rehabilitative - are summarized along with goals, nursing interventions, and considerations for each phase. Wound care including dressing changes and skin grafting is also covered at a high level.
BURNS MANAGEMENT PPT BY DR SUJITH CHADALA MD GEN MED , PGPC , IDCCMDr Sujith Chadala
Dr. Sujith Chadala provides definitions and information about different types of burns. Thermal burns are caused by dry heat, moist heat, smoke or inhalation and result in coagulative necrosis of tissue. The extent of damage from thermal burns depends on temperature, amount of heat and duration of exposure. After a burn, the body undergoes pathophysiological changes including fluid shifts from blood vessels into tissue, metabolic changes causing a hypermetabolic state, and suppressed immune responses increasing infection risk. The body's response involves an emergent phase of pain and increased heart rate, a fluid shift phase of up to 24 hours, and a hypermetabolic phase lasting days to weeks during which nutrient needs increase for repair.
This document discusses burn management and resuscitation. Effective fluid resuscitation is critical for burn patients and aims to prevent shock through formulas like the Parkland formula. The goals of resuscitation are to provide enough fluid replacement to maintain perfusion without causing fluid overload. Infection is a major risk for burn patients, so central venous catheters should be changed regularly to minimize bloodstream infections.
This document provides guidance on transport considerations for burned patients. It discusses burn classification, initial resuscitation, and fluid management. Burns are classified based on depth and percentage of total body surface area affected. The Parkland formula is commonly used to calculate initial fluid resuscitation, with 4 ml of lactated Ringer's solution per kg of body weight per percentage of burn over 24 hours. Accurate assessment of burn size and depth is important for determining fluid needs. Complications like edema formation, systemic inflammatory response, and hypothermia are also addressed.
This document provides an overview of burns, including:
- Definitions of burns as injuries caused by heat, chemicals, electricity or radiation.
- The pathophysiology of burns, including the zones of injury and systemic responses affecting the kidneys, gut and lungs.
- Classification of burns by depth, extent of body surface area burned, and mechanism.
- Common complications of burns like infection, pulmonary issues, and metabolic and fluid shifts.
- The goal of fluid resuscitation to maintain circulation and protocols like the Parkland formula for calculating fluid needs.
The document summarizes the pathophysiology of burns in three phases. The initial ebb phase occurs in the first 24 hours and involves hypotension, low cardiac output, and hypoventilation. The flow phase follows and involves increases in cardiac output and oxygen consumption. A hypermetabolic hyperdynamic response peaks at 10-14 days. Systemic effects include metabolic, cardiac, renal, blood, immunologic, lung, GI, and infectious responses. Burn-induced inflammatory mediators cause widespread vascular permeability and organ dysfunction. Successful resuscitation is needed to avoid multi-organ failure from hypovolemia and infection risk due to impaired immunity and skin barrier function.
This document discusses preoperative considerations for burn patients. It covers challenges in burn anesthetic management including airway issues, pulmonary insufficiency, and altered drug responses. Major preoperative considerations include assessing burn depth, extent, and mechanism. Airway management is crucial given risks of obstruction and inhalation injury. Aggressive resuscitation is needed to treat burn shock and edema formation. The Parkland formula is commonly used to calculate fluid resuscitation needs. Metabolic derangements after major burns can cause cardiovascular issues and loss of temperature regulation.
This document summarizes various physiological alterations that can occur after a burn injury. It notes that burn injuries can cause coagulation necrosis of skin and tissues, releasing vasoactive peptides and altering capillary permeability. This leads to fluid shifts, decreased cardiac output, renal blood flow and oxygen delivery to tissues. Ultimately, this can result in systemic inflammatory response syndrome, multi-organ dysfunction syndrome, shock and infection across multiple organ systems like the lungs, kidneys and gastrointestinal tract. The burn also impairs the skin barrier and immune function, increasing risks of infection and sepsis. Other issues include thermoregulatory failure, metabolic changes like hypermetabolism and acidosis.
The document discusses burns, including:
1. The structure of skin and how burns damage the epidermis and dermis layers.
2. The main causes of burns are thermal, chemical, inhalation, electric, and radiation burns.
3. Burn classification includes depth, extent, location, and patient risk factors which determine prognosis.
4. Burn management has three phases - emergent, acute, and rehabilitative - and the emergent phase focuses on airway management, IV fluids, wound care, drugs, and nutrition to stabilize the patient.
Carl Wilhelm Scheele discovered oxygen in 1773. John Pristley and Antoine Lavoisier further studied oxygen. Oxygen is essential for aerobic metabolism and production of ATP in cells. Hypoxia refers to low oxygen levels in tissues while hypoxemia refers to low blood oxygen levels. The partial pressure of oxygen decreases from the alveoli to the tissues in the "oxygen cascade". Oxygen therapy aims to correct hypoxemia, decrease hypoxic symptoms, and reduce cardiovascular workload. Low-flow oxygen delivery systems like nasal cannulas provide diluted oxygen while high-flow systems like venturi masks provide consistent inspired oxygen. Oxygen therapy must balance addressing hypoxemia while avoiding oxygen toxicity from overuse.
1. Burn management involves rescuing and resuscitating the patient, then focusing on wound care, prevention of complications, and rehabilitation.
2. Key principles include airway management, fluid resuscitation, wound cleaning and coverage, nutrition, and physiotherapy.
3. Burn care proceeds through emergent, acute, and rehabilitation phases, with priorities like fluid resuscitation in the initial phase and wound closure in later phases.
This document discusses the current role of hyperbaric oxygen therapy (HBOT). It begins by explaining the mechanisms of HBOT, including how it increases oxygen delivery to tissues and reduces gas bubble size. It then describes the techniques used, including chamber pressures and treatment durations. The document outlines the contraindications and complications of HBOT. It concludes by describing the clinical uses of HBOT for conditions like carbon monoxide poisoning, decompression sickness, traumatic injuries, radiation injury, infections, and non-healing wounds.
The skin is the largest organ of the body. It protects the body from microbes, regulates temperature, and allows for sensation. The skin has three layers - the epidermis, dermis, and subcutaneous tissue. Burns are injuries caused by heat, chemicals, electricity or radiation and are classified based on depth and extent of damage. Burn management involves emergent care to address life threats, the acute phase during wound healing, and rehabilitation to address scarring and return the patient to normal activities.
This document discusses burn injuries and their management. It covers the types and causes of burns, assessment of burn severity, fluid shifts that occur after burns, phases of burn injury including emergent, acute and rehabilitative, wound care including dressing changes and skin grafts, and nursing considerations such as monitoring for infection and maintaining nutrition and mobility. Burn injuries can lead to complications affecting many body systems and require careful ongoing assessment and treatment.
The document discusses burn injuries and their management. It describes the causes and types of burns including thermal, chemical, electrical, and radiation burns. It covers burn wound assessment including classifying burns by depth and percentage of total body surface area affected. The phases of burn injuries are discussed including the emergent, acute, and rehabilitative phases. Key aspects of management are covered such as fluid resuscitation and shifts, infection prevention and signs, wound care including debridement and dressings, and skin grafting.
The initial resuscitation of the burn patient in icuGhaleb Almekhlafi
This document discusses advances in burn care over the last 50 years that have improved survival rates and reduced morbidity and mortality. Key factors contributing to improved outcomes include developments in resuscitation protocols, respiratory support, infection control, early burn wound closure, and early enteral nutrition. The document then provides guidance on various aspects of burn patient management and treatment, including vascular access, monitoring, resuscitation formulas and endpoints, wound management, pain management, and nutrition.
The document discusses different types of burn injuries including thermal, chemical, smoke inhalation, and electrical burns. It describes the pathophysiology and clinical manifestations in the emergent and acute phases after a burn. Key aspects are fluid and electrolyte shifts leading to shock in the emergent phase and wound healing through debridement, grafting, and rehabilitation in the acute phase. Complications include infection and contractures.
Inhalation injury occurs when toxic gases or smoke are inhaled, potentially causing thermal or chemical damage to the upper and lower airways. This can lead to higher fluid needs, longer ventilation times, pneumonia risk, and acute respiratory distress syndrome. Diagnosis involves considering exposure history and examining for soot or burns, with tools like bronchoscopy and imaging. Management focuses on airway support through ventilation, suctioning, and bronchodilators to prevent obstruction. Targeted therapies aim to reduce inflammation and infection while systemic toxicology addresses issues like carbon monoxide poisoning.
The document discusses emergency management of burns. It provides information on common causes of burns, pathophysiology involving initial and secondary tissue damage, burn wound classification models, and initial management following the EMSB (airway, breathing, circulation, disability, exposure, fluids) protocol. Key points include fluid resuscitation using the Parkland formula, monitoring for signs of circulatory obstruction in limbs, considering escharotomy if needed, and criteria for burn patient transfer to a specialized burn unit.
This document provides information on burns, including:
- The definition and causes of burns including thermal, electrical, chemical and radiation burns.
- The degrees of burns from first to fourth degree based on depth of tissue damage.
- Methods for estimating the percentage of total body surface area burned including the Rule of Nines.
- Criteria for burn admission to hospital care based on factors like surface area, depth and location of burns.
- Complications that can result from severe burns like infection, shock and organ damage.
- The importance of first aid like cooling the burned area in water to minimize further tissue injury.
This document discusses different types of burns including thermal, chemical, electrical, and radiation burns. It describes how burns are assessed based on depth and extent of body surface area involved. First, second, and third degree burns are defined. Fluid imbalances that can occur with burns are also outlined. The phases of burn injuries - emergent, acute, and rehabilitative - are summarized along with goals, nursing interventions, and considerations for each phase. Wound care including dressing changes and skin grafting is also covered at a high level.
BURNS MANAGEMENT PPT BY DR SUJITH CHADALA MD GEN MED , PGPC , IDCCMDr Sujith Chadala
Dr. Sujith Chadala provides definitions and information about different types of burns. Thermal burns are caused by dry heat, moist heat, smoke or inhalation and result in coagulative necrosis of tissue. The extent of damage from thermal burns depends on temperature, amount of heat and duration of exposure. After a burn, the body undergoes pathophysiological changes including fluid shifts from blood vessels into tissue, metabolic changes causing a hypermetabolic state, and suppressed immune responses increasing infection risk. The body's response involves an emergent phase of pain and increased heart rate, a fluid shift phase of up to 24 hours, and a hypermetabolic phase lasting days to weeks during which nutrient needs increase for repair.
This document discusses burn management and resuscitation. Effective fluid resuscitation is critical for burn patients and aims to prevent shock through formulas like the Parkland formula. The goals of resuscitation are to provide enough fluid replacement to maintain perfusion without causing fluid overload. Infection is a major risk for burn patients, so central venous catheters should be changed regularly to minimize bloodstream infections.
This document provides guidance on transport considerations for burned patients. It discusses burn classification, initial resuscitation, and fluid management. Burns are classified based on depth and percentage of total body surface area affected. The Parkland formula is commonly used to calculate initial fluid resuscitation, with 4 ml of lactated Ringer's solution per kg of body weight per percentage of burn over 24 hours. Accurate assessment of burn size and depth is important for determining fluid needs. Complications like edema formation, systemic inflammatory response, and hypothermia are also addressed.
This document provides an overview of burns, including:
- Definitions of burns as injuries caused by heat, chemicals, electricity or radiation.
- The pathophysiology of burns, including the zones of injury and systemic responses affecting the kidneys, gut and lungs.
- Classification of burns by depth, extent of body surface area burned, and mechanism.
- Common complications of burns like infection, pulmonary issues, and metabolic and fluid shifts.
- The goal of fluid resuscitation to maintain circulation and protocols like the Parkland formula for calculating fluid needs.
The document summarizes the pathophysiology of burns in three phases. The initial ebb phase occurs in the first 24 hours and involves hypotension, low cardiac output, and hypoventilation. The flow phase follows and involves increases in cardiac output and oxygen consumption. A hypermetabolic hyperdynamic response peaks at 10-14 days. Systemic effects include metabolic, cardiac, renal, blood, immunologic, lung, GI, and infectious responses. Burn-induced inflammatory mediators cause widespread vascular permeability and organ dysfunction. Successful resuscitation is needed to avoid multi-organ failure from hypovolemia and infection risk due to impaired immunity and skin barrier function.
This document discusses preoperative considerations for burn patients. It covers challenges in burn anesthetic management including airway issues, pulmonary insufficiency, and altered drug responses. Major preoperative considerations include assessing burn depth, extent, and mechanism. Airway management is crucial given risks of obstruction and inhalation injury. Aggressive resuscitation is needed to treat burn shock and edema formation. The Parkland formula is commonly used to calculate fluid resuscitation needs. Metabolic derangements after major burns can cause cardiovascular issues and loss of temperature regulation.
This document summarizes various physiological alterations that can occur after a burn injury. It notes that burn injuries can cause coagulation necrosis of skin and tissues, releasing vasoactive peptides and altering capillary permeability. This leads to fluid shifts, decreased cardiac output, renal blood flow and oxygen delivery to tissues. Ultimately, this can result in systemic inflammatory response syndrome, multi-organ dysfunction syndrome, shock and infection across multiple organ systems like the lungs, kidneys and gastrointestinal tract. The burn also impairs the skin barrier and immune function, increasing risks of infection and sepsis. Other issues include thermoregulatory failure, metabolic changes like hypermetabolism and acidosis.
The document discusses burns, including:
1. The structure of skin and how burns damage the epidermis and dermis layers.
2. The main causes of burns are thermal, chemical, inhalation, electric, and radiation burns.
3. Burn classification includes depth, extent, location, and patient risk factors which determine prognosis.
4. Burn management has three phases - emergent, acute, and rehabilitative - and the emergent phase focuses on airway management, IV fluids, wound care, drugs, and nutrition to stabilize the patient.
Carl Wilhelm Scheele discovered oxygen in 1773. John Pristley and Antoine Lavoisier further studied oxygen. Oxygen is essential for aerobic metabolism and production of ATP in cells. Hypoxia refers to low oxygen levels in tissues while hypoxemia refers to low blood oxygen levels. The partial pressure of oxygen decreases from the alveoli to the tissues in the "oxygen cascade". Oxygen therapy aims to correct hypoxemia, decrease hypoxic symptoms, and reduce cardiovascular workload. Low-flow oxygen delivery systems like nasal cannulas provide diluted oxygen while high-flow systems like venturi masks provide consistent inspired oxygen. Oxygen therapy must balance addressing hypoxemia while avoiding oxygen toxicity from overuse.
1. Burn management involves rescuing and resuscitating the patient, then focusing on wound care, prevention of complications, and rehabilitation.
2. Key principles include airway management, fluid resuscitation, wound cleaning and coverage, nutrition, and physiotherapy.
3. Burn care proceeds through emergent, acute, and rehabilitation phases, with priorities like fluid resuscitation in the initial phase and wound closure in later phases.
This document discusses the current role of hyperbaric oxygen therapy (HBOT). It begins by explaining the mechanisms of HBOT, including how it increases oxygen delivery to tissues and reduces gas bubble size. It then describes the techniques used, including chamber pressures and treatment durations. The document outlines the contraindications and complications of HBOT. It concludes by describing the clinical uses of HBOT for conditions like carbon monoxide poisoning, decompression sickness, traumatic injuries, radiation injury, infections, and non-healing wounds.
The skin is the largest organ of the body. It protects the body from microbes, regulates temperature, and allows for sensation. The skin has three layers - the epidermis, dermis, and subcutaneous tissue. Burns are injuries caused by heat, chemicals, electricity or radiation and are classified based on depth and extent of damage. Burn management involves emergent care to address life threats, the acute phase during wound healing, and rehabilitation to address scarring and return the patient to normal activities.
This document discusses burn injuries and their management. It covers the types and causes of burns, assessment of burn severity, fluid shifts that occur after burns, phases of burn injury including emergent, acute and rehabilitative, wound care including dressing changes and skin grafts, and nursing considerations such as monitoring for infection and maintaining nutrition and mobility. Burn injuries can lead to complications affecting many body systems and require careful ongoing assessment and treatment.
The document discusses burn injuries and their management. It describes the causes and types of burns including thermal, chemical, electrical, and radiation burns. It covers burn wound assessment including classifying burns by depth and percentage of total body surface area affected. The phases of burn injuries are discussed including the emergent, acute, and rehabilitative phases. Key aspects of management are covered such as fluid resuscitation and shifts, infection prevention and signs, wound care including debridement and dressings, and skin grafting.
This document discusses burn injuries and their management. It covers types of burns including thermal, chemical, electrical, and radiation burns. It describes assessing burn wounds based on depth and extent of body surface area involved. Superficial, deep, and full thickness burns are defined. Methods for calculating burned body surface area using Lund and Browder charts or the rule of nines are provided. Vascular, fluid, and metabolic changes resulting from burns are outlined. The phases of burn injuries including emergent, acute, and rehabilitative are summarized. Key aspects of managing burns such as wound care, fluid resuscitation, and monitoring for infection are highlighted.
The presentation is about the definition and type of burns classification and total body surface area involved. Fluid therapy in adults and children. Various formulae of calculating fluid requirement.
Protocols for burn centre management and critical care. Most elaborated description of burn management. Latest guidelines and Protocols, relevant investigation and management.
1) Burns can result from direct contact with flames, hot liquids, gases, chemicals, electricity, or radiation. They cause tissue injuries by denaturing proteins.
2) Burn injuries affect the skin, which acts as a protective barrier and regulates temperature and fluid balance. Deeper burns extend beyond the epidermis into the dermis.
3) Proper evaluation and treatment of burn injuries requires assessing burn depth, size, inhalation injury, and associated complications affecting various organ systems. Early fluid resuscitation is critical.
The document provides information on the management of burn injuries. It discusses goals of treatment which include preventing complications and maintaining vital signs. It also covers classifications of burns based on depth and surface area affected. Treatment involves fluid resuscitation, wound care including debridement and dressings, pain management, and skin grafts if needed. Complications can include shock, anemia, and renal or liver failure.
1) Burns can result from heat, chemicals, electricity, or radiation and cause damage to the skin and underlying tissues. The very young, old, and careless are at high risk of severe burns.
2) Initial burn management involves assessing the airway, giving oxygen, establishing IV access, giving fluids resuscitation based on the Parkland formula, monitoring vitals and urine output, and giving pain medications.
3) Providing anesthesia for burn patients poses challenges due to potential airway issues, pulmonary insufficiency, fluid shifts, and altered drug metabolism. Careful attention to the airway, adequate vascular access and fluid resuscitation, temperature control, and effects of medications are important.
Anesthesia management for burn patient.pdfDagnew Adugna
This document discusses the anesthetic management of burn patients, focusing on pathophysiological changes, airway management challenges, fluid resuscitation, and the critical role of the anesthesia team. It covers topics such as evaluating the extent of burn injuries, managing inhalation injuries, securing vascular access, and maintaining thermoregulation. Special consideration is given to techniques like fiberoptic intubation and intraosseous access that can optimize care for severely burned patients undergoing anesthesia.
This document provides information on the pathophysiology and treatment of burns. It discusses the local and systemic effects of burns including cardiovascular, renal, pulmonary, gastrointestinal and immune responses. It describes methods of assessing burn severity including depth of burn and percentage of total body surface area burned. Treatment involves fluid resuscitation according to the Parkland formula, wound care, infection control, nutrition and management of complications like multiorgan failure.
Burn injuries disrupt the skin and lead to fluid loss, infection, scarring and other issues. Burns are classified by depth of tissue destruction as superficial, deep partial thickness, or full thickness. Local burns under 20% TBSA cause local effects while larger burns over 20% TBSA cause systemic responses. Prevention focuses on fire, electrical, chemical and scald safety. Nursing management assesses airway, breathing, circulation, pain and fluid balance, with priorities of maintaining these functions and preventing complications like infection.
This document discusses different types of burns including thermal, chemical, electrical, and cold burns. It describes the pathophysiology of burns and inhalation injuries. Burn depth is classified as superficial, partial thickness, or full thickness. Burn management involves fluid resuscitation, airway management, infection prevention, wound care including debridement and grafting, nutrition support, and rehabilitation. Complications can include hypovolemic shock, respiratory issues, infections, and scarring/contractures. The goals are to restore fluid and electrolyte balance, support healing, and help patients resume normal activities and lifestyle.
Burns are injuries caused by heat, chemicals, electricity or radiation. They can occur at any age and socioeconomic group. Thermal burns result from flame, hot liquids or objects, while chemical burns are caused by strong acids or alkalis. Electrical burns occur from electricity passing through the body. Radiation burns come from exposure to radiation sources. Burns are classified by depth and extent of body surface area affected. Management involves cooling the wound, establishing airways, fluid resuscitation, and calculating fluid needs using formulas based on total body surface area burned. The goal is adequate circulation and urine output to prevent shock.
This document discusses the anesthetic management of burns. It covers the pathophysiology of burns including the zones of burn injury and complications like inhalation injury. It describes the severity classification of burns and guidelines for fluid resuscitation. Anesthetic concerns in burns include difficult airway management due to facial burns, vascular access issues, temperature control, and fluid management. Drugs may have unpredictable responses due to reduced plasma proteins. Regional anesthesia can be used but general anesthesia is more common, requiring careful monitoring and management of respiratory and hemodynamic parameters.
This document discusses the anatomy, physiology, and management of burn injuries. It begins with classifications of burns according to causative agent, depth, and extent. It then covers the pathophysiology of local and systemic effects of burns. Management is described in three phases: emergent, acute, and rehabilitation. The emergent phase focuses on airway management, fluid resuscitation, and wound care. The acute phase emphasizes infection prevention, wound care, and nutritional support.
The document discusses the structured approach to presenting burn cases including relevant anatomy, classification of burns, complications affecting various organ systems, and the three phases of burn management with a focus on the priorities in the resuscitative phase including airway management, breathing, circulation, fluid resuscitation, and endpoints of successful resuscitation. Specific formulas for fluid resuscitation and indications for endotracheal intubation are also outlined.
This document summarizes the epidemiology, causes, management, and pathophysiology of thermal burn injuries. Some key points:
- Thermal burns are a major cause of death and disability worldwide, especially in those under 40. The average burn patient is 24 years old with 19% total body surface area burned.
- Most burns are preventable and caused by carelessness, while others result from smoking, alcohol, hot substances (2/3 of cases), and fire/flame (1/4 of cases). Major determinants of mortality include organ failure, infection, burn extent, and age/sex.
- Initial burn management focuses on stabilizing respiration, fluid resuscitation, and infection prevention
The document provides information on the management of burns, including definitions, epidemiology, classification, assessment, and treatment approaches. It describes the pathophysiology of burns and potential complications. Management involves initial first aid including cooling, fluid resuscitation proportional to burn size, regular monitoring of urine output and electrolytes, and treatment of complications as needed. Inhalational injury requires special attention and evaluation including possible bronchoscopy.
1. Burns are injuries caused by heat, cold, electricity, chemicals, friction or radiation that damage the skin and other tissues. Most burns are caused by hot liquids, solids or fire.
2. Burns are classified by depth and extent of injury. Depth is classified as partial thickness or full thickness burns. Extent looks at the total body surface area affected.
3. Management of burns involves addressing the patient's hypovolemic state, wound care, infection control and rehabilitation to address scarring and mobility issues. Complications can be both early like fluid shifts and infections or late with scarring and contractures.
This document discusses the management of burn injuries. It begins with an introduction noting that scalds are the most common burn in children from accidents with hot liquids. Classification of burns is then described based on percentage of total body surface area burned and depth of burn. Pathophysiology involves inflammation, hypovolemia, and potential inhalation injury. Assessment involves determining burn size, depth, and severity. Management involves stabilizing the airway, providing fluid resuscitation, controlling the environment, and considering surgery depending on the depth and extent of the burn. Complications can include shock, renal failure, and infection.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
Trauma Outpatient Center is a comprehensive facility dedicated to addressing mental health challenges and providing medication-assisted treatment. We offer a diverse range of services aimed at assisting individuals in overcoming addiction, mental health disorders, and related obstacles. Our team consists of seasoned professionals who are both experienced and compassionate, committed to delivering the highest standard of care to our clients. By utilizing evidence-based treatment methods, we strive to help our clients achieve their goals and lead healthier, more fulfilling lives.
Our mission is to provide a safe and supportive environment where our clients can receive the highest quality of care. We are dedicated to assisting our clients in reaching their objectives and improving their overall well-being. We prioritize our clients' needs and individualize treatment plans to ensure they receive tailored care. Our approach is rooted in evidence-based practices proven effective in treating addiction and mental health disorders.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
Under Pressure : Kenneth Kruk's StrategyKenneth Kruk
Kenneth Kruk's story of transforming challenges into opportunities by leading successful medical record transitions and bridging scientific knowledge gaps during COVID-19.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
Michigan HealthTech Market Map 2024. Includes 7 categories: Policy Makers, Academic Innovation Centers, Digital Health Providers, Healthcare Providers, Payers / Insurance, Device Companies, Life Science Companies, Innovation Accelerators. Developed by the Michigan-Israel Business Accelerator
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
At Apollo Hospital, Lucknow, U.P., we provide specialized care for children experiencing dehydration and other symptoms. We also offer NICU & PICU Ambulance Facility Services. Consult our expert today for the best pediatric emergency care.
For More Details:
Map: https://cutt.ly/BwCeflYo
Name: Apollo Hospital
Address: Singar Nagar, LDA Colony, Lucknow, Uttar Pradesh 226012
Phone: 08429021957
Opening Hours: 24X7
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
MBC Support Group for Black Women – Insights in Genetic Testing.pdf
Burn lecture
1. BURN INJURIES & ITS
MANAGEMENT
Jordan P. Bangot RN, RM, MAN
4/1/2011
1
2. BURNS
Wounds caused by exposure to:
1. excessive heat
2. Chemicals
3. fire/steam
4. radiation
5. electricity
4/1/2011 2
3. BURNS
Results in 10-20 thousand deaths annually
Survival best at ages 15-45
Children, elderly, and diabetics
Survival best burns cover less than 20% of TBA
4/1/2011 3
4. TYPES OF BURNS
Thermal
exposure to flame or a hot object
Chemical
exposure to acid, alkali or organic substances
Electrical
result from the conversion of electrical energy into heat.
Extent of injury depends on the type of current, the
pathway of flow, local tissue resistance, and duration of
contact
Radiation
result from radiant energy being transferred to the body
resulting in production of cellular toxins
4/1/2011 4
7. BURN WOUND ASSESSMENT
Classified according to depth of injury and
extent of body surface area involved
Burn wounds differentiated depending on
the level of dermis and subcutaneous
tissue involved
1. superficial (first-degree)
2. deep (second-degree)
3. full thickness (third and fourth
degree)
4/1/2011 7
9. SUPERFICIAL BURNS
(FIRST DEGREE)
Epidermal tissue only affected
Erythema, blanching on pressure, mild swelling
no vesicles or blister initially
Not serious unless large areas involved
i.e. sunburn
4/1/2011 9
13. DEEP (SECOND DEGREE)
*Involves the epidermis and deep layer of the
dermis
Fluid-filled vesicles –red, shiny, wet, severe pain
Hospitalization required if over 25% of body
surface involved
i.e. tar burn, flame
4/1/2011 13
17. FULL THICKNESS
(THIRD/FOURTH DEGREE)
Destruction of all skin layers
Requires immediate hospitalization
Dry, waxy white, leathery, or hard skin, no pain
Exposure to flames, electricity or chemicals can
cause 3rd
degree burns
4/1/2011 17
23. VASCULAR CHANGES
RESULTING FROM BURN
INJURIES
Circulatory disruption occurs at the burn
site immediately after a burn injury
Blood flow decreases or cease due to
occluded blood vessels
Damaged macrophages within the tissues
release chemicals that cause constriction
of vessel
Blood vessel thrombosis may occur
causing necrosis
Macrophage: A type of white blood that ingests (takes in) foreign
material. Macrophages are key players in the immune response to foreign
invaders such as infectious microorganisms.
4/1/2011 23
24. FLUID SHIFT
Occurs after initial vasoconstriction, then
dilation
Blood vessels dilate and leak fluid into
the interstitial space
Known as third spacing or capillary leak
syndrome
Causes decreased blood volume and blood
pressure
Occurs within the first 12 hours after the
burn and can continue to up to 36 hours
4/1/2011 24
25. FLUID IMBALANCES
Occur as a result of fluid shift and cell
damage
Hypovolemia
Metabolic acidosis
Hyperkalemia
Hyponatremia
Hemoconcentration (elevated blood
osmolarity, hematocrit/hemoglobin) due to
dehydration
4/1/2011 25
26. FLUID REMOBILIZATION
Occurs after 24 hours
Capillary leak stops
See diuretic stage where edema fluid
shifts from the interstitial spaces into the
vascular space
Blood volume increases leading to
increased renal blood flow and diuresis
Body weight returns to normal
See Hypokalemia
4/1/2011 26
28. EMERGENT PHASE
*Immediate problem is fluid loss, edema,
reduced blood flow (fluid and electrolyte
shifts)
Goals:
1. secure airway
2. support circulation by fluid
replacement
3. keep the client comfortable with
analgesics
4. prevent infection through wound care
5. maintain body temperature
6. provide emotional support
4/1/2011 28
29. EMERGENT PHASE
Knowledge of circumstances surrounding the
burn injury
Obtain client’s pre-burn weight (dry weight) to
calculate fluid rates
Calculations based on weight obtained after fluid
replacement is started are not accurate because
of water-induced weight gain
Height is important in determining body surface
area (BSA) which is used to calculate nutritional
needs
Know client’s health history because the
physiologic stress seen with a burn can make a
latent disease process develop symptoms
4/1/2011 29
30. CLINICAL MANIFESTATIONS IN THE
EMERGENT PHASE
Clients with major burn injuries and with inhalation injury
are at risk for respiratory problems
Inhalation injuries are present in 20% to 50% of the clients
admitted to burn centers
Assess the respiratory system by inspecting the mouth, nose,
and pharynx
Burns of the lips, face, ears, neck, eyelids, eyebrows, and
eyelashes are strong indicators that an inhalation injury may
be present
Change in respiratory pattern may indicate a pulmonary
injury.
The client may: become progressively hoarse, develop a brassy
cough, drool or have difficulty swallowing, produce expiratory
sounds that include audible wheezes, crowing, and stridor
Upper airway edema and inhalation injury are most common
in the trachea and mainstem bronchi
Auscultate these areas for wheezes
If wheezes disappear, this indicates impending airway
obstruction and demands immediate intubation4/1/2011 30
31. CLINICAL MANIFESTATIONS
Cardiovascular will begin immediately
which can include shock (Shock is a
common cause of death in the emergent
phase in clients with serious injuries)
Obtain a baseline EKG
Monitor for edema, measure central and
peripheral pulses, blood pressure,
capillary refill and pulse oximetry
4/1/2011 31
32. CLINICAL MANIFESTATIONS
Changes in renal function are related to
decreased renal blood flow
Urine is usually highly concentrated and
has a high specific gravity
Urine output is decreased during the first
24 hours of the emergent phase
Fluid resuscitation is provided at the rate
needed to maintain adult urine output at
30 to 50- mL/hr.
Measure BUN, creat and NA levels
4/1/2011 32
33. CLINICAL MANIFESTATIONS
Sympathetic stimulation during the
emergent phase causes reduced GI
motility and paralytic ileus
Auscultate the abdomen to assess bowel
sounds which may be reduced
Monitor for n/v and abdominal distention
Clients with burns of 25% TBSA or who
are intubated generally require a NG tube
inserted to prevent aspiration and
removal of gastric secretions
4/1/2011 33
34. SKIN ASSESSMENT
Assess the skin to determine the size and
depth of burn injury
The size of the injury is first estimated in
comparison to the total body surface area
(TBSA). For example, a burn that
involves 40% of the TBSA is a 40% burn
Use the rule of nines for clients whose
weights are in normal proportion to their
heights
4/1/2011 34
35. IV FLUID THERAPY
Infusion of IV fluids is needed to maintain sufficient
blood volume for normal CO
Clients with burns involving 15% to 20% of the TBSA
require IV fluid
Purpose is to prevent shock by maintaining adequate
circulating blood fluid volume
Severe burn requires large fluid loads in a short time
to maintain blood flow to vital organs
Fluid replacement formulas are calculated from the
time of injury and not from the time of arrival at the
hospital
Diuretics should not be given to increase urine output.
Change the amount and rate of fluid administration.
Diuretics do not increase CO; they actually decrease
circulating volume and CO by pulling fluid from the
circulating blood volume to enhance diuresis
4/1/2011 35
36. COMMON FLUIDS
Protenate or 5% albumin in isotonic saline (1/2
given in first 8 hr; ½ given in next 16 hr)
LR (Lactate Ringer) without dextrose (1/2 given
in first 8 hr; ½ given in next 16 hr)
Crystalloid (hypertonic saline) adjust to maintain
urine output at 30 mL/hr
Crystalloid only (lactated ringers)
4/1/2011 36
37. NURSING DIAGNOSIS IN THE
EMERGENT PHASE
Decreased CO
Deficient fluid volume r/t active fluid volume loss
Ineffective Tissue perfusion
Ineffective breathing pattern
4/1/2011 37
38. ACUTE PHASE OF BURN INJURY
• Lasts until wound closure is complete
• Care is directed toward continued assessment and
maintenance of the cardiovascular and respiratory
system
• Pneumonia is a concern which can result in respiratory
failure requiring mechanical ventilation
• Infection (Topical antibiotics – Silvadene)
• Tetanus toxoid
• Weight daily without dressings or splints and compare
to pre-burn weight
• A 2% loss of body weight indicates a mild deficit
• A 10% or greater weight loss requires modification of
calorie intake
• Monitor for signs of infection
4/1/2011 38
39. LOCAL AND SYSTEMIC SIGNS
OF INFECTION- GRAM
NEGATIVE BACTERIA
Pseudomonas, Proteus
May led to septic shock
Conversion of a partial-thickness injury to a full-thickness
injury
Ulceration of health skin at the burn site
Erythematous, nodular lesions in uninvolved skin
Excessive burn wound drainage
Odor
Sloughing of grafts
Altered level of consciousness
Changes in vital signs
Oliguria
GI dysfunction such as diarrhea, vomiting
Metabolic acidosis
4/1/2011 39
40. LAB VALUES
Na – hyponatremia or Hypernatremia
K – Hyperkalemia or Hypokalemia
WBC – 10,000-20,000
4/1/2011 40
41. NURSING DIAGNOSIS IN THE
ACUTE PHASE
Impaired skin integrity
Risk for infection
Imbalanced nutrition
Impaired physical mobility
Disturbed body image
4/1/2011 41
42. PLANNING AND
IMPLEMENTATION
Nonsurgical management: removal of exudates
and necrotic tissue, cleaning the area,
stimulating granulation and revascularization
and applying dressings. Debridement may be
needed
4/1/2011 42
43. DRESSING THE BURN WOUND
After burn wounds are cleaned and debrided,
topical antibiotics are reapplied to prevent
infection
Standard wound dressings are multiple layers of
gauze applied over the topical agents on the burn
wound
4/1/2011 43
44. REHABILITATIVE PHASE OF
BURN INJURY
Started at the time of admission
Technically begins with wound closure
and ends when the client returns to the
highest possible level of functioning
Provide psychosocial support
Assess home environment, financial
resources, medical equipment, prosthetic
rehab
Health teaching should include symptoms
of infection, drugs regimens, f/u
appointments, comfort measures to reduce
pruritus
4/1/2011 44
45. DIET
Initially NPO
Begin oral fluids after bowel sounds return
Do not give ice chips or free water lead to
electrolyte imbalance
High protein, high calorie
4/1/2011 45
46. GOALS
Prevent complications (contractures)
Vital signs hourly
Assess respiratory function
Tetanus booster
Anti-infective
Analgesics
No aspirin
Strict surgical asepsis
Turn q2h to prevent contractures
Emotional support
4/1/2011 46
47. DEBRIDEMENT
Done with forceps and curved scissor or through
hydrotherapy (application of water for treatment)
Only loose eschar removed
Blisters are left alone to serve as a protector –
controversial
4/1/2011 47
48. SKIN GRAFTS
Done during the acute phase
Used for full-thickness and deep partial-
thickness wounds
4/1/2011 48
49. POST CARE OF SKIN GRAFTS
Maintain dressing
Use aseptic technique
Graft should look pink if it has taken after 5 days
Skeletal traction may be used to prevent
contractures
Elastic bandages may be applied for 6 mo to 1
year to prevent hypertrophic scarring
4/1/2011 49