Assessment And Management Of BURNS

Question 1

BURNS

Answer 1

•Burn injury refers to tissue damage that results from injury by various aetiological agents.
•Primary injury to skin, but deeper tissues may be affected.
•Agents: thermal(dry and moist heat), electrical, chemical(acidic, alkaline and organic chemicals), radiation
•They cause coagulative necrosis of tissues.

•Injury from moist heat is the commonest.
•Occur commonly as domestic accidents with women and children as victims.
•Flame burns predominate in young adults.
•High incidence of burns from LP gas attributed to increase use in modern times.

Question 2

Classification of burns.

Answer 2

Classification of burns.
•Classified into 4 degrees.
•First degree burn; is limited to the epidermis. Presents as erythema, heals spontanously within 5-7days
•Second degree burn:
•Limited to the dermis. Presents with blistering, spontanous healing within three weeks.

Third degree burns.
•Involves the full thickness of the skin extending into the subcutaneous tissue, it presents with leathery skin sometimes with visible thrombosed subcutaneous vessels.
•No spontaneous healing. It causes scarring.
•Fourth degree burns; the skin is charred and injury extends to deeper tissues such as muscles, joints and bones.

Question 3

Refere to

Answer 3

Slides for diagram

Question 4

Assessment of burn wound

Answer 4

Slides

Question 5

SYSTEMIC CHANGES IN BURNS.

Answer 5

SYSTEMIC CHANGES IN BURNS.
•Cardiovascular changes; massive inflammatory response by the body- severe oedema, shift of fluid from the vascular compartment to interstitial compartment-hypovolaemia and shock.
•Renal changes; acute renal failure. Reversible with immediate fluid resuscitation.
•Respiratory tract changes; tract damage by systemic intoxication from inhalation of by-product of combustion.

•GIT ; metabolic response to trauma include release of hormones. Stress hormones cause increase of acid production- stress ulcers.
•CNS: depression, suicide
•Haematological: severe anaemia.

Question 6

Management of burn patients

Answer 6

Slides

Question 7

COMPLICATIONS

Answer 7

COMPLICATIONS
•Hypovolaemic shock
•Infections
•Stress ulcers
•Tracheo-bronchitis
•Renal failure
•Deep vein thrombosis
•anaemia

LATE COMPLICATIONS
•Unstable scars and chronic burn wounds.
•Burn scar hypertrophy and keloids.
•Burn scar contractures and deformities
•Burn scar metaplasia and marjolin’s ulcer
•Post traumatic depression.

Question 8

Prevention

Answer 8

PREVENTION
•Common denominator; ignorance, carelessness and poverty.
•Matches, cooking areas should be out of reach of children.
•Cooking pots should have handles.
•Epileptics, children should not be left alone with open fires.
•Candles should be put out before sleeping.

•Petroleum service stations must have warnings against smoking and open flames.
•Available fire extinguishers in homes, gas stations etc.