This document provides an overview of principles of management of burns. It defines burns and discusses epidemiology, anatomy of the skin, pathology and pathophysiology of burns. It also covers classification of burns by depth and extent, management including fluid resuscitation, wound dressings, surgery, pain management and infection control. Specific management of electrical burns is also discussed.
The document discusses burns, including the skin layers, causes of burns, burn classifications, burn extent assessment, burn severity, and burn treatment. It describes the epidermis, dermis and hypodermis skin layers. It outlines common causes of burns such as flames, scalds, steam and electricity. It defines first, second and third degree burns based on depth of tissue damage. It provides methods for estimating total body surface area (TBSA) involved in burns using the Rule of Nines. Admission criteria and initial emergency treatment is outlined for different burn depths. Ongoing hospital management including resuscitation, wound cleaning and dressings is also summarized.
Burn injuries can cause skin and tissue damage from heat, electricity, chemicals or radiation. Advances in fluid resuscitation and early wound excision have reduced burn-related deaths by 50% over 20 years. The skin has two layers - the epidermis and dermis - which protect the body but can be damaged by burns. Burn management involves stopping the burning, airway control, fluid resuscitation, wound care including debridement and dressing, and surgery such as skin grafting. Complications include infection, shock, and organ damage. Prevention focuses on education and safety measures.
This document provides information on the acute and intermediate management of burns. The immediate treatment involves stopping the burning process, cooling the burn with water, and seeking medical help for serious burns over 5-10% of the body surface area. Wound care in the acute phase focuses on infection prevention, wound cleaning, topical antibiotics, dressing changes, pain management, and nutritional support. Surgery may be needed for deep burns unlikely to heal within 3 weeks to reduce scarring.
This document discusses burns and their physiotherapy management. It begins by defining burns as tissue injury caused by thermal, electrical, or chemical agents. It then covers burn classification, pathophysiology, complications, and assessment considerations. Burns are classified based on depth of tissue damage as epidermal, superficial partial thickness, deep partial thickness, or full thickness. Complications can include infection, pulmonary issues, fluid and electrolyte imbalances, and scar contractures. A thorough assessment examines burn depth, size, location, and patient factors.
Burn Injury classification and managementDr Alok Kumar
1. The document discusses various types of burn injuries including thermal burns from heat or flames, scalds from hot liquids, and non-thermal burns from electricity, chemicals, radiation, or cold.
2. It describes the pathology of burns including the severity and depth of tissue damage, vascular changes that can cause shock, and high risks of infection when the skin is destroyed.
3. The management of burns is outlined including treatment of shock, general wound care and infection prevention, skin grafting, and physiotherapy to prevent complications and aid rehabilitation.
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
Burns are a significant cause of injury, especially in children under 5. They are often caused by fire or scalding liquids and can range from superficial to full thickness. Initial management involves airway protection, IV fluids based on burn size, antibiotics, dressings, and nutrition. Further treatment may include debridement, grafting, and reconstruction to minimize complications like infection, contractures and disfigurement. Proper management and rehabilitation can help reduce mortality and morbidity from burn injuries.
Burn injuries can result from heat, cold, chemicals, electricity or radiation. They cause skin and tissue damage through coagulation necrosis. Globally, about 1% of the population sustains burns annually. In the US, over 2 million burn injuries are reported each year. Burns significantly increase morbidity and mortality. Younger children commonly experience scalds while flames cause most adult burns. Burn depth, extent, mechanism and presence of inhalation injury are important factors in classification and prognosis. Both local and systemic inflammatory responses can result from severe burns.
The document discusses burns, including the skin layers, causes of burns, burn classifications, burn extent assessment, burn severity, and burn treatment. It describes the epidermis, dermis and hypodermis skin layers. It outlines common causes of burns such as flames, scalds, steam and electricity. It defines first, second and third degree burns based on depth of tissue damage. It provides methods for estimating total body surface area (TBSA) involved in burns using the Rule of Nines. Admission criteria and initial emergency treatment is outlined for different burn depths. Ongoing hospital management including resuscitation, wound cleaning and dressings is also summarized.
Burn injuries can cause skin and tissue damage from heat, electricity, chemicals or radiation. Advances in fluid resuscitation and early wound excision have reduced burn-related deaths by 50% over 20 years. The skin has two layers - the epidermis and dermis - which protect the body but can be damaged by burns. Burn management involves stopping the burning, airway control, fluid resuscitation, wound care including debridement and dressing, and surgery such as skin grafting. Complications include infection, shock, and organ damage. Prevention focuses on education and safety measures.
This document provides information on the acute and intermediate management of burns. The immediate treatment involves stopping the burning process, cooling the burn with water, and seeking medical help for serious burns over 5-10% of the body surface area. Wound care in the acute phase focuses on infection prevention, wound cleaning, topical antibiotics, dressing changes, pain management, and nutritional support. Surgery may be needed for deep burns unlikely to heal within 3 weeks to reduce scarring.
This document discusses burns and their physiotherapy management. It begins by defining burns as tissue injury caused by thermal, electrical, or chemical agents. It then covers burn classification, pathophysiology, complications, and assessment considerations. Burns are classified based on depth of tissue damage as epidermal, superficial partial thickness, deep partial thickness, or full thickness. Complications can include infection, pulmonary issues, fluid and electrolyte imbalances, and scar contractures. A thorough assessment examines burn depth, size, location, and patient factors.
Burn Injury classification and managementDr Alok Kumar
1. The document discusses various types of burn injuries including thermal burns from heat or flames, scalds from hot liquids, and non-thermal burns from electricity, chemicals, radiation, or cold.
2. It describes the pathology of burns including the severity and depth of tissue damage, vascular changes that can cause shock, and high risks of infection when the skin is destroyed.
3. The management of burns is outlined including treatment of shock, general wound care and infection prevention, skin grafting, and physiotherapy to prevent complications and aid rehabilitation.
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
Burns are a significant cause of injury, especially in children under 5. They are often caused by fire or scalding liquids and can range from superficial to full thickness. Initial management involves airway protection, IV fluids based on burn size, antibiotics, dressings, and nutrition. Further treatment may include debridement, grafting, and reconstruction to minimize complications like infection, contractures and disfigurement. Proper management and rehabilitation can help reduce mortality and morbidity from burn injuries.
Burn injuries can result from heat, cold, chemicals, electricity or radiation. They cause skin and tissue damage through coagulation necrosis. Globally, about 1% of the population sustains burns annually. In the US, over 2 million burn injuries are reported each year. Burns significantly increase morbidity and mortality. Younger children commonly experience scalds while flames cause most adult burns. Burn depth, extent, mechanism and presence of inhalation injury are important factors in classification and prognosis. Both local and systemic inflammatory responses can result from severe burns.
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.
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.
This document discusses burns, including their causes, classification, pathology, systemic effects, assessment, management, and specific treatments. Some key points:
- Burns are classified based on depth (1st-4th degree) and cause (flame, scald, contact, chemicals, electricity). Deeper burns affect more tissue layers.
- Severe burns over 40% of total body surface area cause metabolic stress responses like increased cardiac output and protein loss.
- Assessment involves determining burn size, depth, inhalation injury risk, and fluid resuscitation needs.
- Management consists of stopping the burning process, treating inhalation injuries, wound care like cleaning and dressings, and fluid resusc
The document discusses burns, including definitions, causes, classifications, assessment, and management. Burns are injuries caused by heat, chemicals, electricity, or radiation. They can range from superficial to full thickness. Assessment involves determining burn severity and extent using methods like the Rule of Nine. Management consists of three phases - emergent, acute, and rehabilitation. The emergent phase focuses on fluid resuscitation to prevent shock based on established formulas.
This document 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.
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 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.
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.
This is a topic of MSN 2 from the unit of burn which include basic and initial portion of burn which includes:
definition
etiology
prevention
classification of burn
as per depth 1st, 2nd, and 3rd degree burn
rule of nine
pathophysiology
This document provides information on burns, including:
- The definition and causes of burns including thermal, electrical, chemical and radiation burns.
- The degrees of burns from first to fourth degree based on depth of tissue damage.
- Methods for estimating the percentage of total body surface area burned including the Rule of Nines.
- Criteria for burn admission to hospital care based on factors like surface area, depth and location of burns.
- Complications that can result from severe burns like infection, shock and organ damage.
- The importance of first aid like cooling the burned area in water to minimize further tissue injury.
This presentation provides an overview of burns, including:
1. Definitions, causes, types and classifications of burn injuries. Burns can be caused by heat, cold, electricity, radiation or chemicals and are classified by depth and percentage of total body surface area affected.
2. The pathophysiology and assessment of burn wounds, which involves determining burn depth, total body surface area burned, and monitoring vital signs and laboratory values.
3. The primary survey and management of burns, which includes airway control, fluid resuscitation, wound care, nutrition, infection prophylaxis and wound management.
4. Potential complications of burns like infection, stress ulcers, contractures and psychological impacts. Early excision,
Classification, Principles, assessment and management of burnalazarbekele47
The document provides an outline for principles of management of burn injuries. It begins with defining burns and discussing the epidemiology, types, classification, and pathophysiology of burns. It then covers assessment of burn wounds including depth and percentage of total body surface area burned. The document outlines primary survey and management of burns which includes airway management, as inhalation injuries often accompany severe burns. It discusses indications for hospitalization and monitoring of burn patients.
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.
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 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.
This document provides an overview of burns, including definitions, causes, pathophysiology, assessment, and management. It defines burns as tissue damage caused by thermal, electrical, chemical or radiation sources. The depth and extent of burns are assessed using tools like the Rule of Nines. Major burns are those over 25% Total Body Surface Area and can cause local and systemic effects like fluid shifts, metabolic changes and increased risk of infection. Burn management involves three phases - emergent, acute, and rehabilitation - and priorities include wound care, infection prevention and rehabilitation.
Burns are injuries caused by heat, chemicals, electricity or radiation that damage skin tissue. They are commonly caused by scalding liquids, fires, chemicals or sun exposure. Burns are classified based on depth of tissue damage as first, second or third degree. Complications include infection, fluid loss, hypothermia, breathing problems, scarring and contractures. Burn rehabilitation focuses on exercises, gait training, stretching and positioning to prevent contractures and maintain range of motion. Splints and prosthetics are also used to manage limb complications from burns.
This document provides information on burns, including causes, types, assessment, management, and treatment. It discusses:
- The different causes of burns, including thermal, electrical, chemical, and radiation burns.
- How to assess burn severity based on depth and extent of damage. Burns are typically classified as superficial, partial thickness, full thickness, or fourth degree.
- The signs and symptoms associated with different burn depths. More severe burns involve deeper tissue damage and have a poorer prognosis.
- The three phases of burn management: emergent/resuscitative, intermediate, and rehabilitative. The emergent phase focuses on initial first aid, ABCDE assessment, pain management and fluid resuscitation
Burn & its Management for Nurses And Faculty of Nursing.pptxSagar Masne
This document discusses burns, including their classification, causes, symptoms, and treatment. It describes the four main types of burns: thermal, chemical, electrical, and radiation burns. Burns are classified based on depth of tissue damage into four degrees: first, second, third, and fourth degree burns. Causes include heat, chemicals, electricity, radiation, and frostbite. Symptoms vary by severity but can include pain, swelling, and difficulty breathing. Treatment involves first aid such as cooling the burn, followed by medical care like cleaning, dressings, grafts, and managing complications to promote healing.
1) A 38-year-old female patient presented with 85% chemical burns following a household accident. She was admitted to the ICU and died 5 days later from complications.
2) The case presentation aimed to provide comprehensive patient care, understand burn disease and management, and develop a nursing care plan.
3) Chemical burns can result from strong acids/alkalis and cause severe injury depending on concentration, volume, and contact time with the skin. Management involves fluid resuscitation, wound care, pain management, and rehabilitation. Complications can include shock, infection and organ failure.
This document discusses the pathology and management of malignant bowel obstruction. It defines malignant bowel obstruction as luminal narrowing of the small or large bowel due to metastatic cancer. The most common primary cancers causing MBO are colorectal, ovarian, stomach, and pancreatic cancers. The document outlines the classification, signs and symptoms, diagnostic tests including CT scan, and various treatment options for MBO, including surgical resection, endoscopic stenting, non-operative management with medications like octreotide to relieve symptoms, and palliative care since MBO represents terminal cancer. The primary goals of treatment are palliation to improve quality of life by relieving nausea, vomiting and pain.
- Malignant melanoma is a deadly form of skin cancer that has been increasing in incidence over the past 50 years.
- It typically presents as an asymmetric mole with irregular borders and varies in color.
- Risk factors include family history, numerous moles, sun exposure, and fair skin.
- Staging involves evaluating tumor thickness and spread. Treatment may include surgery, lymph node assessment, radiation, immunotherapy, and targeted drug therapy. Prognosis depends on stage, with thinner tumors having better survival rates.
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.
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.
This document discusses burns, including their causes, classification, pathology, systemic effects, assessment, management, and specific treatments. Some key points:
- Burns are classified based on depth (1st-4th degree) and cause (flame, scald, contact, chemicals, electricity). Deeper burns affect more tissue layers.
- Severe burns over 40% of total body surface area cause metabolic stress responses like increased cardiac output and protein loss.
- Assessment involves determining burn size, depth, inhalation injury risk, and fluid resuscitation needs.
- Management consists of stopping the burning process, treating inhalation injuries, wound care like cleaning and dressings, and fluid resusc
The document discusses burns, including definitions, causes, classifications, assessment, and management. Burns are injuries caused by heat, chemicals, electricity, or radiation. They can range from superficial to full thickness. Assessment involves determining burn severity and extent using methods like the Rule of Nine. Management consists of three phases - emergent, acute, and rehabilitation. The emergent phase focuses on fluid resuscitation to prevent shock based on established formulas.
This document 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.
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 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.
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.
This is a topic of MSN 2 from the unit of burn which include basic and initial portion of burn which includes:
definition
etiology
prevention
classification of burn
as per depth 1st, 2nd, and 3rd degree burn
rule of nine
pathophysiology
This document provides information on burns, including:
- The definition and causes of burns including thermal, electrical, chemical and radiation burns.
- The degrees of burns from first to fourth degree based on depth of tissue damage.
- Methods for estimating the percentage of total body surface area burned including the Rule of Nines.
- Criteria for burn admission to hospital care based on factors like surface area, depth and location of burns.
- Complications that can result from severe burns like infection, shock and organ damage.
- The importance of first aid like cooling the burned area in water to minimize further tissue injury.
This presentation provides an overview of burns, including:
1. Definitions, causes, types and classifications of burn injuries. Burns can be caused by heat, cold, electricity, radiation or chemicals and are classified by depth and percentage of total body surface area affected.
2. The pathophysiology and assessment of burn wounds, which involves determining burn depth, total body surface area burned, and monitoring vital signs and laboratory values.
3. The primary survey and management of burns, which includes airway control, fluid resuscitation, wound care, nutrition, infection prophylaxis and wound management.
4. Potential complications of burns like infection, stress ulcers, contractures and psychological impacts. Early excision,
Classification, Principles, assessment and management of burnalazarbekele47
The document provides an outline for principles of management of burn injuries. It begins with defining burns and discussing the epidemiology, types, classification, and pathophysiology of burns. It then covers assessment of burn wounds including depth and percentage of total body surface area burned. The document outlines primary survey and management of burns which includes airway management, as inhalation injuries often accompany severe burns. It discusses indications for hospitalization and monitoring of burn patients.
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.
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 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.
This document provides an overview of burns, including definitions, causes, pathophysiology, assessment, and management. It defines burns as tissue damage caused by thermal, electrical, chemical or radiation sources. The depth and extent of burns are assessed using tools like the Rule of Nines. Major burns are those over 25% Total Body Surface Area and can cause local and systemic effects like fluid shifts, metabolic changes and increased risk of infection. Burn management involves three phases - emergent, acute, and rehabilitation - and priorities include wound care, infection prevention and rehabilitation.
Burns are injuries caused by heat, chemicals, electricity or radiation that damage skin tissue. They are commonly caused by scalding liquids, fires, chemicals or sun exposure. Burns are classified based on depth of tissue damage as first, second or third degree. Complications include infection, fluid loss, hypothermia, breathing problems, scarring and contractures. Burn rehabilitation focuses on exercises, gait training, stretching and positioning to prevent contractures and maintain range of motion. Splints and prosthetics are also used to manage limb complications from burns.
This document provides information on burns, including causes, types, assessment, management, and treatment. It discusses:
- The different causes of burns, including thermal, electrical, chemical, and radiation burns.
- How to assess burn severity based on depth and extent of damage. Burns are typically classified as superficial, partial thickness, full thickness, or fourth degree.
- The signs and symptoms associated with different burn depths. More severe burns involve deeper tissue damage and have a poorer prognosis.
- The three phases of burn management: emergent/resuscitative, intermediate, and rehabilitative. The emergent phase focuses on initial first aid, ABCDE assessment, pain management and fluid resuscitation
Burn & its Management for Nurses And Faculty of Nursing.pptxSagar Masne
This document discusses burns, including their classification, causes, symptoms, and treatment. It describes the four main types of burns: thermal, chemical, electrical, and radiation burns. Burns are classified based on depth of tissue damage into four degrees: first, second, third, and fourth degree burns. Causes include heat, chemicals, electricity, radiation, and frostbite. Symptoms vary by severity but can include pain, swelling, and difficulty breathing. Treatment involves first aid such as cooling the burn, followed by medical care like cleaning, dressings, grafts, and managing complications to promote healing.
1) A 38-year-old female patient presented with 85% chemical burns following a household accident. She was admitted to the ICU and died 5 days later from complications.
2) The case presentation aimed to provide comprehensive patient care, understand burn disease and management, and develop a nursing care plan.
3) Chemical burns can result from strong acids/alkalis and cause severe injury depending on concentration, volume, and contact time with the skin. Management involves fluid resuscitation, wound care, pain management, and rehabilitation. Complications can include shock, infection and organ failure.
This document discusses the pathology and management of malignant bowel obstruction. It defines malignant bowel obstruction as luminal narrowing of the small or large bowel due to metastatic cancer. The most common primary cancers causing MBO are colorectal, ovarian, stomach, and pancreatic cancers. The document outlines the classification, signs and symptoms, diagnostic tests including CT scan, and various treatment options for MBO, including surgical resection, endoscopic stenting, non-operative management with medications like octreotide to relieve symptoms, and palliative care since MBO represents terminal cancer. The primary goals of treatment are palliation to improve quality of life by relieving nausea, vomiting and pain.
- Malignant melanoma is a deadly form of skin cancer that has been increasing in incidence over the past 50 years.
- It typically presents as an asymmetric mole with irregular borders and varies in color.
- Risk factors include family history, numerous moles, sun exposure, and fair skin.
- Staging involves evaluating tumor thickness and spread. Treatment may include surgery, lymph node assessment, radiation, immunotherapy, and targeted drug therapy. Prognosis depends on stage, with thinner tumors having better survival rates.
Antibiotics are antimicrobial substances that are used to treat and prevent infections in surgery. There are several principles for the appropriate use of antibiotics including selecting antibiotics based on the likely pathogen, using the narrowest spectrum antibiotic when possible, and administering antibiotics at the proper dose and duration. Antibiotics can be used prophylactically before surgery to prevent infection or therapeutically to treat an established infection, and the choice is guided by clinical diagnosis, culture results when available, and the urgency of the situation. Indiscriminate antibiotic use can promote resistance and should be avoided.
This document provides an overview of principles of cancer chemotherapy. It defines key terms and outlines the goals of chemotherapy as curative or palliative. The cell cycle is described and how different classes of chemotherapeutic agents work at specific phases. Principles of chemotherapy administration include pre-assessment, counseling, modality selection, dose optimization, administration procedures, management of side effects and follow up. Common drug classes and regimens are mentioned along with mechanisms of drug resistance and future trends in chemotherapy.
PRINCIPLES OF ORGAN TRANSPLANTATION 2003.pptOlofin Kayode
The document provides an overview of principles of transplant surgery. It defines different types of transplants including autotransplants, allotransplants, and xenotransplants. It discusses the history of transplantation, basic immunology including HLA antigens and allo-graft rejection. It also covers clinical immunosuppression with drugs like corticosteroids and cyclosporin. Organ procurement, specific organ transplants, and future trends are briefly mentioned.
The document discusses surgical haemostasis, which is the process of preventing or stopping blood loss from injured blood vessels during or after surgery. It defines haemostasis and outlines its importance in surgery. The physiology of haemostasis is described, involving vasoconstriction, platelet plug formation, and coagulation/fibrin formation. Causes of bleeding during or after surgery are discussed, including defects in haemostasis or platelet function. Methods of achieving haemostasis are covered, such as mechanical techniques like pressure, sutures, and cauterization, as well as chemical agents, blood products, and thermal techniques. Management of haemostasis in the pre-operative, intra-operative, and post-operative periods
Principle of Organ Transplantation.pptxOlofin Kayode
The document provides an overview of organ transplantation, including:
- Definitions of different types of organ transplants such as allografts and xenografts.
- A historical background of major transplant milestones from the 1950s onward including the first successful kidney, liver, lung, and heart transplants.
- Details about transplant immunology, the immune response to foreign organs, and ways to suppress the immune system like with immunosuppressant drugs.
- The types of organ rejection such as hyperacute, acute, and chronic rejection.
- Considerations for organ donation, procurement, preservation, and transplantation.
- Complications after transplantation like infection and potential future directions.
Principles of cancer chemotherapy(1).pptxOlofin Kayode
This document provides an overview of principles of cancer chemotherapy. It defines key terms and outlines the goals of chemotherapy as curative or palliative. The cell cycle is described and how different classes of chemotherapeutic agents work at specific phases. Principles of chemotherapy administration include pre-assessment, counseling, modality selection, dose optimization, administration procedures, management of side effects and follow up. Common drug classes and regimens are mentioned along with mechanisms of drug resistance and future trends in chemotherapy.
This document provides an overview of surgical site infections (SSIs). It defines SSIs and related terms like colonization and contamination. It discusses the historical context, epidemiology, classification, pathogenesis, clinical features, and factors that influence SSIs. The document also covers prevention strategies like proper patient preparation, aseptic technique, and antibiotic prophylaxis. It describes approaches for clinical assessment, wound scoring systems, and management of SSIs.
This document outlines the process and importance of preanesthetic evaluation. It defines preanesthetic evaluation as a medical check-up and lab tests done before surgery to assess patient health and risks. The evaluation aims to optimize patient preparation, ensure surgery is realistic, and anticipate problems. It involves taking a medical history, examining the patient, ordering relevant tests, and developing a preoperative plan. Factors like ASA grade and POSSUM score can help predict perioperative risks. The evaluation helps educate patients, organize care, and plan anesthesia to improve surgical outcomes.
This document discusses the anatomy, classification, clinical features, investigations, and treatment techniques for peripheral nerve injuries. Some key points include:
- Peripheral nerves are composed of bundles of axons surrounded by connective tissue sheaths including the epineurium, perineurium, and endoneurium.
- Nerve injuries are classified based on the severity of damage, with neuropraxia having the best prognosis and neurotmesis having the worst.
- Treatment depends on the type and severity of injury, and may include non-operative management, primary repair, nerve grafting, nerve transfers, or the use of conduits.
- Prognosis is best when the injury
The document discusses the metabolic response to trauma, which refers to adaptive changes that maintain homeostasis after injury. It outlines the triggers, components, and sequelae of the metabolic response. The components include sympathetic nervous system activation, endocrine responses like increased cortisol and growth hormone, and cytokine responses from interleukins and tumor necrosis factor. Prolonged or accentuated metabolic responses can harm surgical patients by increasing energy needs, reducing immunity, and impairing wound healing. The response can be attenuated by measures like fluid replacement, analgesia, nutritional support, and prompt infection treatment.
This document provides an overview of sepsis and septic shock, including definitions, epidemiology, pathogenesis, clinical features, investigation, treatment, complications, and prognosis. It defines sepsis as infection plus SIRS, and septic shock as sepsis that is not responsive to fluid resuscitation and requires vasopressors. The pathogenesis involves an initial inflammatory response to infection that can become dysregulated and lead to organ dysfunction. Treatment involves prompt resuscitation, antibiotics, source control, and organ support. Outcomes depend on factors like age, immune status, pathogen, and need for prolonged vasopressor support.
Day case surgery, also known as ambulatory surgery, involves planned admission and discharge of a patient within 12 hours for a surgical procedure. It provides several benefits over traditional inpatient surgery such as shorter hospital stays, lower infection rates, and more efficient use of healthcare resources. Common procedures performed as day cases include hernia repairs, cataract removal, and tonsillectomies. Careful patient selection and optimization, as well as coordinated perioperative management involving preoperative assessment and education, regional anesthesia when possible, early mobilization and feeding, and established discharge criteria are important for success. Day case surgery allows for treatment of more patients while maintaining high quality care.
This document provides an overview of deep vein thrombosis (DVT) and pulmonary embolism (PE). It covers the definition, epidemiology, risk factors, clinical features, investigations, management including prevention, treatment and anticoagulation. DVT occurs when a blood clot forms in a deep vein, usually in the legs, while PE is a complication that can occur when part of the clot breaks off and travels to the lungs. The document outlines Virchow's triad of factors that contribute to clot formation and discusses various diagnostic tests and therapeutic approaches for DVT and PE.
Fluid and Electrolyte Management in Surgery.pptOlofin Kayode
This document provides an outline and introduction to fluid and electrolyte management in surgery. It discusses the normal distribution and balance of body water and electrolytes like sodium, potassium, calcium and magnesium. It describes various fluid and electrolyte disorders that can occur including volume disturbances, concentration disturbances and composition disturbances. It covers causes, clinical features and treatment of conditions like hyponatremia, hypernatremia, hypokalemia, hyperkalemia, hypocalcemia, hypercalcemia and acid-base imbalances. The document emphasizes the importance of fluid and electrolyte management in the perioperative care of surgical patients.
This document discusses pain from multiple perspectives:
- It defines pain and provides a brief history of pain theories.
- Pain is classified and the physiology of pain transmission is explained through multiple stages from nociception to perception.
- Different types of pain like acute, chronic, neuropathic, and referred pain are described.
- Pain assessment and various scales used to evaluate pain are outlined.
- Non-pharmacological and pharmacological management of pain are summarized.
The document discusses nutrition in surgery, outlining relevant physiology, basic nutrient requirements, causes of malnutrition, nutritional assessment techniques, energy requirements, indications for nutritional support, and methods of enteral and parenteral nutrition to correct deficiencies and support patients during and after surgery. Nutritional support can help reduce complications from malnutrition like impaired wound healing and increased risk of infection.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdfrightmanforbloodline
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Test bank for karp s cell and molecular biology 9th edition by gerald karp.pdf
Co-Chairs, Val J. Lowe, MD, and Cyrus A. Raji, MD, PhD, prepared useful Practice Aids pertaining to Alzheimer’s disease for this CME/AAPA activity titled “Alzheimer’s Disease Case Conference: Gearing Up for the Expanding Role of Neuroradiology in Diagnosis and Treatment.” For the full presentation, downloadable Practice Aids, and complete CME/AAPA information, and to apply for credit, please visit us at https://bit.ly/3PvVY25. CME/AAPA credit will be available until June 28, 2025.
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
3. Introduction/Definition
Definition:
Injury to living tissue arising from exposure to heat, friction, electricity,
radiation, chemicals or cold
• Non-fatal burn injuries are a leading cause of morbidity.
• 2/3 of all burns happen at home
• Burn injuries continue to be a major source of mortality and
morbidity in low- and middle-income countries of the world, of which
Nigeria is a part.
10/30/2023 3
4. Introduction
• Flame is emerging as the predominant cause of burns, and burn
injury is occurring increasingly away from the domestic setting.
• The severity of the injuries is also increasing.
• Several challenges militate against optimal care for burn victims.
• Burn injuries continue to contribute significantly to the burden of
disease in Nigeria.
• Avoidable complications are common and mortality remains high.
10/30/2023 4
5. Epidemiology
• 4.8% of trauma deaths in Nigeria
• 6.7% of surgically related deaths.
• In children, burns and scalds are the 4th commonest cause of
trauma < road traffic accidents < accidental falls < bites.
• Over 95% of fatal fire-related burns occurred in low- and
middle-income countries
• Chemical burns constitute 6.3% of burns in Enugu and 5% in
Ibadan
• Electrical burn injuries have an incidence of less than 1% in
children and 2.8-4.6% in all burn
10/30/2023 5
6. Epidemiology cont.…
• In India, over 1 000 000 people are moderately or severely burnt
every year.
• In Bangladesh, Colombia, Egypt and Pakistan, 17% of children with
burns have a temporary disability and 18% have a permanent
disability.
• Burns are the second most common injury in rural Nepal, accounting
for 5% of disabilities.
• In 2008, over 410 000 burn injuries occurred in the United States of
America, with approximately 40 000 requiring hospitalization.
10/30/2023 6
7. Anatomy of the skin
10/30/2023 7
The skin:
Largest organ
15% of total body weight
1.7 m2
8. Essential for:
• Thermoregulation
• Prevention of fluid loss by evaporation
• Barrier against infection
• Protection from environment provided by sensory information
• Others- social etc.
10/30/2023 8
9. Pathology of burns
• Fire/flames, Contact with hot liquids, hot/cold solid materials
induce cellular damage via transfer of energy directly leads to
coagulation necrosis.
• Chemical and electrical burns cause injury via cell membrane
damage in addition to thermal injury.
• Depth of Injury depends on 3 factors
1. Causative agents
2. Temperature at which skin exposed
3. Duration of Exposure.
10/30/2023 9
13. Pathophysiology
Systemic Effects of Burns
1. Cardiovascular system
2. Renal system
3. Respiratory tract changes
4. Gastrointestinal tract changes
5. Central nervous system
changes
6. Hematological changes
7. Metabolic changes
8. Endocrine changes
9. Immune system changes
10/30/2023 13
14. Pathophysiology cont.…
Post Burn Metabolic Phenomena
Two Distinct phase of metabolic changes observed in post burns.
Ebb phase
• It occurs within the first 48 hours of injury
• Characterized by decrease in cardiac output, oxygen consumption
and metabolic rate, as well as impaired glucose tolerance
The flow phase
• These metabolic variables gradually increase within the first 5 days
post injury to a plateau phase
10/30/2023 14
15. Pathophysiology cont.…
Post Burn Squela
• Cardiac out put increases by 1.5 times
• Liver size increases by 225%
• Muscle protein is degraded much faster than it is synthesized.
• The net protein loss causes loss of lean body mass and severe muscle
wasting.
• 10% loss – Immune Dysfunction
• 20% loss – Decrease wound healing
• 30% loss – Increased risk of Pneumonia & Pressure sores
• 40% loss – Death
10/30/2023 15
20. Deep Partial Thickness
• old 2nd degree
• through epidermis, into reticular
dermis
• Pale or Pink, moist, blisters, very
painful
• Some capacity to heal
10/30/2023 20
22. Full thickness burn
• old 3rd degree (and 4th)
• Through epidermis, dermis and
connective tissue
• Appears waxy white, leathery gray or
charred black and dry and is not painful
• Has various colours
10/30/2023 22
25. Classification cont.…
Extent
Assessment of extent of burn wound
• Rule of Nines:
• Quick estimate of percent of burn
• Lund and Browder:
• More accurate assessment tool
• Useful chart for children – takes into account the head size proportion.
• Rule of Palms:
• Good for estimating small patches of burn wound
10/30/2023 25
30. Management
ATLS protocol
Primary survey
• Airway: Early recognition of airway compromise, intubation.
• Breathing: Pattern of breathing. Breathing?
• Circulation: vascular access, monitor device, blood pressure.
• Disability: other injuries; fractures, abdominal injury or
neurological deficit.
• Exposure: out of clothes, exposure of all orifices.
• Fluid resuscitation:
10/30/2023 30
31. Management cont.…
Secondary survey
Full history
• Biodata
• Cause of the burn
• Time of injury
• Place of the occurrence (closed space, presence of chemicals,
noxious fumes)
• Likelihood of associated trauma (explosion,…)
• Pre-hospital interventions
10/30/2023 31
32. Management cont.…
• Detection of the mechanism of injury.
• Consideration of abuse
• Possibility of carbon monoxide intoxication
Full examination
• TBSA, Burn depth, inhalational injury
• Concomitant injury, deformity, dx habitus
• Height and weight.
10/30/2023 32
37. Management cont.…
Resuscitation Formula’s
• total area
FORMULA CRYSTALLOID COLLOID
Parkland 4 mL/kg per %
TBSA burn
None None
Brooke 1.5 mL/kg/%
TBSA burn
0.5 mL/kg per
% TBSA burn
Galveston
(pediatric)
5000 mL/m 2
burned area +
1500 mL/m 2
10/30/2023 37
38. Management cont.…
Parklands
• Commonest
• 1/2 in first 8hrs post burn
• 1/2 in next sixteen hrs.
• Subsequently, Daily requirements plus ongoing losses after 24hrs
• Ongoing losses = 1cc/kg x TBSA
• Monitor urinary output!!! As determinant of adequate resuscitation
(except in ARF)
10/30/2023 38
39. Management cont.…
Pain management
• Pain- Hyperalgesia develops from exposed viable and growing nerve
endings
• Pain with time becomes learned and is psychological and difficult to
manage
• Pain is REAL to the patient
• IV injections not advised when burns exceeds 10% TBSA
10/30/2023 39
40. Management cont.…
Analgesics-
• Opioids- morphine(adults). Pethidine , PCM
• NSAIDS-
• Oral ketamine
• Anesthesia for dressings
• Psychotherapy, encouragement
• Good dressing techniques
• Soak dressings-shower
• Products- Non Adherent, Fewer intervals
• Early mobilization
10/30/2023 40
43. Management cont.…
Burn Wound dressings
Principles:
• Full-thickness and deep-dermal burns need antibacterial dressings to
delay colonization prior to surgery
• Superficial burns will heal and need simple dressings
• An optimal healing environment can make a difference to outcome in
borderline-depth burns
10/30/2023 43
44. Management cont.…
wound dressing
• Regular intervals as determined by the need (not by staffing)
• Give analgesics I.V 30 mins before procedure ( or proceed with
psychotherapy)
• Layered removal of dressing
• Debride when required
• Clean with normal saline
• Dab dry
• Apply topical antibiotic
• Layered dressings applied systematically
10/30/2023 44
45. Management cont.…
Dressings can be occlusive or open
Benefits of occlusive dressing
• Protects against infection
• Reduces pain- nerve endings exposed to air is painful
• Providers a moist environnent for re-epithelisation
• Nursing care is easier/ not messy like open dressing
• Reduces need for frequent dressings with pain and pressure on
nursing personnel
10/30/2023 45
46. Management cont.…
Benefits of Open Dressings
• Easy , Quicker
• Dressing procedure less painful
• Cheaper
• Easy access to assess wounds for infection
• Great for hot tropical weather
• Difficult to move patient if extensive
• Messy on beddings
• More difficult to control hypothermia
• Requires strict control of environment, visitors
10/30/2023 46
49. Management cont.…
Skin Substitutes
• Transcyte- cultured human fibroblasts in semi-permiable membrane
on nylon matrix
• Alloderm
• Integra
• CEA – cultured epithelial autograft
10/30/2023 49
50. Management cont.…
Blisters
To rupture or to leave?
• Controversial
• Blister fluid contains vasoactive mediators-
progression of the ischemic zone, and inhibit healing.
• The intact blister also serves as a physiologic dressing
• Blisters larger than several inches in diameter are
most likely to rupture and should be removed.
• Small blisters- Can leave
• Large blister- Rupture
• Blisters over joints- Rupture
10/30/2023 50
53. Management cont.…
• Commence oral feeds as soon as possible
• Enteral feed superior to parenteral
• NGT in burns > 20% TBSA in children and > 30% TBSA in adults
• Manage Ileus
• Tight glucose control – esp ICU pts
• Protein – 2g/kg body wt/day
10/30/2023 53
55. Management cont.…
Infection control
• Wash down on arrival
• Anti Tetanus prophylaxis
• Meticulous protocol in the burn unit
• Disciplined antibiotic use
• Early debridement and wound closure
• Nutrition
• Topical antibiotic dressing
10/30/2023 55
56. Electrical Burn
• Of all burns patients admitted, 3% to 5% are injured from electrical
contact.
• Electrical current enters a part of the body, such as the fingers or
hand, and proceeds through tissues with the lowest resistance to
current, generally the nerves, blood vessels, and muscles.
• The skin has a relatively high resistance to electrical current and is
therefore mostly spared.
• Heat generated by the transfer of electrical current and passage of
the current itself then injures the tissues.
10/30/2023 56
57. Electrical Burn cont.…
• The muscle is the major tissue through which the current flows, and
thus it sustains the most damage.
• Injuries are divided into high- and low-voltage injuries. Threshold
being 1000v
• Low-voltage injury is similar to thermal burns without transmission to
the deeper tissues.
10/30/2023 57
58. Electrical Burn cont.…
• The syndrome of high-voltage
injury consists of varying
degrees of cutaneous burn at
the entry and exit sites,
combined with hidden
destruction of deep tissue .
• Address Cardiac derangement.
• The key to managing patients
with an electrical injury lies in
the treatment of the wound.
10/30/2023 58
63. Prognosis
Baux score
Expressed as % TBSA + Age
The score is a comparative indicator of burn severity, with a score over 140
considered as being un-survivable, depending on the available treatment
resources
Modified Baux score = body area affected + age of patient + 17
10/30/2023 63
.
65. Prevention
According to the WHO,
• Improve awareness
• Develop and enforce effective policy
• Describe burden and identify risk factors
• Set research priorities with promotion of promising interventions
• Provide burn prevention programs
• Strengthen burn care
• Strengthen capacities to carry out all of the above.
10/30/2023 65
66. First aid
What to do
• Stop the burning process by removing clothing and irrigating the
burns.
• Extinguish flames by allowing the patient to roll on the ground, or by
applying a blanket, or by using water or other fire-extinguishing
liquids.
• Use cool running water to reduce the temperature of the burn.
• In chemical burns, remove or dilute the chemical agent by irrigating
with large volumes of water.
• Wrap the patient in a clean cloth or sheet and transport to the
nearest appropriate facility for medical care.
10/30/2023 66
67. What not to do
• Do not start first aid before ensuring your own safety (switch off
electrical current, wear gloves for chemicals etc.)
• Do not apply paste, oil, haldi (turmeric) or raw cotton to the burn.
• Do not apply ice because it deepens the injury.
• Avoid prolonged cooling with water because it will lead to
hypothermia.
• Do not open blisters until topical antimicrobials can be applied, such
as by a health-care provider.
10/30/2023 67
68. • Do not apply any material directly to the wound as it might become
infected.
• Avoid application of topical medication until the patient has been
placed under appropriate medical care.
10/30/2023 68
69. Conclusion
The treatment of burns is complex and require a multidisciplinary
approach
• Minor injuries can be treated in the community by knowledgeable
physicians.
• Moderate and severe injuries, however, require treatment in
dedicated facilities.
• Burn injury treatment depends on the depth and total body surface
area affected.
10/30/2023 69
70. Conclusion cont.…
• Early fluid resuscitation with adequate fluids and addressing
inhalation injury saves lots of life.
• Addressing wound comes second after initial resuscitation with
adequate covering of wound.
• Main aim of wound care is to protect body from infection and
hypothermia.
• Early wound excision and grafting prevents wound contracture.
• Primary prevention- Best bet.
• Prevent burns from occurring at all
10/30/2023 70
71. References
• Burns in Nigeria: a Review A.O. Oladele and J.K. Olabanji Ann Burns
Fire Disasters. 2010 Sep 30; 23(3): 120–127. Published online 2010
Sep 30.
• Bailey & Love's Short Practice of Surgery, 27th Edition 27th Edition
• Overview of the management of burns, Dr. Dafieware O.R
• Https://www.Who.Int/news-room/fact-sheets/detail/burns
• Ann burns fire disasters. 2010 sept 30; 23(3): 120–127.
• Grabb and Smith's plastic surgery seventh edition
• Principles and practice of surgery including pathology in the tropics
4th edition
• Principles and practice of burn care editor-in-chief sujata sarabahi
10/30/2023 71
Severe burns covering more than 20% of the TBSA are typically followed by a period of stress, inflammation, and hypermetabolism .
1. Vasoactive mediators leucotriens bradikinins atria natriuretic peptide. 7. 12-25% of total RBC mass can be loss with 12hrs Hemolysis direct heat, massive upper GI bleeding, viscosity depressing factor 5,7 consumptive coagulopathy dic. 8. catecholamine 8. diabetes of burns 9. skin loss, damage to vascular endothelium and microcirculatory stasis
1- put off fire, switch of power. 2- Stop drop and roll. 3- ABC 4- 10mins minimum of running cold water is effective up to 1hr after burns, slows down delayed microvascular damage , provides analgesia, 5-, 6
Airway – hot gases cause supraglottic airway burns and laryngeal oedema
- Steam can cause subglottic burns and loss of respiratory epithelium, Smoke chemical alveolitis and respiratory failure
Poisons eg CO2 Hydrogen cyanide metabolic poisoning
Full thickness burns to the chest cause mechanical blockage to rib movement
Airway occlusion occurs btw 4-24hrs
Intubation and cricothyrodotomy if delayed
From moderate burns give fluid
In some parts of the world intravenous resuscitation is commenced only with burns that approach 30% TBSA
Crystalloid – Ringers lactate, Nacl, hypertonic saline. Colloid – human albumin solution
Maintenance for children
Fasiotomy commonly for electrical burns, tangential excision dead portion of skin removed layer by layer until healthy bleeding is seen.
Circumferential full-thickness burns to the limbs require emergency surgery ,incising the whole length of the injury releases its tourniquet effect
Mid-axial line avoiding nerves and vessels
Early debridement and grafting is the key to effective treatment of deep partial and full thickness burns in majority of cases