外科急诊创伤(英文)-烧伤

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Skin
Largest organ of the body
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Anatomy
Epidermis Dermis Subcutaneous tissue
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8Hale Waihona Puke Baidu
Anatomy & Physiology of the Skin
Layers
Epidermis
Dermis
Subcutaneos
Underlying Structures
dehydration trauma light infection
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Dermis
Gel like matrix Consists of collagen and elastin Contains blood vessels, lymphatics, sweat glands, hair follicles, sensory fibers
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Child with burns from a scald
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Determining Severity
1st degree 2nd degree 3rd degree (4th degree)
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Depth of Burn
Superficial Burn Partial Thickness Burn Full Thickness Burn
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General Impression
33 yo male pt writhing in pain. Screams and begs for pain medication however poor historian.
S- blistering to back and chest, R upper ventral area leg exposed muscle; eyebrows singed
Describe and apply treatment modalities for the burn patient.
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Burns, thermal. Escharotomy to release chest wall and allow for ventilation of the patient.
BURNS
Leaugeay Webre BS, CCEMT-P, NREMT-P
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Scenario
Paramedic is called to the scene of a structure fire. FD has removed a victim from the house. BSI Scene safe 1 patient A/C standby FD/ PD on scene Now what?
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Burn Depth
Superficial Burn: 1st Degree Burn
Signs & Symptoms
Reddened skin Pain at burn site Involves only
epidermis
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Second Degree
Involve epidermis and dermis Partial thickness
A- PCN, codeine
M- none
P- none
L- earlier today
E- woke up on fire
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ABCTransport decision? % BSA burned? Tx?
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Objectives
Describe the structure and function of skin
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Subcutaneous
Connective tissue Adipose tissue
cushioning insulation
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Causes
Thermal Electrical Chemical Radiation
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Thermal
Majority flame scald contact with hot objects
superficial partial thickness red, painful, blistered
deep partial thickness pale, mottled
Very painful Infection may evolve into 3rd degree
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Burn Depth
Partial-Thickness Burn: 2nd Degree Burn
Signs & Symptoms
Intense pain White to red skin Blisters Involves epidermis
& dermis
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Third Degree
Involve epidermis, dermis, subcutaneous tissue White, waxy, red, brown, leathery Dry and painless (muscle and bone)
Discuss the types of burns.
Explain the degrees of thermal burns.
Discuss causes and treatments of inhalation injuries.
Identify methods of approximating burn injuries.
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First Degree
Superficial involve only epidermis Local pain and redness No blistering present Heal spontaneously 2-5 days without scarring Not included when calculating % TBSA
Fascia
Nerves
Tendons
Ligaments
Muscles
Organs
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Function
Protection Regulation Prevention Sensory
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Epidermis
Outer, thinner layer Consists of dead keratinized cells Protects