外科急诊创伤(英文)-烧伤

ABCTransport decision? % BSA burned? Tx?
Objectives
Describe the structure and function of skin Discuss the types of burns. Explain the degrees of thermal burns. Discuss causes and treatments of inhalation injuries. Identify methods of approximating burn injuries. Describe and apply treatment modalities for the burn patient.
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 A- PCN, codeine M- none P- none L- earlier today E- woke up on fire
Depth of Burn
Superficial Burn Partial Thickness Burn Full Thickness Burn
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
Burn Depth
Partial-Thickness Burn: 2nd Degree Burn

Signsຫໍສະໝຸດ Baidu& Symptoms
Intense pain White to red skin Blisters Involves epidermis & dermis

Third Degree
Causes
Thermal Electrical Chemical Radiation
Thermal
Majority flame scald contact with hot objects
Child with burns from a scald
Determining Severity
1st degree 2nd degree 3rd degree (4th degree)
BURNS
Leaugeay Webre BS, CCEMT-P, NREMT-P
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?
Dermis
Gel like matrix Consists of collagen and elastin Contains blood vessels, lymphatics, sweat glands, hair follicles, sensory fibers
Subcutaneous
Connective tissue Adipose tissue cushioning insulation
Function
Protection Regulation Prevention Sensory
Epidermis
Outer, thinner layer Consists of dead keratinized cells Protects dehydration trauma light infection
Anatomy & Physiology of the Skin
Layers



Epidermis Dermis Subcutaneos Underlying Structures

Fascia Nerves Tendons Ligaments Muscles Organs
Burn Depth
Superficial Burn: 1st Degree Burn

Signs & Symptoms
Reddened skin Pain at burn site Involves only epidermis

Second Degree
Involve epidermis and dermis Partial thickness superficial partial thickness red, painful, blistered deep partial thickness pale, mottled Very painful Infection may evolve into 3rd degree
Involve epidermis, dermis, subcutaneous tissue White, waxy, red, brown, leathery Dry and painless (muscle and bone)
Burns, thermal. Escharotomy to release chest wall and allow for ventilation of the patient.
Skin
Largest organ of the body
Anatomy
Epidermis Dermis Subcutaneous tissue