Professional Documents
Culture Documents
E . James Radin , MD
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Objectives
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Epidemiology
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Estimates of Involved Surface
• Rule of Nines . . . . . . . . .
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Degree of Burn
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First Degree
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Second Degree
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Third Degree
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Facial Burns
• Surface
• Ocular
• Airway
• Singed Nasal Hairs
• Airway edema
• Glossal Swelling
• Epiglottic edema
• Glottic edema
• Rapidly progressive deterioration
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Ocular Burns
• Often chemical
• Contact lenses need to be removed
• Copious irrigation
• Sterile dressings
• Notify ED ASAP to arrange
Opthamology Evaluation
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Pulmonary Burns
• Closed space
• Facial involvement
• Carbonaceous sputum
• Singed nasal hairs
• Lip edema
• Thermal
• Chemical
• Foreign debris
• Rapidly progressive deterioration
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Pulmonary Burns
• ABC’s
• Definitive control of the airway
• Humidified Oxygen
• Prevent Hypoxia
• Assist Ventilation
• NG / Oral Gastric tubes
• Monitor . . . . . . . .
• Pulses
• Doppler flow
• Tightness / Compartment pressures
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Electrical Burns
• CNS injury
• Peripheral nerve injury
• Cardiac arrhythmias
• Occult injury
• Low / high resistance tissues
• Low / high voltage < 1000 volts >
• Muscle injury / Myoglobinemia
• Renal injury / direct electrical / myoglobin
• Entry and Exit wounds
• AC / DC
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Electrical Burns
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Burns can be by direct
contact or by arcing
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Chemical Burns
• Treatment Specific . . . . . . . .
• Hydrofluoric : Irrigate , Calcium Gluconate
• HCL / Sulfuric : Bicarbonate irrigation
• Phenol : No irrigation
• White Phosphorous : Ignites with irrigation
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Fluid Resuscitation
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Parkland Formula
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Wound Care
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Burn Center Transport Guidelines