Burns and Their Causes

Study Notes

Definition: Damage to the skin caused by heat, radiation, friction, or chemicals
Causes:
- Thermal: fire, hot liquids, high temperature tap water, hot cooking oil, steam
- Chemical: strong acid or base substances, e.g. sulfuric acid, bleach, hydrofluoric acid
- Electrical: high voltage (>1000V), low voltage (<1000V), flash burns
- Radiation: UV light, ionizing radiation
- Non-accidental: intentional harm
- Friction: rapid movement of surface against skin
Degrees of burns:
- Superficial (First-Degree): epidermis, red, painful, heals in 5-10 days
- Superficial Partial Thickness (Second-Degree): papillary dermis, red, blistered, painful, heals in 2-3 weeks
- Deep Partial Thickness (Second-Degree): reticular dermis, less blanching, may require excision and skin grafting
- Full Thickness (Third-Degree): entire dermis, white/brown, leathery, painless, requires excision and skin grafting
- Fourth-Degree: extends through skin and into underlying fat, muscle, and bone

Accidental poisoning common in toddlers aged 1-3 years
Types of poisoning:
- Medication: ingestion of incorrect dose or wrong medication
- Household products and pesticides: ingestion or inhalation of substances like bleach, toilet bowl cleaners, pesticides
- Carbon monoxide: colorless, odorless gas emitted from fuel-burning appliances
- Household plants: toxins in plants like daffodils, foxglove, and lilies
- Alcohol, nicotine, and illicit substances: ingestion or contact with substances like liquor, nicotine gum, and illicit drugs
- Hydrocarbons: gasoline, kerosene, lamp oil, and other substances
- Batteries: ingestion of small batteries, especially button-cell batteries
- Personal care products: ingestion of nail polish remover, perfume, and other products
Signs and symptoms: nausea, vomiting, drowsiness, abdominal pain, fitting
Prevention: store medicines and household products out of reach, avoid distractions when administering medicine, and check child-resistant caps

Definition: physical, sexual, and/or psychological maltreatment or neglect of a child by a parent or caregiver
Types of child abuse:
- Physical abuse: intentional use of physical force against the child
- Sexual abuse: participation of a child in a sexual act for the benefit of another person
- Psychological abuse: verbal or symbolic acts that cause significant psychological harm
- Neglect: failure to provide basic needs, medical care, or supervision
Causes/risk factors:
- Unintended conception
- Intent to punish
- Abused by spouse
- Economic recession
- Substance abuse
Effects of child abuse:
- Immediate physical harm
- Developmental problems
- Chronic physical and psychological effects
- Shortened lifespan

Definition: group of permanent movement disorders that appear in early childhood
Causes:
- Abnormal development or damage to the developing brain
- Problems in intrauterine development, hypoxia, birth trauma, and complications around birth or childhood
Risk factors:
- Preterm birth
- Term infants with placental problems, birth defects, low birth weight, and breathing meconium in the lungs
- Genetics (autosomal recessive)
- Infections, toxins, physical brain injury, and stroke in early childhood
Diagnosis:
- Neuroimaging with CT or MRI
- Symptoms and diagnosis typically occur by age 2, but may be diagnosed later in adulthood
Signs and symptoms:
- Low bone mineral density
- Eating problems
- Speech and language disorder
- Pain and sleep disturbances### Cerebral Palsy (CP) Types
Spastic CP (80% of overall CP cases):
- Characterized by spasticity or high muscle tone, resulting in stiff, jerky movements
- Affects the motor cortex of the brain, responsible for planning and completing voluntary movements
- Subtypes:
  - Spastic Hemiplegia
  - Spastic Diplegia
  - Spastic Quadriplegia
  - Spastic Monoplegia (affects one limb or specific area of the body)

Associated with lesions during brain development due to bilirubin encephalopathy and hypoxic-ischemic brain injury
Characterized by both hypertonia and hypotonia due to inability to control muscle tone
Non-spastic, extrapyramidal form of CP
Subtypes:
- Choreo-Athetoid CP: characterized by involuntary movements, mainly in the face and extremities
- Dystonic ADCP: characterized by slow, strong contractions, which may be local or affect the entire body

Characterized by simultaneous symptoms of Athetoid, Ataxic, and Spastic CP, varying in degree
Most difficult to treat due to heterogeneity and unpredictability of symptoms and development over time