This document provides an overview of burns, including definitions, causes, pathophysiology, assessment, and management. It discusses the different types and depths of burns, how to assess total body surface area burned using methods like the Rule of Nines, and the phases of burn care from the emergent/resuscitative phase through the acute and rehabilitation phases. Priority concerns are outlined for each phase, including initial first aid, fluid resuscitation, wound care and closure, prevention of complications, and long-term rehabilitation. Criteria for hospital admission based on factors like suspected inhalation injury, need for fluid resuscitation or surgery, and location of burns are also summarized.
Initial assessment of burn injuries should focus on ABCs. Evaluate airway for inhalation injury and need for intubation. Assess circulation and signs of shock. Complete secondary survey including burn size, depth, other trauma, and history. Treat for smoke inhalation with 100% oxygen and cyanide antidote if needed. Calculate total body surface area burned using rule of nines or Lund and Browder chart. Follow Parkland formula for fluid resuscitation over first 24 hours. Refer large or complex burns to burn center. Control pain aggressively. Consider non-accidental trauma in pediatric burns and monitor closely.
Burns are one of the most common household injuries, especially among children. The term “burn” means more than the burning sensation associated with this injury. Burns are characterized by severe skin damage that causes the affected skin cells to die.
This document discusses types and degrees of burns, including thermal, electrical, chemical, and radiation burns. It describes the anatomy of the skin and degrees of burn damage from superficial to full thickness. Treatment approaches are outlined, including immediate care, fluid resuscitation based on percentage of total body surface area burned, wound treatment techniques, surgery, reconstruction, and complications. The focus is on clinical assessment and management of burn patients.
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.
This document provides an overview of burn injuries including:
1. It defines burn injuries and discusses the local and systemic effects including damage to the skin, airways, and metabolic effects.
2. Burn injuries are classified based on etiology (thermal, chemical, electrical, radiation), depth (first through fourth degree), and severity (mild, moderate, major). Common thermal burn mechanisms like scalds, flames, and contact burns are described.
3. A thorough clinical assessment of burn wounds including characteristics of different degree burns is outlined to classify burn depth and severity.
This document provides an overview of burns, including:
1) Burns are injuries caused by direct contact with heat, chemicals, electricity, radiation or flame. Thermal burns are the most common type.
2) Burn classifications include depth of burn (1st-4th degree), type of burn (thermal, chemical, electrical etc.), and percentage of total body surface area burned.
3) Burn pathophysiology involves local effects like edema formation and systemic effects like hypovolemia, increased vascular permeability, immune dysfunction and hypermetabolism.
Thermal injuries can be caused by heat, cold, electricity, chemicals or radiation. Heat injuries include burns from dry heat, flames, scalds from moist heat, heat stroke, heat cramps and heat exhaustion. Cold injuries include frostbite and immersion foot. Electrical injuries depend on voltage, and can cause internal or external burns. Thermal injuries are evaluated based on depth, area affected and cause (heat, cold, electricity, chemicals), and treated depending on severity to prevent infection, hypothermia or hyperthermia.
Thermal injuries to the body can occur from various heat sources and cause burns or scalds of different depths. Scalds are caused by moist heat and result in blistering while burns are caused by dry heat and cause tissue desiccation and necrosis. The degree of burn is classified based on depth of tissue injury. Proper assessment of burn size, depth, and inhalation injury is important. Major burns can lead to hypovolemic shock, infection, organ dysfunction and death if not managed promptly with fluid resuscitation, wound care, infection control and surgery. Outcomes depend on percentage of body surface area burned, depth of burn and presence of inhalational injury.
Initial assessment of burn injuries should focus on ABCs. Evaluate airway for inhalation injury and need for intubation. Assess circulation and signs of shock. Complete secondary survey including burn size, depth, other trauma, and history. Treat for smoke inhalation with 100% oxygen and cyanide antidote if needed. Calculate total body surface area burned using rule of nines or Lund and Browder chart. Follow Parkland formula for fluid resuscitation over first 24 hours. Refer large or complex burns to burn center. Control pain aggressively. Consider non-accidental trauma in pediatric burns and monitor closely.
Burns are one of the most common household injuries, especially among children. The term “burn” means more than the burning sensation associated with this injury. Burns are characterized by severe skin damage that causes the affected skin cells to die.
This document discusses types and degrees of burns, including thermal, electrical, chemical, and radiation burns. It describes the anatomy of the skin and degrees of burn damage from superficial to full thickness. Treatment approaches are outlined, including immediate care, fluid resuscitation based on percentage of total body surface area burned, wound treatment techniques, surgery, reconstruction, and complications. The focus is on clinical assessment and management of burn patients.
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.
This document provides an overview of burn injuries including:
1. It defines burn injuries and discusses the local and systemic effects including damage to the skin, airways, and metabolic effects.
2. Burn injuries are classified based on etiology (thermal, chemical, electrical, radiation), depth (first through fourth degree), and severity (mild, moderate, major). Common thermal burn mechanisms like scalds, flames, and contact burns are described.
3. A thorough clinical assessment of burn wounds including characteristics of different degree burns is outlined to classify burn depth and severity.
This document provides an overview of burns, including:
1) Burns are injuries caused by direct contact with heat, chemicals, electricity, radiation or flame. Thermal burns are the most common type.
2) Burn classifications include depth of burn (1st-4th degree), type of burn (thermal, chemical, electrical etc.), and percentage of total body surface area burned.
3) Burn pathophysiology involves local effects like edema formation and systemic effects like hypovolemia, increased vascular permeability, immune dysfunction and hypermetabolism.
Thermal injuries can be caused by heat, cold, electricity, chemicals or radiation. Heat injuries include burns from dry heat, flames, scalds from moist heat, heat stroke, heat cramps and heat exhaustion. Cold injuries include frostbite and immersion foot. Electrical injuries depend on voltage, and can cause internal or external burns. Thermal injuries are evaluated based on depth, area affected and cause (heat, cold, electricity, chemicals), and treated depending on severity to prevent infection, hypothermia or hyperthermia.
Thermal injuries to the body can occur from various heat sources and cause burns or scalds of different depths. Scalds are caused by moist heat and result in blistering while burns are caused by dry heat and cause tissue desiccation and necrosis. The degree of burn is classified based on depth of tissue injury. Proper assessment of burn size, depth, and inhalation injury is important. Major burns can lead to hypovolemic shock, infection, organ dysfunction and death if not managed promptly with fluid resuscitation, wound care, infection control and surgery. Outcomes depend on percentage of body surface area burned, depth of burn and presence of inhalational injury.
This document provides information on various cold weather injuries including chilblain, frostbite, trench foot, hypothermia, dehydration, and snow blindness. It describes the symptoms of each injury and outlines treatment recommendations such as gradually rewarming affected areas, removing wet clothing, giving warm fluids, and seeking immediate medical aid. The key message is that cold weather injuries can occur above freezing and depend on factors like wind chill, exposure duration, and individual susceptibility.
Burn and scald injuries can be caused by heat, electricity, chemicals, or radiation. Thermal burns are the most common and are classified as superficial, partial thickness, or full thickness depending on the depth of tissue damage. A severe burn over 25% of the total body surface area can cause systemic effects like shock due to fluid loss, decreased blood pressure, and increased heart rate. Complications include infection, respiratory failure, renal failure, and contractures. The severity of the burn is estimated using methods like the Rule of Nines or Lund and Browder chart which divide the body into sections and assign a percentage of total body surface area to each.
This document summarizes the pathophysiology and classification of burns. It describes how burns are caused by thermal, radiation or chemical injury, leading to tissue destruction. Burn depth is classified as superficial, deep partial thickness, or full thickness depending on the extent of epidermal and dermal damage. Burn extent is estimated using methods like the Rule of Nines or Lund-Browder chart based on percentage of total body surface area affected. Classification determines burn management and predicts healing outcomes.
1. Burns can be classified based on the type of injury, percentage of total body surface area burned, and depth of burn into the skin.
2. Fluid resuscitation is essential to correct burn shock and hypovolemia. Formulas like Parkland and Brooke are used to calculate fluid needs.
3. Wound management includes initial silver dressings, then foams, hydrocolloids, or hydrogels depending on wound characteristics. Nutrition, infection control, and rehabilitation are also important.
The document summarizes the anatomy and physiology of the skin. It describes the three layers of skin - epidermis, dermis and subcutaneous tissue. It explains the structure and functions of the epidermis and dermis. The key functions of skin include protection, temperature regulation through sweating and blood flow, and sensory perception. The skin regulates body temperature through mechanisms like sweating, shivering and blood flow to dissipate or conserve heat.
This document provides an overview of burn injuries, including the assessment and management of thermal burns. It discusses the pathophysiology and stages of thermal burns. Assessment involves determining the extent and depth of the burn using methods like the Rule of Nines. Management of minor burns includes local cooling, but moderate to severe burns require sterile dressings and consideration of fluid resuscitation using formulas like the Parkland formula to prevent shock. Complications like infection and organ failure are also addressed.
This document discusses the classification, pathophysiology, clinical signs, and management of burns. It describes burns as injuries caused by heat, electricity, or chemicals that can range from superficial damage of the epidermis to full thickness damage involving muscle and fascia. Burns are classified based on their depth and severity into four degrees. Management involves cooling the burn, applying antibacterial creams, managing shock, preventing infection, and promoting wound healing through dressings and nutrition. Smoke inhalation injuries also require airway management and bronchodilation treatments.
This document discusses temperature regulation by the skin. It begins by defining core and skin temperatures, noting that core temperature remains constant while skin temperature varies. It then explains how the hypothalamus acts as the body's thermostat to detect temperatures and activate mechanisms to increase or decrease body heat through the skin and other effectors. These include sweating, vasodilation, shivering and thyroid secretion to cool down or vasoconstriction and piloerection to warm up. The roles of the anterior hypothalamus, skin receptors and posterior hypothalamus in temperature detection are also summarized.
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.
Cold Related Injuries. Hypothermia, Frostbite & Trench footEneutron
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This document discusses various cold-related injuries including hypothermia, frostbite, and trench foot. It defines these conditions and describes risk factors, stages or classifications, signs and symptoms, and treatment approaches. Hypothermia occurs when the body loses heat faster than it can produce it, causing a dangerous drop in core body temperature. Frostbite causes skin and tissue damage from freezing, with severity classified into degrees. Trench foot results from prolonged exposure of wet or damp feet to cold conditions. Proper treatment depends on injury severity but prioritizes rewarming and seeking medical help.
Flaps can be classified in several ways:
(1) By circulation/blood supply - direct or indirect, axial or random;
(2) By composition - skin, fascia, muscle, bone, or visceral;
(3) By contiguity - local, regional, or free. Perforator flaps allow for minimal donor site morbidity.
This document provides information on burns management. It discusses the causes of burns, the different degrees of burns from first to fourth degree, and Jackson's burn wound model. It also covers total body surface area calculations, first aid measures including cooling burns, emergency treatment including analgesia and antibiotics, and acute management including the Parkland formula for fluid resuscitation. Surgical procedures for burns such as escharotomy, excision, and grafting are outlined. Reconstruction and rehabilitation for burns patients is also mentioned.
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.
This document discusses various types of excessive sweating conditions (hyperhidrosis) including their causes, presentations, and treatments. It describes primary cortical (emotional) hyperhidrosis which commonly affects the axillae and palms. Secondary causes include hyperhidrosis related to the hypothalamus or gustatory system. Treatment options mentioned are topical antiperspirants, oral medications like glycopyrrolate, and botulinum toxin injections for select cases.
This document provides information on the management and care of burn patients. It discusses prevention of burns, types of burns including thermal, chemical, electrical and inhalation injuries. It describes the depth and extent of burns. The emergency phase focuses on airway management, fluid resuscitation, wound care and pain management. The acute phase involves monitoring for infections and complications. Rehabilitation aims to restore function. Nursing care is tailored based on the severity and specifics of each patient's burn injury.
The document discusses wounds and the wound healing process. It defines a wound as a break in the skin or tissue integrity caused by injury. Wounds are classified based on various factors like cleanliness, depth, and type. The healing process involves three phases - inflammatory, proliferative, and remodeling. The inflammatory phase prepares the wound for healing. In proliferation, new tissue is formed through granulation. Remodeling provides increased strength over months. Healing occurs through regeneration or repair, with the former restoring original tissue and the latter resulting in scar tissue. Growth factors play important roles in the complex cellular cascade of wound healing.
This document discusses scars and tattoos and their medicolegal importance. It defines scars as healed granulation tissue formed during wound healing and tattoos as designs made by puncturing the skin with colored ink. It describes how to identify different types of scars based on appearance and the weapon that caused the injury. Tattoos can identify aspects like religion, country, and language. Both scars and tattoos are important for personal identification. Their appearance changes with time and they can indicate medical information like injuries.
This document provides information on burns and sudden death. It begins by defining burns and classifying them based on depth and extent. It then discusses the pathophysiology of burns, including edema, cardiac, renal and immunologic effects. Burn management in the hospital is outlined, including fluid resuscitation, airway management, infection control, pain relief and nutrition. Complications of burns like shock, infections and scarring are also summarized. The document concludes by defining sudden death and noting it is important in forensic analysis of unexpected deaths within 24 hours of burn onset.
1) Burns are wounds caused by heat, chemicals, electricity or radiation that lead to skin tissue death. Thermal burns include flame, scald, smoke or radiation burns.
2) Burns are classified based on depth and percentage of total body surface area affected. Deeper burns involving deeper skin or muscle layers require grafting to heal.
3) Large burns trigger systemic inflammatory responses, increasing vascular permeability and fluid shifts that can cause shock. This impacts the cardiovascular and respiratory systems.
Burns are caused by thermal, chemical, electrical or radiation injury leading to tissue damage. The extent and severity of burns is classified based on the percentage of total body surface area affected and depth of tissue injury. Major systemic effects include circulatory shock, respiratory complications, metabolic changes and increased risk of infection due to suppression of the immune system. Prompt resuscitation and treatment is needed to prevent further tissue damage and organ failure.
This document provides information on various cold weather injuries including chilblain, frostbite, trench foot, hypothermia, dehydration, and snow blindness. It describes the symptoms of each injury and outlines treatment recommendations such as gradually rewarming affected areas, removing wet clothing, giving warm fluids, and seeking immediate medical aid. The key message is that cold weather injuries can occur above freezing and depend on factors like wind chill, exposure duration, and individual susceptibility.
Burn and scald injuries can be caused by heat, electricity, chemicals, or radiation. Thermal burns are the most common and are classified as superficial, partial thickness, or full thickness depending on the depth of tissue damage. A severe burn over 25% of the total body surface area can cause systemic effects like shock due to fluid loss, decreased blood pressure, and increased heart rate. Complications include infection, respiratory failure, renal failure, and contractures. The severity of the burn is estimated using methods like the Rule of Nines or Lund and Browder chart which divide the body into sections and assign a percentage of total body surface area to each.
This document summarizes the pathophysiology and classification of burns. It describes how burns are caused by thermal, radiation or chemical injury, leading to tissue destruction. Burn depth is classified as superficial, deep partial thickness, or full thickness depending on the extent of epidermal and dermal damage. Burn extent is estimated using methods like the Rule of Nines or Lund-Browder chart based on percentage of total body surface area affected. Classification determines burn management and predicts healing outcomes.
1. Burns can be classified based on the type of injury, percentage of total body surface area burned, and depth of burn into the skin.
2. Fluid resuscitation is essential to correct burn shock and hypovolemia. Formulas like Parkland and Brooke are used to calculate fluid needs.
3. Wound management includes initial silver dressings, then foams, hydrocolloids, or hydrogels depending on wound characteristics. Nutrition, infection control, and rehabilitation are also important.
The document summarizes the anatomy and physiology of the skin. It describes the three layers of skin - epidermis, dermis and subcutaneous tissue. It explains the structure and functions of the epidermis and dermis. The key functions of skin include protection, temperature regulation through sweating and blood flow, and sensory perception. The skin regulates body temperature through mechanisms like sweating, shivering and blood flow to dissipate or conserve heat.
This document provides an overview of burn injuries, including the assessment and management of thermal burns. It discusses the pathophysiology and stages of thermal burns. Assessment involves determining the extent and depth of the burn using methods like the Rule of Nines. Management of minor burns includes local cooling, but moderate to severe burns require sterile dressings and consideration of fluid resuscitation using formulas like the Parkland formula to prevent shock. Complications like infection and organ failure are also addressed.
This document discusses the classification, pathophysiology, clinical signs, and management of burns. It describes burns as injuries caused by heat, electricity, or chemicals that can range from superficial damage of the epidermis to full thickness damage involving muscle and fascia. Burns are classified based on their depth and severity into four degrees. Management involves cooling the burn, applying antibacterial creams, managing shock, preventing infection, and promoting wound healing through dressings and nutrition. Smoke inhalation injuries also require airway management and bronchodilation treatments.
This document discusses temperature regulation by the skin. It begins by defining core and skin temperatures, noting that core temperature remains constant while skin temperature varies. It then explains how the hypothalamus acts as the body's thermostat to detect temperatures and activate mechanisms to increase or decrease body heat through the skin and other effectors. These include sweating, vasodilation, shivering and thyroid secretion to cool down or vasoconstriction and piloerection to warm up. The roles of the anterior hypothalamus, skin receptors and posterior hypothalamus in temperature detection are also summarized.
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.
Cold Related Injuries. Hypothermia, Frostbite & Trench footEneutron
Â
This document discusses various cold-related injuries including hypothermia, frostbite, and trench foot. It defines these conditions and describes risk factors, stages or classifications, signs and symptoms, and treatment approaches. Hypothermia occurs when the body loses heat faster than it can produce it, causing a dangerous drop in core body temperature. Frostbite causes skin and tissue damage from freezing, with severity classified into degrees. Trench foot results from prolonged exposure of wet or damp feet to cold conditions. Proper treatment depends on injury severity but prioritizes rewarming and seeking medical help.
Flaps can be classified in several ways:
(1) By circulation/blood supply - direct or indirect, axial or random;
(2) By composition - skin, fascia, muscle, bone, or visceral;
(3) By contiguity - local, regional, or free. Perforator flaps allow for minimal donor site morbidity.
This document provides information on burns management. It discusses the causes of burns, the different degrees of burns from first to fourth degree, and Jackson's burn wound model. It also covers total body surface area calculations, first aid measures including cooling burns, emergency treatment including analgesia and antibiotics, and acute management including the Parkland formula for fluid resuscitation. Surgical procedures for burns such as escharotomy, excision, and grafting are outlined. Reconstruction and rehabilitation for burns patients is also mentioned.
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.
This document discusses various types of excessive sweating conditions (hyperhidrosis) including their causes, presentations, and treatments. It describes primary cortical (emotional) hyperhidrosis which commonly affects the axillae and palms. Secondary causes include hyperhidrosis related to the hypothalamus or gustatory system. Treatment options mentioned are topical antiperspirants, oral medications like glycopyrrolate, and botulinum toxin injections for select cases.
This document provides information on the management and care of burn patients. It discusses prevention of burns, types of burns including thermal, chemical, electrical and inhalation injuries. It describes the depth and extent of burns. The emergency phase focuses on airway management, fluid resuscitation, wound care and pain management. The acute phase involves monitoring for infections and complications. Rehabilitation aims to restore function. Nursing care is tailored based on the severity and specifics of each patient's burn injury.
The document discusses wounds and the wound healing process. It defines a wound as a break in the skin or tissue integrity caused by injury. Wounds are classified based on various factors like cleanliness, depth, and type. The healing process involves three phases - inflammatory, proliferative, and remodeling. The inflammatory phase prepares the wound for healing. In proliferation, new tissue is formed through granulation. Remodeling provides increased strength over months. Healing occurs through regeneration or repair, with the former restoring original tissue and the latter resulting in scar tissue. Growth factors play important roles in the complex cellular cascade of wound healing.
This document discusses scars and tattoos and their medicolegal importance. It defines scars as healed granulation tissue formed during wound healing and tattoos as designs made by puncturing the skin with colored ink. It describes how to identify different types of scars based on appearance and the weapon that caused the injury. Tattoos can identify aspects like religion, country, and language. Both scars and tattoos are important for personal identification. Their appearance changes with time and they can indicate medical information like injuries.
This document provides information on burns and sudden death. It begins by defining burns and classifying them based on depth and extent. It then discusses the pathophysiology of burns, including edema, cardiac, renal and immunologic effects. Burn management in the hospital is outlined, including fluid resuscitation, airway management, infection control, pain relief and nutrition. Complications of burns like shock, infections and scarring are also summarized. The document concludes by defining sudden death and noting it is important in forensic analysis of unexpected deaths within 24 hours of burn onset.
1) Burns are wounds caused by heat, chemicals, electricity or radiation that lead to skin tissue death. Thermal burns include flame, scald, smoke or radiation burns.
2) Burns are classified based on depth and percentage of total body surface area affected. Deeper burns involving deeper skin or muscle layers require grafting to heal.
3) Large burns trigger systemic inflammatory responses, increasing vascular permeability and fluid shifts that can cause shock. This impacts the cardiovascular and respiratory systems.
Burns are caused by thermal, chemical, electrical or radiation injury leading to tissue damage. The extent and severity of burns is classified based on the percentage of total body surface area affected and depth of tissue injury. Major systemic effects include circulatory shock, respiratory complications, metabolic changes and increased risk of infection due to suppression of the immune system. Prompt resuscitation and treatment is needed to prevent further tissue damage and organ failure.
This document provides an overview of burn injuries including:
1. The pathophysiology of burns including fluid shifts, systemic changes, and the hypermetabolic response.
2. Classification of burns by depth and severity. Thermal burns can cause damage from coagulation to hyperemia.
3. Management of burns focuses on airway control, fluid resuscitation using formulas like Parkland, and wound care including escharotomy, fasciotomy, and debridement.
Burn injuries affect over 1.25 million people per year in the United States. Thermal burns can be caused by fire, scalding liquids, or electricity and result in damage to the epidermis and dermis layers of the skin. Chemical and electrical burns involve additional injury mechanisms. Burn severity is classified by depth and total body surface area affected. Minor burns involve less than 10% total body surface area, while critical burns involve over 20% or burns of special areas like hands or face. Initial management of burns focuses on the ABCs - airway, breathing, and circulation. Fluid resuscitation is initiated for larger burns to prevent hypovolemic shock. Wound care and infection prevention are also important in treatment
This document provides information on the definition, causes, classifications, pathophysiology, and management of burn injuries. It defines burns as damage to body tissues caused by heat, chemicals, electricity, sunlight, or radiation. It describes the different classifications of burns from superficial to deep full-thickness burns. It explains the pathophysiological changes that occur due to fluid shifts, electrolyte imbalances, metabolic changes, and infections in burn patients. Finally, it outlines the various treatment approaches for burns, including airway management, fluid resuscitation, wound care, and rehabilitation.
Burn injuries cause significant damage and health issues globally. They are the fourth most common type of trauma worldwide, with nearly 200,000 deaths annually. Most burns occur in low to middle income countries that lack infrastructure to treat them. Burns damage skin tissue through heat, chemicals, electricity or other sources. They are classified based on the depth of tissue destruction. Proper assessment of burn severity and depth is important for treatment. Burn injuries can cause shock, fluid and electrolyte imbalances, and long-term metabolic changes like increased energy expenditure if not properly managed.
1. A burn is an injury to the skin or flesh caused by heat, electricity, chemicals, friction or radiation. The severity depends on the temperature and duration of exposure.
2. About 2.4 million people suffer burns annually in the US, with 700,000 cases requiring medical treatment. The main causes are thermal, electrical, chemical and radiation burns.
3. Burns are classified by depth and extent of the affected body surface area. Depth is classified as superficial, partial-thickness, or full-thickness. Extent is classified using methods like the Rule of Nines or Lund and Browder chart.
The document discusses burn injuries, including their definition, types, causes, symptoms, assessment, management, and reconstructive treatments. It covers:
1. Burns are classified by degree of skin damage, from superficial first-degree burns to full-thickness third-degree burns. Thermal burns from heat are most common but burns can also be caused by chemicals, electricity, radiation, or sunlight.
2. Burn assessment involves estimating the total body surface area affected using methods like the Rule of Nines. Management involves fluid resuscitation, wound care, pain management, and rehabilitation.
3. Later treatments may include skin grafts or other reconstructive surgeries to repair damage and improve function and appearance.
The document discusses anatomy and physiology of the skin, types of burns, burn classifications, burn depth assessment, burn management, and burn complications. It describes the three layers of skin - epidermis, dermis, and hypodermis - and their functions. It classifies burns as superficial, partial thickness, or full thickness depending on the depth of tissue damage. Burn management includes wound care, fluid resuscitation, antibiotics, surgery, and physiotherapy. Complications can be immediate, early, or late and include shock, infection, organ failure, contractures, and cancer.
Thermal burns can damage the epidermis and dermis layers of skin and are classified as superficial, partial-thickness, or full-thickness based on depth of injury. Initial management of burns focuses on airway protection, fluid resuscitation to prevent shock, analgesia, and wound care. Extent of burns is estimated based on total body surface area involved. Hospital admission is recommended for burns over 10% TBSA in children or 15% in adults due to risk of complications like infection, low blood volume, breathing issues, and joint problems that require close monitoring.
This document provides information on burns, including:
1. Burns are injuries to skin or tissue caused by heat, radiation, electricity, friction or chemicals. The history and mechanism of the burn is important for treatment.
2. Burns are classified based on depth of skin involvement, ranging from superficial first degree burns to full thickness third degree burns.
3. Initial evaluation of a burn patient focuses on airway management, other injuries, estimating burn size, and checking for carbon monoxide or cyanide poisoning. A secondary survey examines the burn mechanism and presence of inhalation injury.
4. Different burn types include thermal, chemical, and electrical burns. The pathophysiology of burns involves local tissue damage
This document summarizes the pathophysiology and management of different types of burns. It describes the classification of burns based on depth and extent of injury. Thermal burns are the most common and can be caused by flame, scald, or contact with hot objects. Chemical and electrical burns cause tissue destruction through different mechanisms. The pathophysiology of burns involves fluid shifts, hypermetabolism, and immune dysfunction. Burn management focuses on airway protection, fluid resuscitation according to the Parkland formula, wound care, pain control, and infection prevention.
This document discusses the pathophysiology and management of burn patients. It covers:
1) Major burns cause massive tissue destruction and inflammatory response, leading to burn shock from fluid shifts and systemic effects if >20% TBSA.
2) Burns trigger a hypermetabolic response for weeks, with increased cardiac work and protein catabolism impairing healing.
3) Resuscitation follows the Parkland formula to replace fluid losses. Fluid management aims to maintain urine output and prevent organ dysfunction.
This document provides information on burn training, assessment, and management. It discusses the anatomy of the integumentary system and skin, determining burn severity, the different types and depths of burns, zones of burn injury, pediatric considerations, and the three phases of burn management - emergent, acute, and rehabilitation. The emergent phase focuses on initial assessment and management, including airway protection, fluid resuscitation using the Parkland formula, and monitoring for potential cardiovascular, respiratory, and renal complications in the first 48 hours.
This document provides information on the management of burns. It begins with objectives of understanding burn management and classifying burns according to depth and percentage of total body surface area affected. Superficial partial thickness burns involve only the epidermis while deep partial thickness burns also involve the dermis. Full thickness or third degree burns destroy the epidermis, dermis and subcutaneous tissue. Management involves fluid resuscitation, wound care like cleaning and dressing, monitoring for complications, and skin grafting for deep burns.
This document provides an overview of burn management. It begins with definitions and epidemiology, noting that burns are a global health problem disproportionately impacting children and low-income countries. It then covers burn classification based on depth, severity, and etiology. The pathophysiology section outlines the local and systemic effects of burns, including impacts on respiratory, gastrointestinal, immune, and other systems. Management priorities are stopping the burning process, providing fluid resuscitation based on the Parkland formula, and treating for complications like infection and inhalation injury. The document provides context and guidelines to inform burn patient assessment and treatment.
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.
Burns can be caused by heat, cold, electricity, chemicals, friction or radiation. They are classified by depth and extent of the burn. First degree burns affect the outer layer of skin while fourth degree burns damage deeper tissues. Burn management involves three phases - emergent, acute, and rehabilitative care. The emergent phase focuses on assessment, wound care, and fluid resuscitation. The acute phase emphasizes infection prevention, wound grafting, pain management, and exercise. Rehabilitation aims to minimize scarring and functional loss through exercise, pressure garments, and psychological support.
Thermal burns can range from superficial first degree burns affecting just the epidermis to full thickness third degree burns extending through the dermis. Jackson's theory describes three zones of injury - the zone of coagulation nearest the heat source suffers the most damage, the zone of stasis surrounding it has decreased blood flow, and the outer zone of hyperemia has increased blood flow. Burn depth and extent determine severity and influence fluid shifts, metabolic changes, and risk of infection in the acute phase after injury.
The document discusses postoperative patient care, including:
1. The role of the post-anesthesia care unit (PACU) in allowing anesthesia to wear off and monitoring patients.
2. Procedures in the PACU like handing over patients from the operating room, caring for patients, monitoring for complications, and discharging patients to wards once criteria are met.
3. Common postoperative complications involving different body systems like respiratory, cardiovascular, and genitourinary systems and their appropriate interventions.
This document discusses various aspects of intraoperative care for anaesthetized patients including induction, airway management, maintenance of anaesthesia, monitoring of vital signs, fluid therapy and reversal of anaesthesia. It covers common techniques for securing the airway like face masks, LMAs and endotracheal intubation. It also addresses factors to consider like patient positioning, maintenance of normothermia, administration of analgesics and fluid resuscitation. Monitoring parameters include respiration, circulation, temperature and equipment function.
PRE-OPERATIVE AND INTRA-OPERATIVE CARE OF THE ANESTHESIA PATIENT group 8-2.pptxDakaneMaalim
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1. The document discusses pre-operative and intra-operative care of anesthesia patients, outlining factors like history, physical exam, labs, and risk assessment that are important to evaluate patients.
2. Key parts of evaluation include assessing airway, cardiovascular and respiratory systems, medications, allergies, and relevant medical history.
3. The goals are to decrease risks and complications, make plans for anesthesia, and optimize patient condition and education prior to surgery.
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The document summarizes key information about local anesthetic agents. It discusses two main classes of local anesthetics - amino esters and amino amides. Examples are provided for each class. The mode of action, pharmacokinetics, metabolism, toxicity risks, contraindications and interactions are outlined for local anesthetic drugs. Specific properties are highlighted for common local anesthetics like lidocaine, bupivacaine and procaine.
This document discusses various regional anesthetic techniques including:
- Topical anesthesia which uses creams or ointments to numb skin and mucous membranes.
- Intravenous regional anesthesia (Bier block) which involves injecting local anesthetic around a tourniqueted limb to numb it.
- Peripheral nerve blocks which involve injecting local anesthetic near specific nerves to numb surgical areas. Brachial plexus and lumbar plexus blocks are examples.
- Potential complications include local tissue damage, nerve injury, seizures and cardiac issues if too much drug is absorbed systemically. Proper technique and drug choice can minimize adverse outcomes.
LOCAL ANAESTHETICS.pptbshsjsjsjsjsjsjjsjsDakaneMaalim
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Local anaesthetics are drugs that cause reversible loss of sensation in a specific body region without loss of consciousness. They are classified based on their structure and potency. Local anaesthetics work by blocking sodium channels to prevent nerve impulse propagation. Factors like lipid solubility, protein binding, and pKa determine a drug's potency, duration of action, and onset. Local anaesthetics are widely used for infiltration, nerve blocks, epidurals, and other regional techniques to provide anaesthesia or post-operative analgesia. Toxicity can occur if local anaesthetics enter the systemic circulation in high amounts. Proper dosing and technique help prevent local anaesthetic systemic toxicity.
This document outlines the syndromic approach to diagnosing and treating common sexually transmitted infections (STIs). It describes the symptoms of vaginal discharge, urethral discharge, and genital ulcers, which can be caused by organisms like Chlamydia, gonorrhea, trichomoniasis, and herpes. The approach involves taking a history, examining the patient, confirming the presence of symptoms, and providing treatment based on the syndrome presented and the likely causative organisms. Treatments aim to cover the major organisms and include antibiotics like azithromycin, doxycycline, and ceftriaxone, as well as antivirals like acyclovir. Partners are also treated to prevent
git and gut complications of anaesthesiology by unc pow_101535.pptxDakaneMaalim
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This document discusses post-operative complications related to the genitourinary system. It outlines risk factors for post-operative nausea and vomiting (PONV) and strategies for prevention. It also discusses acute kidney injury, urinary retention, and urinary tract infections as common genitourinary complications. For each complication, it describes the causes, risk factors, signs, and treatment approaches. Prevention of complications through proper fluid management, avoidance of nephrotoxic drugs, and aseptic catheterization is emphasized.
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This document discusses post-operative complications related to the genitourinary system. It outlines risk factors for post-operative nausea and vomiting (PONV) and strategies for prevention. It also discusses acute kidney injury, urinary retention, and urinary tract infections as common genitourinary complications. For each complication, it describes the causes, risk factors, signs, and treatment approaches. Prevention of complications through proper fluid management, avoidance of nephrotoxic drugs, and aseptic catheterization is emphasized.
The document discusses various post-operative complications related to the cardiovascular system (CVS), central nervous system (CNS), and recovery in the post-anesthesia care unit (PACU). Some key points include: common CVS complications are hypotension and hypertension, which can be treated with fluid administration or vasopressors/antihypertensives respectively; arrhythmias are also common after cardiac surgery; common neuropsychiatric complications in PACU include delirium, delayed arousal, and failure to arouse due to various medical causes; and hypothermia is another potential complication addressed by maintaining normothermia.
This document outlines approaches to health promotion. It discusses focusing on individual versus population determinants of health. Three main approaches to health promotion are described: behavioral, self-empowerment, and collective action. Targeted and universal approaches are also covered. The settings approach and social marketing are explained as useful tools. Ethical principles and the role of the state in health promotion are debated. Scenarios on HIV/AIDS and obesity ask learners to choose appropriate approaches.
231125 Group 6 Sedation and Regional Anesthesia.pptxDakaneMaalim
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The document discusses sedation and regional anesthesia. It begins by introducing sedation as a continuum between consciousness and general anesthesia, allowing patients to maintain protective reflexes and respond to stimuli. It then describes the levels of sedation from minimal to general anesthesia. Regional anesthesia techniques are also discussed, including neuraxial methods like epidural and spinal anesthesia, as well as peripheral nerve blocks and topical anesthesia. Specific drugs, procedures, indications, contraindications and complications are outlined for both sedation and regional anesthesia.
1. Introduction to dermatology Year 5.2023.pptxDakaneMaalim
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This document provides an introduction to dermatology, covering the structure and functions of the skin, its derivatives like hair and nails, and common terminology used to describe skin lesions. The skin consists of three layers - the epidermis, dermis, and subcutaneous tissue. It has structures like hair follicles, sebaceous glands, eccrine and apocrine sweat glands. The skin acts as a barrier, regulates temperature, has sensory functions, and plays a role in vitamin D production and immunity. Common skin conditions are described.
The document discusses essential clinical symptoms and signs for assessing common serious diseases. It emphasizes that the most useful symptoms and signs are those that are commonly observed in common illnesses, help evaluate the nature and severity of illness, indicate risk of death, are useful for monitoring progress, can differentiate diseases, and are easy for everyone to observe and learn. It describes choosing symptoms and signs that have a strong evidence base for the most common childhood disorders and are included in the Integrated Management of Neonatal and Childhood Illness approach.
OBSTRETICS AND GYNAECOLOGY HISTORY AND PHYSICAL EXAM.pptxDakaneMaalim
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1. This document provides guidelines for taking an obstetrics and gynecology history and physical exam. It outlines components to include in the patient's history of present illness, past medical history, family/social history, and physical exam.
2. Key items in the history include biodata, obstetric history, last menstrual period, estimated due date calculations, antenatal care profile, past pregnancies and deliveries, gynecological history, and medical/surgical history.
3. The physical exam section focuses on examining patients in the postpartum period and includes assessing pain, bleeding, lochia, feeding, urination, bowel movements, and neonate status.
L11-Trauma and Stressor Related Disorders AND Dissociative Disorders-1.pptxDakaneMaalim
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Trauma and Stressor Related Disorders include disorders where exposure to a traumatic or stressful event is listed as a diagnostic criterion. These include reactive attachment disorder, disinhibited social engagement disorder, posttraumatic stress disorder, acute stress disorder, and adjustment disorders. Major psychological stress involves threat or loss which can lead to emotional, physical, and psychological responses. Reactive attachment disorder is caused by neglect and results in inhibited behavior toward caregivers, while disinhibited social engagement disorder is characterized by indiscriminate social behavior. Posttraumatic stress disorder involves re-experiencing, avoidance, negative alterations in mood and cognition, and arousal following a traumatic event.
Personality disorders are characterized by enduring patterns of behavior that deviate from cultural norms. They are grouped into three clusters - A, B, and C. Cluster A disorders include paranoid, schizoid and schizotypal personality disorders. Cluster B includes antisocial, borderline, histrionic and narcissistic disorders. Cluster C comprises avoidant, dependent and obsessive-compulsive personality disorders. The disorders are generally stable over time and can lead to unhappiness and impairment.
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This document provides information on various child and adolescent psychiatric disorders including:
- Mental retardation which is defined as an IQ below 70 and can be mild, moderate or severe.
- Pervasive developmental disorders like autism which involve impairments in social skills, communication, and restricted behaviors.
- Disruptive behavior disorders such as ADHD, oppositional defiant disorder, and conduct disorder which are characterized by behaviors like impulsivity, aggression, and rule-breaking.
- Anxiety disorders are also common in children and involve feelings of fear, worry or panic in response to perceived threats.
This document provides an overview of the approach to upper GI bleeding. It begins with definitions of terms like hematemesis, melena, and hematochezia. It then discusses the causes of upper GI bleeding, which can be variceal or non-variceal. For patients presenting with upper GI bleeding, the summary provides that history, physical exam, and investigations like endoscopy are important to determine the cause and guide management. Management may involve treating any active bleeding, administering PPIs for non-variceal causes, or using vasoactive agents, balloon tamponade, or endoscopic therapies for variceal bleeding.
This document provides an overview of intestinal obstruction. It begins with an introduction defining intestinal obstruction and its causes. It then covers the classification of intestinal obstruction including location, degree, and specific causes. Risk factors and pathophysiology are discussed. Clinical presentation includes symptoms like pain, vomiting, and distension. Investigations involve imaging studies like abdominal x-rays and CT scans. Management is outlined, differentiating conservative treatment from surgical intervention depending on factors like failure to resolve or signs of strangulation. Surgical procedures aim to relieve the obstruction and resect non-viable bowel.
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THE SACRIFICE HOW PRO-PALESTINE PROTESTS STUDENTS ARE SACRIFICING TO CHANGE T...indexPub
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The recent surge in pro-Palestine student activism has prompted significant responses from universities, ranging from negotiations and divestment commitments to increased transparency about investments in companies supporting the war on Gaza. This activism has led to the cessation of student encampments but also highlighted the substantial sacrifices made by students, including academic disruptions and personal risks. The primary drivers of these protests are poor university administration, lack of transparency, and inadequate communication between officials and students. This study examines the profound emotional, psychological, and professional impacts on students engaged in pro-Palestine protests, focusing on Generation Z's (Gen-Z) activism dynamics. This paper explores the significant sacrifices made by these students and even the professors supporting the pro-Palestine movement, with a focus on recent global movements. Through an in-depth analysis of printed and electronic media, the study examines the impacts of these sacrifices on the academic and personal lives of those involved. The paper highlights examples from various universities, demonstrating student activism's long-term and short-term effects, including disciplinary actions, social backlash, and career implications. The researchers also explore the broader implications of student sacrifices. The findings reveal that these sacrifices are driven by a profound commitment to justice and human rights, and are influenced by the increasing availability of information, peer interactions, and personal convictions. The study also discusses the broader implications of this activism, comparing it to historical precedents and assessing its potential to influence policy and public opinion. The emotional and psychological toll on student activists is significant, but their sense of purpose and community support mitigates some of these challenges. However, the researchers call for acknowledging the broader Impact of these sacrifices on the future global movement of FreePalestine.
A Free 200-Page eBook ~ Brain and Mind Exercise.pptxOH TEIK BIN
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Andreas Schleicher presents PISA 2022 Volume III - Creative Thinking - 18 Jun...EduSkills OECD
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Andreas Schleicher, Director of Education and Skills at the OECD presents at the launch of PISA 2022 Volume III - Creative Minds, Creative Schools on 18 June 2024.
How to Setup Default Value for a Field in Odoo 17Celine George
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In Odoo, we can set a default value for a field during the creation of a record for a model. We have many methods in odoo for setting a default value to the field.
How to Download & Install Module From the Odoo App Store in Odoo 17Celine George
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Custom modules offer the flexibility to extend Odoo's capabilities, address unique requirements, and optimize workflows to align seamlessly with your organization's processes. By leveraging custom modules, businesses can unlock greater efficiency, productivity, and innovation, empowering them to stay competitive in today's dynamic market landscape. In this tutorial, we'll guide you step by step on how to easily download and install modules from the Odoo App Store.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
1. Burns
Dr Janai A. M. Ondieki
For Clinical Medicine Diploma Class
yr 2
2. Definitions
• Burns are caused by transfer of energy from a
heat source to the body. Heat may be transferred
through conduction or electromagnetic radiation.
• Burns are defined as a wound caused by
exogenous agent leading to coagulative necrosis
of tissue
• Tissue destruction results from coagulation,
protein denaturation, or ionization of cellular
contents.
4. Thermal Burns
– Heat changes the molecular structure of tissue causing
denaturing of proteins
– The extent of burn damage depends on
• Temperature
• Amount of heat
• Duration of contact
For example, in the case of scald burns in adults, 1 second of contact
with hot tap water at 68.9°C (156°F) may result in a burn that
destroys both the epidermis and the dermis, causing a fullthickness
(third-degree) injury.
Fifteen seconds of exposure to hot water at 56.1°C (133°F) results in a
similar full-thickness injury.
5. • The effects of thermal burns are influenced by
– Intensity of the energy
– the duration of exposure
– the type of tissue injured
6. Pathophysiology of burns
•Burns that do not exceed 25% TBSA produce a primarily local
response.
•Burns that exceed 25% TBSA may produce both a local and a
systemic response and are considered major burn injuries.
•The incidence, magnitude, and duration of pathophysiologic
changes in burns are proportional to the extent of burn injury,
with a maximal response seen in burns covering 60% or more
TBSA
•These systemic responses are due to the release of cytokines
and other mediators into the systemic circulation
7. • Fluid shift
– period of inflammatory response
– Vessels adjacent to burn injury dilate, increased
capillary hydrostatic pressure and permeability
– Continous leak of plasma from intravascular space
into interstitial space
– associated imbalences in fluids, electrolytes and
acid-base occur
– Haemoconcentration
– Lasts 24-36 hours
8. • Fluid mobilization
– capillary leak ceases and fluid shifts back into the
circulation
– Restores fluid balance and renal perfusion
• increased urine formation and diuresis
– continued electrolyte imbalances
• hypokalaemia
• Hyponatremia
– Haemodilution
9. • Systemic Changes
• Cardiac
– decreased cardiac output
• Pulmonary
– Respiratory insufficiency as a secondary process
– can lead to respiratory failure
• Gastrointestinal
– Decreased or absent motility
– Stress Ulcer formation ( Curlings Ulcer)
10. • Metabollic
– Hypermetabolic state
– increased oxygen and calorie requirements
– increased in core body temperature
• Immunological
– loss of protective barrier
– increased risk of infection
– suppression of humoral and cell-mediated immune responses
11. Acute Phase
• Clinical issues
• External loss of Plasma
• Loss ofd circulating red cells
• Burn oedema
12. Sub Aute Phase
• Diuresis
• Clinical Anaemia
• Accelerated metabolic rate
• Nitrogen Disequilibrium
• Bone and joint changes
• Endocrine disturbances
• Electrolyte and chemical imbalance
• circulatiry derangements
• loss of function of skin as an organ
13. Body's response to Burns
• Emergent Phase (stage 1)
– Pain response
– Catecholamine release
– tachycardia, tachypnoea, mild Hypertension, mild anxiety
• Fluid Shift Phase (stage 2)
– Length 8-24 hours
– Begins after emergent phase
• reaches peak in 6-8 hours
– damaged cells initiate inflammatory response
• increased blood flow to cells
• Shift of fluid from intravascular to extra vascular space
– MASSIVE OEDEMA
14. • Hypermetabolic Phase (stage 3)
– Lasts for days to weeks
– Large increase in the body's need for nutrients as
it repairs itself
• Resolution phase(stage 4)
– scar formation
– general rehabilitation and progression to normal
function
15. Jackson's theory of Thermal Burns
• Zone of coagulation
– Area nearest to the heat
source that suffers the most
damage as evidenced by
clotted blood and
thrombosed blood vessels
• Zone of Stasis
– Area surrounding zone of
coagulation characterized by
decreased blood flow
• Zone of Hyperemia
– Peripheral area around burn
that has increased blood flow
16.
17. • Severity of burns is determined by
– depth of the burn
– Extent of the burn/total Burn Surface A (TBSA)
– Location of the burn
– Patient risk factors
18. Grading of burn according to depth
• First Degree - Injury to the
Epidermis
• Superficial Second Degree -
injury to epidermis and
Superficial Papillary dermis
• Deep secondary Degree -
Injury from epidemis to
reticular dermis
• Third degree -full thickness
burn through epidermis and all
layers of dermis
• Fourth degree - injury trhough
skin, subcutaneous fat into
underlying muscle or bone
19. • Burn Depth
• Burn depth determines whether epithelialization will occur.
• Determining burn depth can be difficult even for the
experienced burn care provider.
• The following factors are considered in determining the
depth of the burn:
– How the injury occurred
– Causative agent, such as flame or scalding liquid
– Temperature of the burning agent
– Duration of contact with the agent
– Thickness of the skin
20. 1st Degree Burn
• Involves only the epidermis
• Reddening/Darkening of the
skin
• Pain at burn site
• Blanch to touch
• Have an intact epidermal
barrier
• Do not result in scarring
• Examples: Sun Burn, Minor
Scald from Kitchen accident
• Treatment aimed at comfort
21. 2nd degree Superficial
Burn
• Involves the epidermis
and papillary dermis
• Intense pain
• Blisters
• reddening/darkening
• Spares hair follicles ,
sweat glands etc
• erythematous & blanch
to touch
• Very painful/sensitive
• No/Minimal Scaring
• Spontaneously re-
epithelialize from
retained epidermal
structures in 7-14 days
22. 2nd degree deep burn
• Involves the epidermis and
reticular dermis
• less pain, remain painful to
pin prick
• Appears pale and mottled
• do not blanch to touch
• capillary return sluggish or
absent
• takes 14-35 days to heal by
epithelialisation from hair
follicles & sweat glands
often with severe scaring
• Contractures possible
• may require excision & skin
grafting
23. 3rd degree burns
• dry, leathery skin(white,
dark, brown or charred)
• Loss of sensation
• All dermal layers are
invovled
• will require surgery
26. Assessing Total Burn Surface Area
• Rule of Nines
– best used for large surface areas
– Expedient tool to measure extent of burn
– Modified to Rule of Sevens for pediatric age group
• Rule of palms
– best used for burns< 10% BSA
• Lund and Browder Chart
31. Criteria for Classifying the Extent of Burn
Injury(American Burn Association)
Minor Burn Injury
• Second-degree burn of less than 15% total body
surface area(TBSA) in adults or less than 10%
TBSA in children
• Third-degree burn of less than 2% TBSA not
involving special care areas (eyes, ears, face,
hands, feet, perineum, joints)
• Excludes electrical injury, inhalation injury,
concurrent trauma, all poor-risk patients (eg,
extremes of age, concurrent disease) 31
32. Criteria for Classifying the Extent of Burn
Injury(American Burn Association)
Moderate, Uncomplicated Burn Injury
• Second-degree burns of 15%–25% TBSA in
adults or10%–20% in children
• Third-degree burns of less than 10% TBSA not
involving special care areas
• Excludes electrical injury, inhalation injury,
concurrent trauma, all poor-risk patients (eg,
extremes of age, concurrent disease) 32
33. Criteria for Classifying the Extent of Burn
Injury(American Burn Association)
Major Burn Injury
• Second-degree burns exceeding 25% TBSA in adults
or 20% in children
• All third-degree burns exceeding 10% TBSA
• All burns involving eyes, ears, face, hands, feet,
perineum, joints
• All inhalation injury, electrical injury, concurrent
trauma, all poor-risk patients 33
34. Pre Hospital care for burn victims
• Ensure rescuer safety
• Stop the burning process: Stop, drop and roll
• Check for other injuries
– Standard ABC (airway, breathing, circulation)followed by a rapid
secondary survey
• Cool the burn wound
– Analgesia
– Slows the delayed microvascular damage
– minimum of 10 min
– effective up to 1 hour after the burn injury
• give oxygen
• elevate
35. Management of the Patient With a
Burn Injury
35
• Burn care must be planned according to the burn
depth and local response, the extent of the injury,
and the presence of a systemic response.
• Burn care then proceeds through three phases:
– Emergent/resuscitative phase (on-the-scene care),
– Acute/intermediate phase, and
– Rehabilitation phase.
• Although priorities exist for each of the phases, the
phases overlap, and assessment and management
of specific problems and complications are not
limited to these phases but take place throughout
burn care.
36. Table: phases of burn care
36
Phase Duration Priorities
Emergent or
immediate
resuscitative
From onset of injury to
completion
of fluid resuscitation
ď‚· First aid
ď‚· Prevention of shock
ď‚· Prevention of respiratory distress
ď‚· Detection and treatment of concomitant
injuries
ď‚· Wound assessment and initial care
Acute From beginning of diuresis
to near
completion of wound
closure
ď‚· Wound care and closure
ď‚· Prevention or treatment of
complications, including infection
ď‚· Nutritional support
Rehabilitatio
n
From major wound closure
to return
to individual’s optimal level
of physical
and psychosocial
adjustment
ď‚· Prevention of scars and contractures
ď‚· Physical, occupational, and vocational
rehabilitation
ď‚· Functional and cosmetic reconstruction
ď‚· Psychosocial counseling
37. • Criteria for admission to hospital/Burns Unit
• suspected airway/inhalational injury
• any burn requiring fluid resuscitation (>15% in adults and 10% in
children)
• any burn requiring surgery
• burns to special areas; face, hands, feet perineum
• pts with psychiatric or social circumstance making it inadvisable to
send them home
• any suspicion of non-accidental Injury
• Any burn in a patient at extremes of age
• any burn associated with potentially serious sequelae
• high tension electrical burns
• Chemical burns
38. Emergent/resuscitative phase mgt
• Emergency Medical Management
• A: Airway Control
• B: Breathing and ventilation
• C: Circulation
• D: Disability - neurological status
• E: Exposure with environmental control
• F: Fluid resuscitation
38
39. • Airway Recognition of the
potentially burned airway
– A history of being trapped in
the presence of smoke or hot
Gases
– Burns on the palate or nasal
mucosa, or loss of all the
hairs in the nose
– burns around the mouth and
neck
40. Burned airway
• Early elective intubation is
safest
• Delay can make intubation
very difficult because of
Swelling
• Be ready to perform an
emergency cricothyroidotomy
if intubation is delayed
41. Upper Airway Injury
• Injury above the glottis
• Results from direct heat (hot air) or edema
• Manifested by mechanical obstruction of the
upper airway, including the pharynx and the
larynx
• Assess patients for facial burns, erythema,
swelling, tachypnea, dyspnea, hoarsness, and
singed nasal hairs.
• Treatment: early endotracheal or nasotracheal
intubation
42. Lower Airway Injury
• Injury below the glottis
• Results from inhaling toxic gases and chemical
contained in inhaled smoke
• When these substances come in contact with
pulmonary mucosa, irritation and inflammation
reaction occurs, resulting in hypersecretion, severe
mucosal edema, ciliary action , and possibly
bronchospasm
• Pulmonary surfactant is reduced, causing atelectasis
• Assess patient for expectoration of sputum with
carbon particles
43. Carbon Monoxide (CO) Poisoning
• CO is a colorless, odorless
gas that is a by-product of
the combustion of organic
materials.
• The affinity of hemoglobin
for CO is 200X greater than
that for Oâ‚‚
• CO combines with
hemoglobin to form
carboxyhemoglobin and
blocks the uptake of Oâ‚‚ and
causing tissue hypoxia
• Treatment: early intubation
and mechanical ventilation
with 100% Oâ‚‚
44. Fluids for resuscitation
• In children with burns over 10% TBSA and adults with burns
over 15% TBSA, consider the need for intravenous fluid
resuscitation
• Fluids needed can be calculated from a standard formula
• Parkland Formula: Total percentage body surface area ×
weight(kg) Ă— 4 = volume (ml)
– Half this volume is given in the first 8 hours, and
– the second half is given in the subsequent 16hours.
45. • Crystalloid : Ringer’s lactate
• Hypertonic saline
• Human albumin solution
• Colloid resuscitation
Not Routinely
Used in Our set
up !!
46. Management of fluid loss and shock
Fluid Replacement Therapy:
• The total volume and rate of intravenous fluid
replacement are gauged by the patient’s
response.
• The adequacy of fluid resuscitation is determined
by:
– urine Output totals of 30 to 50 mL/hour
–systolic blood pressure exceeding 100 mm Hg
and/or
– pulse rate less than 110/minute. 46
48. Acute Phase management
• Hemodynamically stable through diuresis
• Capillary permeability is restored
• 48-72 hours after injury
• Goal is restorative therapy
• Focus on infection control, wound care and
closure, nutritional support, pain management,
PT
• Concluded when the burned area is completely
covered by skin grafts or when the wounds are
healed 48
49. Full to deep partial
thickness HWB
Skin graft
Day 1
3 weeks
Day 12
50. Acute Phase management
Pathophysiology
• Diuresis from fluid mobilization occurs, and the
patient is no longer grossly edematous
• Bowel sounds return
• Healing begins
• Formation of granulation tissue
• A partial-thickness burn wound will heal from
the edges
• Full-thickness burns must be covered by skin
grafts 50
51. Acute Phase management
• Wound Care
• Daily observation
• Assessment
• Cleansing
• Debridement
• Appropriate coverage of the burn
51
52. TREATING THE BURN WOUND
• Escharotomy Circumferential
full-thickness burns to the limbs
require emergency surgery.
• The tourniquet effect of this
injury is easilytreated by incising
the whole length of full-
thickness burns..
• Escharotomy•
– Incise along medialand/or
lateral surfaces.
– Avoid bonyprominences.
– Avoid tendons, nerves,major
vessels.
53. • Debridement•
• Types of debridement:
– 1. Auto debridement.
– 2. Tangential excision (at the
end of 1st week)
– 3. Staged primary
debridement (1-3 days
postburn).
• This early debridement of
dead tissue interrupts and
attenuates the systemic
inflammatory response and
normalize immune function
– .4. For deep circumferential
burn, urgent escharotomy is
done
54. • Superficial burns expected to heal by
epitheliaization are managed by either
Exposure Method or by Closed Dressing
55. Acute Phase management
Excision and Grafting
• Eschar is removed down to the subcutaneous
tissue or fascia and skin grafts done
55
59. Acute Phase management
Pain Management
• Opioids
• Several drugs in combination ( MULTIMODAL
ANALGESIA)
• Non pharmacologic strategies
• Relaxation tapes
• Visualization, guided imagery
• Meditation
59
60. Acute Phase management
• Nutrition
– Burns patients need extra feeding
– A nasogastric tube should be used in allpatients with
burns over 15% of TBSA
– Removing the burn and achieving healing stops the
catabolic drive.
• Nutrition Sutherland formula
– Children: 60 kcal/ kg + 35 kcal% TBSA
– Adults: 20 kcal /kg + 70 kcal% TBSA
– Protein20% of energy1.5 to 2 g/kg protein/day
61. Acute Phase management
Infection Prevention
• Tetanus prophylaxis
– Tetanus toxoid, 0.5 mL intramuscularly, if thelast booster dose was
more than 5 years beforethe injury.
– If immunization status is unknown,human tetanus immunoglobulin
250 to 500units, I.M. plus tetanus toxoid in opposite side
• Monitoring and control of infection
– Burns patients are immunocompromised
– They are susceptible to infection from manyroutes
– Sterile precautions must be rigorous
– Swabs should be taken regularly
– A rise in white blood cell count,thrombocytosis and increased
catabolism are warnings of infection
62. • Topical treatment of deep burns
– 1% silver sulphadiazine cream
– • 0.5% silver nitrate solution
– Mafenide acetate cream•
– Serum nitrate, silver sulphadiazine and
ceriumnitrate
63. Rehabilitation Phase
• The rehabilitation phase is defined as
beginning when the patient’s burn wounds
are covered with skin or healed and the
patient is able to resume a level of self-care
activity
• Complications
– Skin and joint contractures
– Hypertrophic scarring
63
64. Rehabilitation Phase
• Both patient and family actively learn how to
care for healing wounds
• Cosmetic surgery is often needed following
major burns
• Role of exercise (physiotherapy) cannot be
overemphasized
• Constant encouragement and reassurance
• Address spiritual and cultural needs
• Maintain a high-calorie, high-protein diet
• Occupational therapy 64
65. Complications of Burns
• Emergent phase
– Shock and multi organ failure
• Renal failure
– Respiratory failure (inhalational Injury)
– Hypothermia
70. Chemical Burns
Chemical Burns
Acids
• Protein injury by hydrolysis.
• Thermal injury is made with skin contact.
Alkali
• Saponification of fat
• Hygroscopic effect- dehydrates cells
• Dissolves proteins by creation of alkaline
proteinates (hydroxide ions)
71. Electrical Burns
• Greatest heat occurs at the points
of resistance
• –Entrance and Exit wounds
• –Dry skin = Greater resistance
• – Wet Skin = Less resistance
• Longer the contact, the greater the
potential of injury
– Increased damage inside body
• Smaller the point of contact, the
more concentrated the energy, the
greater the injury.
72. • Electrical Current Flow
• –Tissue of Less Resistance
• • Blood vessels
• • Nerve
– –Tissue of Greater Resistance
• • Muscle
• • Bone
• Results in………..
• –Serious vascular and nervous injury
• –Immobilization of muscles
• –Flash burns
• Late complications: cataracts, progressive
demyelinating neurologic loss
73.
74. • Assess patient
• Entrance & Exit wounds
• Remove clothing, jewelry, and leather items
• Treat any visible injuries– Thermal burns
• ECG monitoring– Bradycardia, Tachycardia, VF or
Asystole– Treat cardiac & respiratory arrest– Aggressive
airway, ventilation, and circulatory management.
• Consider Fluid bolus for serious burns– 20 ml/kg
• Look out for compartment syndrome – prohylactic
fasciotomy
• Myoglobinuria – leads to renal failure
Editor's Notes
CO poisoning is the most common cause of inhalation injury because it is a byproduct of the combustion of organic materials and therefore present in smoke
The pathophysiologic effects of CO poisoning is hypoxemia
100% Oâ‚‚ is essential to accelerate the removal of CO from hemoglobin molecules