Burns How To Cool

Burns

How To Cool…

“All the flower, children were as

alike”

What actually burning..... Burns are leading cause of Death in children

Approximately 1.2 million people require medical care each year, most shocking is 30% to 40% are younger than 15 years of age

What burns your child…..?

But how….? Child abuse-18% Accidents Neglect House fires Electrical shocks

first aid

- Cover the child with a blanket , coat, or carpet - Remove child from smoke - Ensure that child’s airway is patent. - Remove jewelry if any - If it happen by chemicals brush it off reaming - Cover burn area with a clean dry sheeting - do not apply cold for large injury

HOW DEEP IT MAY BURNS...?

1st degree burn 

Skin Dry, no blisters. Minimal or no edema. Erythematous. Blanches, bleeds

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Pain Very Painful

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Depth Epidermal layers only

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Healing time 2-5 days with no scaring

2nd degree 

Skin Moist blebs, blisters. Underlying tissue is mottled pink and white, with fair capillary refill. Bleeds

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Pain Very Painful

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Depth Epidermis, papillary, and reticular layers of dermis. May include domes of subcutaneous layers.

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Healing time Superficial: 5-21 days with no grafting. Deep partial: 21-35 days with no infection. If infected, converts to full-thickness burn.

3rd degree 

Skin Dry, leathery eschar. Mixed white, waxy, khaki, mahogany, soot-stained. No blanching or bleeding

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Pain insensate

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Depth Down to and may include fat, subcutaneous tissue, fascia, muscle, and bone.

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Healing time Large areas require grafting, but small areas may heal from the edges after wks.

Children are not little adults

rule OF Palm or nine…? The Rule of Palm’s assumes that the palm size of the patient represents approximately 1% of the TBSA. TBSA is then estimated by approximating the number of “palms” it would take to completely cover the burn.

Start

Parkland formula

Parkland formula is an appropriate starting guideline for fluid resuscitation-4 mL lactated Ringer/kg/% BSA burned-. Half of the fluid is given over the 1st 8 hr, calculated from the time of onset of injury. The remaining ½ is given at an

What to apply for burnt skin…..?

If it burnt below 10% of BSA 0.5%

silver nitrate solution

Silver

sulfadiazine

If above 30%...........? Cover the wound Grafting Sodium supplement Protein and electrolyte supplement

Control infections  Covering

of wound should be made by sterile material  Isolate the child to prevent cross infections  Use penicillin as prophylactic.  Periodic replacement of central venous catheter.  Strict aseptic dressings  Topical anti microbial

Inhalation injury…..! These may occur from 2. 3. 4.

5.

Direct heat Acute asphyxia Carbon monoxide poisoning Toxic fumes, including cyanides from plastics.

HOW TO TREAT THIS……..?

Maintain patent airway Put naso-trachial tube Oxygen therapy Corticosteroids Chest physiotherapy

What to do for pain….? Adequate analgesics  Psychological support  Allow the primary care giver to be with the child  Decrease the stress of child and primary care giver  Oral morphine suphate 0.3-0.6mg/kg every 46th hourly  Benzodiazepines SOS 

Nutrition for child………..?

Mortality related burn injury is related mainly due to malnutrition not the skin that burnt Protein

supplement Albumin supplement High caloric diet

Future must be BEAUTIFUL….… Ensure

maximum cosmetic effect of treatment Physical and occupational rehabilitation Assist in ADL Special garments

If Not Treated Well……? Pain  Dry skins  Itching  Amputations  Osteoporosis  Sleep disorders  Depressions  Phobia  Renal failure  C.V disorders 

So stop it before it happens…. Install and use smoke detectors  Control hot water to be reached to children  Keep cloths away form heat  Avoid smoking in child’s presence  Protest child abuse  Do not leave child alone  Do not neglect child  Keep chemicals out of reach to child  Use safe electrical devices 

“There is no other sadness in this world than losing a child”