Acute Burns.docx

Acute Burns • The skin • 15% body weight // Largest organ // Protection, sensation, warming • Pathology of wound • Zones of injury —> Necrosis —> Stasis (injury) —> Hyperaemia • Waxy look • Full thickness burn • No viable remaining dermis • Effect of inflammatory mediators • Increased cap permeability • Increase vasodilators • Increase vasoconstrictors • Chemotaxis Monitoring burn injury • Lund and browder Burn chart • Burn depth assessment • Clinical examination —> COlor (Red/ PAle) // Sensation // Bleeding —> capillary bed intact • Vasodilatation in intact ca Wound management BURN MANAGEMENT • Stop burn • Cool the wound —> Tap water (15 deg) for 15 minutes • Primary survey —> ABCDE • CABCDE —> Massive haemorrhage will kill first • Imaging • Lateral cervical spine • Chest • 2ndary assessment • History • SAMPLE • S+S // Allergies // Medication // Precipitating hx // • Adult resuscitation - Parkland formula • Inhalation injury • Carboxyhaemoglobin (normally 2-3 // >15%) —> 30-50% nearing fatal • Perioral burn • Carbonaceous sputum Metabolic effects • Skin graft —> Excision of skin • Flap —> With blood supply // Arteries and vein // Joined up at graft site • Where = Local —> Distal Microstomia —> Tightening of mouth Foliculitis burble