Burns.pptx it's management is absolutely

Using the formula correctly

1. BURNS ZERA COLLEGE / HARVEST UNIVERSITY 2023/1/25 DR KAPAMBWE CHRISPINE D 1

2. OUTLINE Definion Types Anatomy Classification Pathophysiology Assessment Management Complications 2023/1/25 DR KAPAMBWE CHRISPINE D 2

3. Definition & Types Definition A burn is a thermal injury caused by biological, chemical, electrical and physical agents with local and systemic effects Etiology Thermal injury Chemical burns Cold injury Ionising radiation Sun burns 2023/1/25 DR KAPAMBWE CHRISPINE D 3

4. Anatomy Skin layers 2023/1/25 DR KAPAMBWE CHRISPINE D 4

5. Classification Superficial (first degree) Partial thickness (second degree) 1) Superficial partial 2) Deep partial Full thickness (third degree) 2023/1/25 DR KAPAMBWE CHRISPINE D 5

6. Pathophysiology Burns induce local and systemic damage that seriously alter homeostasis. Local 1. Zone of coagulation 2. Zone stasis 3. Zone of hyperemia Systemic Systemic changes depend on the affected body surface (usually greater than 10%). Present according to the affected system. 2023/1/25 DR KAPAMBWE CHRISPINE D 6

7. Assesment History Causative agent, duration, intervention and circumstance Examination TBSA estimation 1) Wallace rule 2) Rule of palms 3) Lund and browder chart 2023/1/25 DR KAPAMBWE CHRISPINE D 7

8. TBSA ESTIMATION 2023/1/25 DR KAPAMBWE CHRISPINE D 8

9. 2023/1/25 DR KAPAMBWE CHRISPINE D 9

10. MANAGEMENT 1 Burn management is conducted by members of a multidisciplinary burn team which include medical, surgical, intensive care, nursing, physiotherapy, occupational therapy, diatetics , social work, psychiatry, , speech therapy, . Serious burn requiring hospitalization Greater than 15% burns in an adult Greater than 10% burns in a child Any burn in the very young, the elderly or the infirm Any full thickness burn Burns of special regions: face, hands, feet, perineum Circumferential burns Inhalation injury - Associated trauma or significant pre-burn illness: e.g. diabetes 2023/1/25 DR KAPAMBWE CHRISPINE D 10

11. Management 2 1) First aid Stop the burning process Cool the area with tap water 2023/1/25 DR KAPAMBWE CHRISPINE D 11

12. Management cont... 2)Definitive Admit the patient. Do ABCDE Determine percentage, degree and type of burn IV access and early fluid replacement. Investigations Medication Other care 2023/1/25 DR KAPAMBWE CHRISPINE D 12

13. Management cont... Fluid replacements a) Barclay & Muir formula or Leads formula: Body wt. x TBSA%/2 = Xmls b) Parkland formula : Body wt x TBSA% x (1-4mls) = X mls 2023/1/25 DR KAPAMBWE CHRISPINE D 13

14. Parkland formula: Body wt x TBSA% x (1-4mls) = X mls -1 st give half of Xmls in the 1 st 8hrs from time of burns event -2 nd give next half of Xmls in the next 16hrs The fluids used are Crystalloids , N-saline , Ringer’s lactate or Hartmann’s solution • TBSA>15%: blood transfusion after 24 hours (pediatrics) • TBSA>20%: blood transfusion (adults) 2023/1/25 DR KAPAMBWE CHRISPINE D 14

15. Management cont... Investigations Full Blood Count and Differential count. Wound swab for Microscopy Culture and Sensitivity Biochemistry ESR 2023/1/25 DR KAPAMBWE CHRISPINE D 15

16. Management cont... Medications Tetanus toxoid 0.5mls IM-single dose Topical Antibacterial agents - Silver Sulphadiazine,Povidone cream or Chloherxidine cream for those allergic to sulfur containing medication. Antibiotics if burns are infected depending on the sensivity tests of the centre. Haematinics to boost blood levels. • Analgesia Others care 2023/1/25 DR KAPAMBWE CHRISPINE D 16

17. Complications 1. Early Airway obstruction Hypovolaemia 2. Intermediate Wound infection Septicemia Amputation 3. Late Contractures Hypertrophic scar or keloids 2023/1/25 DR KAPAMBWE CHRISPINE D 17

18. Marjolins ulcers (malignant) Nerve compression Psychological effects- cosmetic effect 2023/1/25 DR KAPAMBWE CHRISPINE D 18

19. ASANTENI SAANA 2023/1/25 DR KAPAMBWE CHRISPINE D 19