Beruflich Dokumente
Kultur Dokumente
BURNS
• Airway injuries
• % of area of burns
• Depth of burn
• M/c burns- scalds (hot liquid) children
• M/c burns in hospital (thermal or flame)
• Electrical burns-1000V
• Low tension- interfere with SA node rhythm
• High tension- Direct myocardial damage
• AIRWAY
• Assess damage- inhalational injury
• EARLY recognition of airway burn
• Thermal burns
• HYPOXIA
• Swelling of airway (upper airway-flame, lower airway- steam)
• Inhalation- chemical alveolitis
• Toxin (C0, HCN)- Met acidosis
• Eschar (deep burn) over chest wall- impaired respiration
• ET tube
• Tarcheostomy
• Needle cric(12 G)
• Crico thyroidotomy
Breathing
• Humidified air
• Ventilator support
• CIRCULATION
• First 36 hr
Wallace rule
Lund browder
• Head and neck in infant- 18% (<1yr)
reduce 1% every year till it reaches 9%
• One LL in infants- 14% (<1yr)
increased 0.5% every year till it reaches 18%
• Depth of burns- temperature, duration
• Parkland 4 x BSA burnt x wt in kg (1st 24hr only crystalloids)
½ in 1st 8hours, ½ in next 16hours
• 1st degree burns not included in calculating volume of area burns
• Fluid preferred RL- Hartmann solution
Capillary + - -
Sensation + + -
Blister - + -
• Catecholamines,
• Steroids,
• Glucagon,
• GH,
• TSH
Entry point