Burns can damage the skin and underlying tissues through thermal injury. The severity is classified based on depth of damage. Nutritional management of burns involves three stages - an early shock period, recovery phase, and later anabolic phase. Early enteral feeding within 6-18 hours is important to prevent complications. Diet must be high in calories, protein, and nutrients to support healing and immunity. Fluid resuscitation follows Parkland formula initially. Infection control and pain management are also critical aspects of burns treatment.
This document discusses nutritional considerations in burn patients. It notes that burns greater than 20% total body surface area result in a massive metabolic injury due to increased caloric demands and systemic catabolism. Proper nutrition is critical for wound healing and recovery. The document outlines macronutrient and micronutrient requirements, emphasizing adequate protein intake of 1.5-2 g/kg/day for adults and 2.5-4 g/kg/day for children. Early enteral nutrition is preferred but parenteral nutrition may be needed for patients with gastrointestinal issues. Close monitoring is required to prevent complications like refeeding syndrome or electrolyte abnormalities that can arise from nutritional support.
A 65-year-old male was admitted to the ICU with 40% TBSA burns. He has a history of smoking and alcohol use. On exam, he has burns on his face, arms, back, buttocks, and legs requiring escharotomy. His calorie needs are estimated at 4,752 kcal/day and protein at 162 g/day. The nutrition care plan is to start NPO with EN at 60 ml/hr increasing to 120 ml/hr over 36 hours to provide 4,300 kcal, 497 g CHO, 146 g fat, 270 g protein and prevent sepsis. Labs will be monitored for stabilization.
The document discusses the nutritional needs of burn patients. Burn injuries cause hypermetabolism, rapid fluid shifts, and increased protein breakdown. Nutrition therapy aims to promote wound healing, maintain lean body mass, and restore fluid levels. Formulas are used to calculate caloric needs based on factors like total body surface area burned, age, weight, and activity level. Monitoring includes weight, prealbumin, nitrogen balance, and indirect calorimetry. Adequate intake of proteins, carbohydrates, lipids, vitamins, and minerals is important to support the body's response and healing process. Nutrients can be delivered enterally or parenterally depending on the severity and extent of burns.
- The document discusses the anatomy, classification, pathophysiology, assessment, and management of pediatric burns. It describes the layers of the skin and how burns are classified based on depth. Management of minor burns involves debriding dead tissue, evaluating the wound, and applying semiocclusive dressings. Major burns require IV fluids and special attention to risks like hypothermia and fluid imbalance due to immature kidneys in young children.
Management of a severely burnt patient by Dr. Sunil Keswani, National Burns C...NationalBurnsCentre2000
The document discusses the management of severely burnt patients. It outlines the goals of burn care including rescue, resuscitation, referral, resurfacing, rehabilitation, reconstruction, and review. It then discusses the intensive burn care unit and protocols for airway management, fluid resuscitation, wound management, nutrition, and surgery. Key aspects covered include use of the Parkland formula for fluid resuscitation, early excision and grafting for wounds, and management of specific injury types and anatomical areas.
The document provides information on burns including statistics, pathophysiology, metabolic response, case study of a patient, nutritional assessment and management, fluid management, enteral versus parenteral nutrition, and current therapeutic treatments. An estimated 180,000 deaths occur annually from burns, which disproportionately impact low and middle income countries. Burns result in an inflammatory response and immune dysfunction. Nutritional management aims to provide adequate calories and nutrients to support the hypermetabolic response while avoiding overfeeding.
This document provides guidelines for the management of burns from the pre-hospital setting through hospital care. Some key points:
- In the pre-hospital setting, remove the patient from the source of injury, stop the burning process, and pour water on burnt areas. For chemical or electrical burns, irrigate with water or turn off the current, respectively.
- In the hospital, initial care includes assessment of airway, breathing, circulation, labs, wound culture, and starting IV fluids based on the Parkland formula. Burns over 15% TBSA or with inhalation injury usually require admission.
- Wound care involves cleaning, applying antimicrobial agents like silver sulfadiazine, and dressing
This document discusses nutritional considerations in burn patients. It notes that burns greater than 20% total body surface area result in a massive metabolic injury due to increased caloric demands and systemic catabolism. Proper nutrition is critical for wound healing and recovery. The document outlines macronutrient and micronutrient requirements, emphasizing adequate protein intake of 1.5-2 g/kg/day for adults and 2.5-4 g/kg/day for children. Early enteral nutrition is preferred but parenteral nutrition may be needed for patients with gastrointestinal issues. Close monitoring is required to prevent complications like refeeding syndrome or electrolyte abnormalities that can arise from nutritional support.
A 65-year-old male was admitted to the ICU with 40% TBSA burns. He has a history of smoking and alcohol use. On exam, he has burns on his face, arms, back, buttocks, and legs requiring escharotomy. His calorie needs are estimated at 4,752 kcal/day and protein at 162 g/day. The nutrition care plan is to start NPO with EN at 60 ml/hr increasing to 120 ml/hr over 36 hours to provide 4,300 kcal, 497 g CHO, 146 g fat, 270 g protein and prevent sepsis. Labs will be monitored for stabilization.
The document discusses the nutritional needs of burn patients. Burn injuries cause hypermetabolism, rapid fluid shifts, and increased protein breakdown. Nutrition therapy aims to promote wound healing, maintain lean body mass, and restore fluid levels. Formulas are used to calculate caloric needs based on factors like total body surface area burned, age, weight, and activity level. Monitoring includes weight, prealbumin, nitrogen balance, and indirect calorimetry. Adequate intake of proteins, carbohydrates, lipids, vitamins, and minerals is important to support the body's response and healing process. Nutrients can be delivered enterally or parenterally depending on the severity and extent of burns.
- The document discusses the anatomy, classification, pathophysiology, assessment, and management of pediatric burns. It describes the layers of the skin and how burns are classified based on depth. Management of minor burns involves debriding dead tissue, evaluating the wound, and applying semiocclusive dressings. Major burns require IV fluids and special attention to risks like hypothermia and fluid imbalance due to immature kidneys in young children.
Management of a severely burnt patient by Dr. Sunil Keswani, National Burns C...NationalBurnsCentre2000
The document discusses the management of severely burnt patients. It outlines the goals of burn care including rescue, resuscitation, referral, resurfacing, rehabilitation, reconstruction, and review. It then discusses the intensive burn care unit and protocols for airway management, fluid resuscitation, wound management, nutrition, and surgery. Key aspects covered include use of the Parkland formula for fluid resuscitation, early excision and grafting for wounds, and management of specific injury types and anatomical areas.
The document provides information on burns including statistics, pathophysiology, metabolic response, case study of a patient, nutritional assessment and management, fluid management, enteral versus parenteral nutrition, and current therapeutic treatments. An estimated 180,000 deaths occur annually from burns, which disproportionately impact low and middle income countries. Burns result in an inflammatory response and immune dysfunction. Nutritional management aims to provide adequate calories and nutrients to support the hypermetabolic response while avoiding overfeeding.
This document provides guidelines for the management of burns from the pre-hospital setting through hospital care. Some key points:
- In the pre-hospital setting, remove the patient from the source of injury, stop the burning process, and pour water on burnt areas. For chemical or electrical burns, irrigate with water or turn off the current, respectively.
- In the hospital, initial care includes assessment of airway, breathing, circulation, labs, wound culture, and starting IV fluids based on the Parkland formula. Burns over 15% TBSA or with inhalation injury usually require admission.
- Wound care involves cleaning, applying antimicrobial agents like silver sulfadiazine, and dressing
The document provides guidelines for the initial care of burn patients. It describes evaluating the patient's airway, breathing, and circulation as top priorities in the primary survey. It recommends establishing intravenous access and monitoring vital signs. The secondary survey involves a full head-to-toe examination to assess the extent and depth of burns and check for other injuries. Proper wound care includes cleaning and dressing burns, with topical antibiotics like silver sulfadiazine applied. Fluid resuscitation is also critical based on the percentage of total body surface area burned. Admission to a burn unit is recommended for deeper or more extensive burns.
Burns are a leading cause of accidental pediatric injuries and deaths worldwide. Scalding from hot liquids is the most common cause of burns in children, often related to cooking practices. Initial management involves fluid resuscitation, antibiotics, dressings, and nutrition to support wound healing. Complications can include disfigurement, contractures, and emotional trauma. Ultimately, decreasing the burden of pediatric burns requires prevention through education, legislation, and environmental modifications.
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.
WARNING: VERY VISUAL PRESENTATION. My first presentation on burns and their various medical, surgical and nursing interventions. It's a total crash course. Pardon me for forgetting the references. PS: All images are from Google.
Fever is a common reason children see doctors and causes concern for parents. A fever is defined as a temperature over 37.2°C before noon or 37.7°C after noon. Fever occurs due to infection, inflammation or injury and raises the hypothalamic temperature set point. While sometimes indicating a minor self-limiting infection, fever can also signal a serious disorder. The document discusses evaluating fever, defining related terms like bacteremia and sepsis, the pathophysiology of fever production, and methods for safely measuring a child's temperature.
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.
The lesson plan provides information on burns, including definitions, causes, pathophysiology, types, signs and symptoms, investigations, management, complications, and prevention. The objectives are for students to understand burns and manage burn patients. Burns are caused by heat, chemicals, electricity, friction or radiation. Management involves fluid resuscitation, wound care, medications, nutrition, and rehabilitation. Complications can be acute like infection, ulcers or chronic like scarring. Prevention of burns through education is also discussed.
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 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.
Anaesthetic management in a patient of burns injurykshama_db
This document provides an overview of the anaesthetic management of a burn patient. It begins with definitions and classifications of burns. It then discusses the pathophysiology of burns which involves inflammatory and circulatory changes, injury to the airway and lungs, immune system response, and effects on other organ systems. The document outlines assessment of burn wounds including total body surface area involved and depth of burns. It discusses the role of the anaesthesiologist in airway management, vascular access, fluid resuscitation, and surgical procedures for burn patients. The goal of management is to maintain intravascular volume following a burn to provide sufficient circulation to preserve organ function.
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.
This document discusses various topics related to thermoregulation including types of temperature, factors affecting thermoregulation, fever, hyperthermia, hypothermia, and frostbite. It defines these conditions and discusses their causes, signs and symptoms, diagnosis, and management. Nursing considerations are provided for assessment and care of patients experiencing fever, hyperthermia, and hypothermia. Current trends in cooling techniques for hyperthermia are also reviewed.
This document discusses the evaluation and management of fever without a source in children. It defines fever of unknown origin and provides background on the incidence and common causes. Guidelines are presented for evaluation and treatment based on a child's age, appearance, and vital signs. For children who appear well, testing and treatment depends on factors like temperature and white blood cell count. Toxic-appearing children should receive a full evaluation and empiric antibiotics in the hospital. The importance of careful evaluation and follow-up is discussed to avoid potential medical/legal issues.
This document discusses fevers in children. It defines normal temperatures and grades fevers from mild to hyperpyrexia. Fevers are caused by infections and inflammation which trigger cytokines and change the temperature regulation set point. Fevers have benefits like enhancing defenses but also risks like dehydration, tachycardia, and febrile seizures. Common infectious causes in children include viral infections, gastrointestinal infections, ear infections, and respiratory infections. Treatment involves antipyretics like acetaminophen or ibuprofen and fluids. Sponging may be used for high fevers over 41°C or seizures.
Hypothermia is a significant problem in neonates that can lead to increased mortality and morbidity. It is caused by situations that lead to excessive heat loss or poor ability to produce heat in babies. These include cold environments, wet skin, procedures like bathing, and low birth weight. Newborns are prone to hypothermia due to their large surface area and limited ability to generate heat. Prevention focuses on keeping babies warm through immediate drying and skin-to-skin contact with the mother. Treatment involves gradually rewarming the baby and minimizing further heat loss. Healthcare providers must be alert to the risks and take steps to maintain the baby's temperature within a normal range.
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.
This document provides an overview of burn injury management. It discusses the epidemiology, pathophysiology, classification, and treatment principles for burns. The key aspects of management include initial resuscitation using fluid replacement formulas to prevent shock, wound care, infection prevention, and long-term rehabilitation to address physical and psychological impacts of severe burns. Proper management requires a multidisciplinary team to address the many systemic effects of serious burns.
1) Burns are classified based on depth of tissue damage, with first degree affecting only the epidermis and third degree extending into deeper tissues.
2) Burn injuries cause fluid shifts, increased metabolism, and immune dysfunction that must be addressed through resuscitation and wound management.
3) Initial treatment involves fluid resuscitation, airway protection, infection control and pain management. Hospitalization is needed for severe or complicated burns.
This document summarizes key information about burns. It discusses that burns are most commonly caused by flames, scalds, or other sources of heat/fire. It notes the severity of burns is related to temperature and duration of exposure. It describes the different degrees of burns from first to fourth degree. It discusses pediatric considerations for burns and outlines management including wound care, fluid resuscitation, nutrition, and criteria for transfer to a burn center. Nursing care focuses on addressing issues like impaired mobility, disturbed body image, pain, infection risk and more.
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.
The document provides guidelines for the initial care of burn patients. It describes evaluating the patient's airway, breathing, and circulation as top priorities in the primary survey. It recommends establishing intravenous access and monitoring vital signs. The secondary survey involves a full head-to-toe examination to assess the extent and depth of burns and check for other injuries. Proper wound care includes cleaning and dressing burns, with topical antibiotics like silver sulfadiazine applied. Fluid resuscitation is also critical based on the percentage of total body surface area burned. Admission to a burn unit is recommended for deeper or more extensive burns.
Burns are a leading cause of accidental pediatric injuries and deaths worldwide. Scalding from hot liquids is the most common cause of burns in children, often related to cooking practices. Initial management involves fluid resuscitation, antibiotics, dressings, and nutrition to support wound healing. Complications can include disfigurement, contractures, and emotional trauma. Ultimately, decreasing the burden of pediatric burns requires prevention through education, legislation, and environmental modifications.
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.
WARNING: VERY VISUAL PRESENTATION. My first presentation on burns and their various medical, surgical and nursing interventions. It's a total crash course. Pardon me for forgetting the references. PS: All images are from Google.
Fever is a common reason children see doctors and causes concern for parents. A fever is defined as a temperature over 37.2°C before noon or 37.7°C after noon. Fever occurs due to infection, inflammation or injury and raises the hypothalamic temperature set point. While sometimes indicating a minor self-limiting infection, fever can also signal a serious disorder. The document discusses evaluating fever, defining related terms like bacteremia and sepsis, the pathophysiology of fever production, and methods for safely measuring a child's temperature.
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.
The lesson plan provides information on burns, including definitions, causes, pathophysiology, types, signs and symptoms, investigations, management, complications, and prevention. The objectives are for students to understand burns and manage burn patients. Burns are caused by heat, chemicals, electricity, friction or radiation. Management involves fluid resuscitation, wound care, medications, nutrition, and rehabilitation. Complications can be acute like infection, ulcers or chronic like scarring. Prevention of burns through education is also discussed.
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 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.
Anaesthetic management in a patient of burns injurykshama_db
This document provides an overview of the anaesthetic management of a burn patient. It begins with definitions and classifications of burns. It then discusses the pathophysiology of burns which involves inflammatory and circulatory changes, injury to the airway and lungs, immune system response, and effects on other organ systems. The document outlines assessment of burn wounds including total body surface area involved and depth of burns. It discusses the role of the anaesthesiologist in airway management, vascular access, fluid resuscitation, and surgical procedures for burn patients. The goal of management is to maintain intravascular volume following a burn to provide sufficient circulation to preserve organ function.
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.
This document discusses various topics related to thermoregulation including types of temperature, factors affecting thermoregulation, fever, hyperthermia, hypothermia, and frostbite. It defines these conditions and discusses their causes, signs and symptoms, diagnosis, and management. Nursing considerations are provided for assessment and care of patients experiencing fever, hyperthermia, and hypothermia. Current trends in cooling techniques for hyperthermia are also reviewed.
This document discusses the evaluation and management of fever without a source in children. It defines fever of unknown origin and provides background on the incidence and common causes. Guidelines are presented for evaluation and treatment based on a child's age, appearance, and vital signs. For children who appear well, testing and treatment depends on factors like temperature and white blood cell count. Toxic-appearing children should receive a full evaluation and empiric antibiotics in the hospital. The importance of careful evaluation and follow-up is discussed to avoid potential medical/legal issues.
This document discusses fevers in children. It defines normal temperatures and grades fevers from mild to hyperpyrexia. Fevers are caused by infections and inflammation which trigger cytokines and change the temperature regulation set point. Fevers have benefits like enhancing defenses but also risks like dehydration, tachycardia, and febrile seizures. Common infectious causes in children include viral infections, gastrointestinal infections, ear infections, and respiratory infections. Treatment involves antipyretics like acetaminophen or ibuprofen and fluids. Sponging may be used for high fevers over 41°C or seizures.
Hypothermia is a significant problem in neonates that can lead to increased mortality and morbidity. It is caused by situations that lead to excessive heat loss or poor ability to produce heat in babies. These include cold environments, wet skin, procedures like bathing, and low birth weight. Newborns are prone to hypothermia due to their large surface area and limited ability to generate heat. Prevention focuses on keeping babies warm through immediate drying and skin-to-skin contact with the mother. Treatment involves gradually rewarming the baby and minimizing further heat loss. Healthcare providers must be alert to the risks and take steps to maintain the baby's temperature within a normal range.
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.
This document provides an overview of burn injury management. It discusses the epidemiology, pathophysiology, classification, and treatment principles for burns. The key aspects of management include initial resuscitation using fluid replacement formulas to prevent shock, wound care, infection prevention, and long-term rehabilitation to address physical and psychological impacts of severe burns. Proper management requires a multidisciplinary team to address the many systemic effects of serious burns.
1) Burns are classified based on depth of tissue damage, with first degree affecting only the epidermis and third degree extending into deeper tissues.
2) Burn injuries cause fluid shifts, increased metabolism, and immune dysfunction that must be addressed through resuscitation and wound management.
3) Initial treatment involves fluid resuscitation, airway protection, infection control and pain management. Hospitalization is needed for severe or complicated burns.
This document summarizes key information about burns. It discusses that burns are most commonly caused by flames, scalds, or other sources of heat/fire. It notes the severity of burns is related to temperature and duration of exposure. It describes the different degrees of burns from first to fourth degree. It discusses pediatric considerations for burns and outlines management including wound care, fluid resuscitation, nutrition, and criteria for transfer to a burn center. Nursing care focuses on addressing issues like impaired mobility, disturbed body image, pain, infection risk and more.
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 Presentation is about burn in children it's defination ,causes , classification , methods of estimation of TBSA of burn , diagnose , medical , surgical and nursing management and complications.
This document provides an overview of burn injuries, including epidemiology, classification, pathophysiology, management approaches, and specific considerations for certain burn types. Some key points:
- Burn injuries represent a devastating physical and psychological trauma that remains a major problem globally.
- Burn depth, extent, cause, and presence of inhalation injury or other comorbidities determine classification and treatment approach.
- Goals of burn care include restoring form and function as well as facilitating psychological recovery.
- Initial management focuses on rescue, resuscitation, and wound care with subsequent rehabilitation.
- Surgical excision and skin grafting are often needed to promote healing.
This document provides an overview of burn management and treatment. It discusses the different types of burns including thermal, chemical, electrical, and radiation burns. It describes burn depth classification and assessment tools like the Rule of Nines. It outlines the principles of burn resuscitation and fluid management over the first 72 hours. It also covers monitoring, wound care, infections, surgical procedures, and first aid for burns. The goal is to prevent shock, maintain organ perfusion, control infections, and promote wound healing.
This document provides information about burns from Prof. A. Akila Devi. It defines burns as wounds caused by exogenous agents leading to tissue necrosis. It discusses the types of burns including thermal, chemical, electrical, radiation, and inhalation burns. It describes the changes that occur in the body during the emergent, fluid shift, systemic, and resolution phases. It also covers burn wound assessment, calculating total body surface area, management during the emergent, acute, and rehabilitative phases, and prevention and first aid measures for burns.
A complete review for all medical students and doctors working in burn unit in any hospital. #Emergency #BurnProtocol #protocol #Burns #Abhishek #MUSTKNOW #knowledge #Medical #Health
This document discusses nutrition therapy goals and requirements for burn patients. It outlines three main goals: promote wound healing, maintain lean body mass, and restore fluid levels. It classifies burn severity into three degrees and describes their effects on the body. Nutrition therapy should aim to meet high protein and calorie needs through oral intake if possible or enteral feeding if needed. A sample diet plan emphasizes lean proteins, fruits/vegetables, whole grains, and healthy fats to aid recovery.
this slide is selection important part of thermal burn topic in
Tintinalli's Emergency Medicine
with this presentation you can have a great present in your collage.
A burn is a cutaneous injury caused by heat, electricity, chemicals, friction, or radiation. Burns are classified based on the depth of skin involvement, ranging from superficial 1st degree burns only involving the epidermis to full thickness 3rd degree burns extending into subcutaneous tissue. Management involves stopping the burning process, assessing airway and breathing needs, administering fluid resuscitation based on formulas like Parkland that account for total body surface area burned, and treating wounds appropriately based on depth. Proper initial burn management and resuscitation are critical to prevent complications and optimize healing outcomes.
This document discusses the management of burns. It begins by providing global statistics on burn deaths and defines what constitutes a burn. It then covers the pathophysiology and classification of burns based on etiology, depth and total body surface area affected. The document outlines the emergency management of burns, including fluid resuscitation using the Parkland formula. It discusses the acute, intermediate and rehabilitation phases of management, focusing on wound care, nutrition, rehabilitation and scar management. The goal is optimal long-term function and quality of life for burn patients.
Burns can cause significant injury and require careful management. The document discusses:
1) The classification of burns as first, second, third, or fourth degree based on depth of tissue damage. Deep burns involving muscle and bone carry the worst prognosis.
2) Burn extent is evaluated using methods like the Rule of Nines to determine percentage of total body surface area affected to guide fluid resuscitation.
3) Initial priorities are airway protection, stopping the burning process, and preventing hypothermia. Fluid resuscitation based on formulas like Parkland is critical to avoid hypovolemic shock.
4) Long term concerns include wound care, risk of infection, contractures, and psychological impacts
1. A burn injury is damage to skin and tissues caused by thermal, chemical, electrical or radiation sources. Burn injuries are common, especially among children and the elderly.
2. Scalds from hot liquids are a leading cause of burns, especially in children under 5 years old. Flame burns also commonly result from house fires or improper use of flammable materials.
3. Severe burns require extensive fluid resuscitation to prevent shock, along with wound management, nutritional support, and rehabilitation services. Proper treatment of burns focuses on preventing complications and promoting healing.
This document provides information on nursing management of patients with burns. It discusses assessment of burns including determining burn depth, size, and severity. It outlines management of minor burns including cleaning, dressing, and ensuring analgesia. Management of major burns involves establishing airway, ensuring breathing and circulation, administering intravenous fluids, and transferring patients to a burn center for specialized care. Immediate steps include stopping the burning process, assessing for inhalation injuries, and providing fluid resuscitation.
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.
Similar to Burnsqtfinal 140320090236-phpapp02 (20)
Letter to MREC - application to conduct studyAzreen Aj
Application to conduct study on research title 'Awareness and knowledge of oral cancer and precancer among dental outpatient in Klinik Pergigian Merlimau, Melaka'
This particular slides consist of- what is hypotension,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 the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
INFECTION OF THE BRAIN -ENCEPHALITIS ( PPT)blessyjannu21
Neurological system includes brain and spinal cord. It plays an important role in functioning of our body. Encephalitis is the inflammation of the brain. Causes include viral infections, infections from insect bites or an autoimmune reaction that affects the brain. It can be life-threatening or cause long-term complications. Treatment varies, but most people require hospitalization so they can receive intensive treatment, including life support.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
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About this webinar: This talk will introduce what cancer rehabilitation is, where it fits into the cancer trajectory, and who can benefit from it. In addition, the current landscape of cancer rehabilitation in Canada will be discussed and the need for advocacy to increase access to this essential component of cancer care.
Rate Controlled Drug Delivery Systems, Activation Modulated Drug Delivery Systems, Mechanically activated, pH activated, Enzyme activated, Osmotic activated Drug Delivery Systems, Feedback regulated Drug Delivery Systems systems are discussed here.
Hypertension and it's role of physiotherapy in it.Vishal kr Thakur
This particular slides consist of- what is hypertension,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 summary of hypertension -
Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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:
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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.
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.
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Map: https://cutt.ly/BwCeflYo
Name: Apollo Hospital
Address: Singar Nagar, LDA Colony, Lucknow, Uttar Pradesh 226012
Phone: 08429021957
Opening Hours: 24X7
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.
2. The skin has an important role to play in the
fluid and temperature regulation of the
body. If enough skin area is injured, the
ability to maintain that control can be lost.
The skin also acts as a protective barrier
against the bacteria and viruses that inhabit
the world outside the body.
3. There are three
layers:
1.Epidermis, the outer
layer of the skin.
2.Dermis, made up
of collagen and elastic
fibers and where
nerves, blood vessels,
sweat glands, and hair
follicles reside.
3.Hypodermis
or subcutaneous
tissue, where larger
blood vessels and
nerves are located.
This is the layer of
tissue that is most
important in
temperature
regulation.
4. • Burns are a result of the effects of thermal
injury on the skin and other tissues
• Human skin can tolerate temperatures up to
42-440
C (107-1110
F) but above these, the
higher the temperature the more severe the
tissue destruction
• Below 450
C (1130
F), resulting changes are
reversible but >450
C, protein damage
exceeds the capacity of the cell to repair
5. Classification According to Depth
• First-degree Burns (mild): epidermis
Pain, erythema & slight swelling, no blisters
Tissue damage usually minimal, no scarring
Pain resolves in 48-72 hours
• Superficial Second-degree Burns:
entire epidermis & variable dermis
Vesicles and blisters characteristic
Extremely painful due to exposed nerve
endings
Heal in 7-14 days if without infection
• Midlevel to Deep Second-degree Burns:
Few dermal appendages left
There are some fluid & metabolic effects
• Full-thickness or Third-Degree: entire
epidermis and dermis, no residual epidermis
Painless, extensive fluid & metabolic deficits
Heal only by wound contraction, if small, or if
big, by skin grafting or coverage by a skin flap
7. • Burns are measured as a percentage of
total body area affected. The"rule of
nines“ , is a measurement adjusted for
infants and children.
• This calculation is based upon the fact that
the surface area of the following parts of
an adult body each correspond to
approximately 9% of total (and the total
body area of 100% is achieved):
• Head = 9%
• Chest (front) = 9%
• Abdomen (front) = 9%
• Upper/mid/low back and buttocks = 18%
• Each arm = 9%
• Each palm = 1%
• Groin = 1%
• Each leg = 18% total (front = 9%, back =
9%)
• As an example, if both legs (18% x 2 =
36%), the groin (1%) and the front chest
and abdomen were burned, this would
involve 55% of the body.
8. • Rule of Nines
• Rule of Palms
• Lund & Browders chart
• Baux Score = Age + % of Burn
9. Classification According to Extent
• Mild: 10%
• Moderate:
10-30%
• Severe: > 30%
• Hospitalization
for > 10% of
body surface area
Anatomic
structure
Surface
area
Head 18%
Anterior Torso 18%
Posterior Torso 18%
Each Leg 14%
Each Arm 9%
Perineum 1%
Infant Rule of Nines
(for quick assessment of
total body surface area
affected by burns)
10. • Scald Burn: most frequent in home injuries; hot
water, liquids and foods are most common causes;
above 65o
C, cell death
• Flame Burn: due to gasoline, kerosene, liquified
petroleum gas (LPG) or burning houses
• Chemical Burn: common in industries and
laboratories but may also occur at home; acid is
more common than alkali
• Electrical Burn: worse than the other types; with
entrance and exit wounds; may stop the heart and
depress the respiratory center; may cause
thrombosis and cataracts
• Radiation Burn: from X-ray, radioactive radiation
and nuclear bomb explosions
13. Electrical Burns
Entrance Wounds
Electrical Burns
Exit Wounds
Entrance wound of electrical
burns from an overheated tool
Severe swelling
peaks 24-72 hrs after
Electrical burns mummified
1st
2 fingers later removed
14. COMPLICATIONS OF
BURNS
• Burn Shock
• Pulmonary complications due to
inhalation injury
• Acute Renal Failure
• Infections and Sepsis
• Curling’s ulcer in large burns over
30% usually after 9th
day
• Extensive and disabling scarring
• Psychological trauma
• Cancer called Marjolin’s ulcer, may
take 21 years to develop
15. • Typically, biphasic response
• The initial period of hypofunction manifests as:
• (a) Hypotension,
• (b) Low cardiac output,
• (c) Metabolic acidosis,
• (d) Ileus,
• (e) Hypoventilation,
• (f) Hyperglycemia,
• (g) Low oxygen consumption and
• (h) Inability to thermoregulate
16. Nutritional care for a patient in burns is adjusted to
individual needs and is given in three stages:
This ebb phase/ Shock Period occurs usually in the
first 24 hours and responds to fluid resuscitation
The flow/ Recovery phase, resuscitation, follows and
is characterized by gradual increases in (a) Cardiac
output, (b) Heart rate, (c) Oxygen consumption
and (d) Supranormal increases of temperature
The Anabolic Phase/ hypermetabolic hyperdynamic
response peaks in 10-14 days after the injury after
which condition slowly recedes to normal as the
burn wounds heal naturally or surgically closed by
applying skin grafting
17. GOALS OF NUTRITIONAL
MANAGEMENT
•To promote optimal wound healing and rapid recovery
from burn injuries.
•To minimise risk of complications, including infections
during the treatment period
•To attain and maintain normal nutritional status
•To minimise metabolic disturbances during the
treatment process
18. OBJECTIVES OF
NUTRITIONAL
MANAGEMENT
•Provide nutrition via enteral route within 6 - 18
hours post burn injury
•Maintain weight within 5 % - 10 % of pre-burn
weight
•Prevent signs and symptoms of micronutrient
deficiency
•Minimise hyperglycaemia
•Minimise hypertriglyceridaemia
19. NUTRITIONAL MANAGEMENT
Enteral Feeding Should Be Commenced Early
Aggressive Nutritional Support is Often
Required
Energy Requirements are Elevated by the Burn
Injury
Protein Requirements are Substantially
Increased
An Increased Requirement Exists for Nutrients
Associated with Healing and Immune Function
20. Enteral nutrition support with a high–protein, high–carbohydrate
diet is recommended, and timing may be critical.
Feedings started within ~ 4 to 36 hours following injury appear to
have advantages over delayed (> 48 hours) feedings.
Enteral support can reduce the burn–related increase in secretion of
catabolic hormones and help maintain gut mucosal integrity.
The duodenal route is better tolerated than gastric feeding, due to an
18% failure rate in the latter from regurgitation.
Total parenteral nutrition (TPN) is not recommended, due to its
ineffectiveness in preventing the catabolic response to burns.TPN
also impairs immunity and liver function and increases mortality,
when compared with enteral nutrition.
21. ENERGY AND
MACRONUTRIENT SUPPORT
Significant weight loss is preventable with nutritional support.
Recommended daily energy intake is as follows:
for adults,
25 calories per kilogram plus 40 calories per each percent
of burn area
for children,
1,800 calories plus 2,200 calories per m2 of burn area.
Individualized nutrition assessment is recommended for patients
with burns on >20% of TBSA
22. •High–carbohydrate, low–fat diets for burn patients result in less
proteolysis and more improvement in lean body mass, compared
with high–fat diets,and may reduce infectious morbidity and
shorten hospitalization time, when compared with a high–fat
regimen.
•However, the benefit of a high–carbohydrate formula must be
balanced against the risk for hyperglycemia, which can negatively
influence the outcome of critically ill patients. Nearly all burn
patients experience insulin resistance as part of their
hypermetabolic response and will need to be placed on an insulin
drip to maintain tight control of their blood glucose level.
•Protein and fluid needs must also be considered carefully. Protein
oxidation rates are 50% higher in burn patients, and protein needs
are ~1.5 to 2.0 grams/kg. Water loss can be as much as 4
liters/m2/day, and a range of 30 to 50 ml/hour is given depending
on urine output
23. FIRST AID MEASURES IN
BURNS
1. Extinguish flames by rolling in the ground, cover
child with blanket, coat or carpet
2. After determining airway is patent, remove
smoldering clothes and constricting accessories
during edema phase in the 1st
24-72 hours after
3. Brush off remaining chemical if powdered or solid
then wash or irrigate abundantly with water
4. Cover burn wounds with clean, dry sheet and
apply cold (not iced) wet compresses to small
injuries; significant burns (>15-20% BSA)
decreases body temperature which
contraindicates use of cold compress dressings
5. If burn caused by hot tar, mineral oil to remove it
24. NON DIETARY MANAGEMENT
For 1st
and 2nd
degree burns less than
10% BSA
• Blisters should be left intact and
dressed with silver sulfadiazine
cream
• Dressings should be changed daily
washing with lukewarm water to
remove any cream left
25. INITIAL PROCEDURES
• Fluid infusion must be started immediately
• NGT insertion to prevent gastric dilatation,
vomiting and aspiration
• Urinary catheter to measure urine output
• Weight important and has to be taken daily
• Local treatment delayed till respiratory
distress and shock controlled
• Hematocrit and bacterial cultures necessary
26. Fluid Resuscitation
• For most, Parkland formula a suitable starting
guide (4 ml Ringer’s Lactate/kg body weight/%
BSA burned), ½ to be given over 1st
8 hr from
time of onset while remaining over the next 16 hr
• During 2nd
24 hr, ½ of 1st
day fluid requirement to
be infused as D5LR
• Oral supplementation may start 48 hr after as
homogenized milk or soy-based products given
by bolus or constant infusion via NGT
• Albumin 5% may be used to maintain serum
albumin levels at 2 g/dl
• Packed RBC recommended if hematocrit falls
below 24% (Hgb <8 g/dl)
• Sodium supplementation may be needed if burns
greater than 20% BSA
27. Inhalation Injury
• Three syndromes:
1. Early CO poisoning, airway obstruction &
pulmonary edema major concerns
2. ARDS usually at 24-48 hrs or much later
3. Pneumonia and pulmonary emboli as late
complications (days to weeks)
• Assessment:
1. Observation (swelling or carbonaceous material
in nasal passages
2. Laboratory determination of
carboxyhemoglobin and ABGs
• Treatment:
1. Maintain patient airway by early ET intubation,
adequate ventilation and oxygenation
2. Aggressive pulmonary toilet and chest
physiotherapy
28. Infection Control
• Tetanus prophylaxis: 250-500 IU or 3000 units
equine ATS ANST IM; Toxoid
• Antibiotic of choice is one that will include
Pseudomonas in its spectrum; most frequent
pathogens in burns are Staphylococcus aureus,
Pseudomonas aeruginosa and the Klebsiella-
Enterobacter species
• Topical therapy:
0.5% Silver nitrate dressing
Mafenide acetate or Sulfacetamide acetate
cream
Silver sulfadiazine cream
Povidone-iodine ointment
Gentamicin cream or ointment
29. Pain Relief and Adjustment
• Important to provide adequate
analgesia, anxiolytics and
psychological support to:
a) Reduce early metabolic stress
b) Decrease potential for
posttraumatic stress syndrome
c) Allow future stabilization and
rehabilitation
• Family support patient through
grieving process and help accept
long-term changes in appearance
Editor's Notes
The extent of burns is expressed as percentage of the total surface area.
Scalds are the leading cause of burn injuries during the first 3 years of life.
Burns lead to alterations in the function of all organ systems. There is inability to thermoregulate because of the skin’s abnormal evaporative loss. In very extensive burns, the amount may reach 8-10 L/day. For every ml evaporated, 0.5 calorie is needed to restore the body temperature to normal since evaporation cools the body.
Nutritional Management
Enteral Feeding Should Be Commenced Early
Appropriate nutritional management of the severely burned patient is necessary to ensure optimal outcome. Initiation of early enteral feeding, within 6 to 18 hours post-burn injury, is recognised as beneficial, and has been shown to be safe in children as well as adults. Advantages of utilising the enteral route, as opposed to the parenteral route, include improved nitrogen balance, reduced hypermetabolic response, reduced immunological complications and mortality.
Aggressive Nutritional Support is Often Required
Although oral nutrition is encouraged, young children with severe burn injuries often require naso-gastric feeding as they tend to have difficulty meeting their nutritional goals with oral intake alone.
Energy Requirements are Elevated by the Burn Injury
The hypermetabolic response associated with severe burn injury results in high calorie requirements to allow optimal healing and outcome. Several predictive equations exist which enable estimations of energy requirements. Changes in management of these patients in the past decade have resulted in some reduction in the metabolic response and care must be taken to avoid over-feeding. Variation in energy needs between individuals, as well as with time, means that indirect calorimetry is recommended where practical to aid in determining energy expenditure.
Protein Requirements are Substantially Increased
Aggressive protein delivery, providing approximately 20 % of calories from protein, has been associated with improved mortality and morbidity.
An Increased Requirement Exists for Nutrients Associated with Healing and Immune Function
Provision of those nutrients known to be associated with healing and immune function, particularly vitamins A, C, E, some B vitamins and zinc, is especially important. Recent studies have indicated that benefits may also be achieved by supplementation with various additives, including fish-oil and arginine.
n physiology and medicine,hypovolemia (alsohypovolaemia, oligemia orshock) is a state of decreasedblood volume; more specifically, decrease in volume of blood plasma.[1][2] It is thus the intravascular component ofvolume contraction (or loss of blood volume due to things such as hemorrhaging or dehydration), but, as it also is the most essential one,hypovolemia and volume contraction are sometimes used synonymously.
Hypovolemia is characterized by salt (sodium) depletion and thus differs fromdehydration, which is defined as excessive loss of body water
Catecholamines are hormones produced by the adrenal glands, which are found on top of the ... They are released into the blood during times of physical or emotional stress
Thrombocytopenia-low platelet count
Thrombocytosis – high platelt count
opsonic function : is any molecule that enhances phagocytosis by marking an antigen for an immune response (i.e., causes the phagocyte to &quot;relish&quot; the marked cell).
ABG- Qarterial Blood gas
ARDS- Acute respiratory distress syndrome