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BURNS Myrna D.C. San Pedro, MD, FPPS
Definition ,[object Object],[object Object],[object Object]
Classification According to Depth ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Photos Mild Burn 2 nd  degree Burn 1 hr 2 nd  degree Burn 1 day 2 nd  degree Burn 2 days
Extent of Burns
Classification According to Extent ,[object Object],[object Object],[object Object],[object Object],[object Object],Infant Rule of Nines  (for quick assessment of total body surface area affected by burns) 1% Perineum 9% Each Arm 14% Each Leg 18% Posterior Torso 18% Anterior Torso 18% Head Surface area Anatomic structure
Kinds of Burns ,[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Photos Scald Burns Flame Burns
Burn Photos Chemical (Acid) Burns Radiation (Flash) Burns
Burn Photos 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 1 st  2 fingers later removed
U.S. Statistics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Review of PGH Cases ,[object Object],[object Object],[object Object],[object Object]
Physiological Response  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Pathologic Features ,[object Object],[object Object],[object Object]
Burn Pathophysiology: Edema ,[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Pathophysiology: Cardiac ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Pathophysiology: Blood ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Pathophysiology: Metabolic ,[object Object],[object Object],[object Object],[object Object],[object Object]
Burn Pathophysiology: Renal ,[object Object],[object Object]
Burn Pathophysiology: Immunologic ,[object Object],[object Object],[object Object],[object Object]
First Aid Measures in Burns ,[object Object],[object Object],[object Object],[object Object],[object Object]
Outpatient Management ,[object Object],[object Object],[object Object]
 
Recommendations for Hospitalization ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Hospital Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Airway compromise?  Respiratory distress?  Circulatory compromise? Intubation, 100% O 2  IV access, fluids Multiple trauma? Yes No Evaluate & treat injuries Burns >15% or complicated burns? Yes No Burn care, tetanus prophylaxis, analgesia IV access; fluid replacement Circumferential full thickness burns? Escharotomy Yes Yes No No
Initial Procedures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fluid Resuscitation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inhalation Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Infection Control ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Pain Relief and Adjustment ,[object Object],[object Object],[object Object],[object Object],[object Object]
Nutritional Support ,[object Object],1500 kcal/m 2  BSA burned + 1500 kcal/m 2  total BSA  Adolescents 1300 kcal/m 2  BSA burned + 1800 kcal/m 2  total BSA 2-15 years 1000 kcal/m 2  BSA burned + 2100 kcal/m 2  total BSA Infants
Complications of Burns ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Only those who will risk  going too far, can possibly  find out how far one can go. -- T. S. Elliott Thank You!

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Burns

  • 1. BURNS Myrna D.C. San Pedro, MD, FPPS
  • 2.
  • 3.
  • 4. Burn Photos Mild Burn 2 nd degree Burn 1 hr 2 nd degree Burn 1 day 2 nd degree Burn 2 days
  • 6.
  • 7.
  • 8. Burn Photos Scald Burns Flame Burns
  • 9. Burn Photos Chemical (Acid) Burns Radiation (Flash) Burns
  • 10. Burn Photos 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 1 st 2 fingers later removed
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.  
  • 24.
  • 25.
  • 26. Airway compromise? Respiratory distress? Circulatory compromise? Intubation, 100% O 2 IV access, fluids Multiple trauma? Yes No Evaluate & treat injuries Burns >15% or complicated burns? Yes No Burn care, tetanus prophylaxis, analgesia IV access; fluid replacement Circumferential full thickness burns? Escharotomy Yes Yes No No
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34. Only those who will risk going too far, can possibly find out how far one can go. -- T. S. Elliott Thank You!

Hinweis der Redaktion

  1. The extent of burns is expressed as percentage of the total surface area.
  2. Scalds are the leading cause of burn injuries during the first 3 years of life.
  3. 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.