Burn Injury PDF - NCMB 312 RLE

Summary

This document provides information on burn injury, including causes, classifications, stages, and management. Detailed information regarding the first stage, second stage, and third stage is included. The document also includes calculations for fluid volume replacement and mentions important aspects such as the Parkland formula.

Full Transcript

Burn injury J.A.K.E NCMB 312 RLE BURNS c) Non-electrolytes – D5Water - Causes:...

Burn injury J.A.K.E NCMB 312 RLE BURNS c) Non-electrolytes – D5Water - Causes: Promoting comfort Thermal – hot objects or substances a) Morphine SO4 – to relief pain Chemical – strong acids, alkali b) Bed cradle – to relieve pressure from topsheet Electrical – electrical appliances and sources Preventing infection Radiation – excessive exposure to sunlight a) Asepsis - Classifications: b) Reverse-protective isolation 1st Degree – Superficial thickness burn - epidermis, c) Tetanus-toxoid immunization reddish, painful d) Sterile NSS to irrigate the area 2nd Degree – Partial thickness burn - dermis, moist Maintaining adequate nutrition surface, with vesicles, painful a) Avoid oral fluids – decreased peristalsis 3rd Degree – Full thickness burn - epidermis, dermis b) Diet – increase CHON, increase CHO, low Fat, and other underlying structure, subcutaneous layer, increase vitamins and minerals pearly white, no pain Wound care 4th Degree – Deep full thickness burn - muscles & - Antimicrobials - Mafenide acetate 10% (Sulfamylon)- bones, blackish or charred, no pain good choice as penetrate in the eschar Skin grafting Stages of Burns - Isograft / Syngeneic graft – identical twin First Stage - Homograft / Allograft – another human being - Shock/ Fluid Accumulation Phase - Autograft – self - first 48 hours (1-2 days) - Heterograft / Xenograft – animal (temporary) - avoid oral fluids – decreased peristalsis - Skin grafting is a surgical procedure that involves - NGT for decompression removing skin from one area of the body and moving it, - generalized dehydration or transplanting it, to a different area of the body. This - hypovolemia – plasma loss, decrease BP surgery may be done if a part of your body has lost its - oliguria – no urine output protective covering of skin due to burns, injury, or - hyponatremia, hyperkalemia (fluid shifting) illness. STSG – Split Thickness Skin Grafting - CBC results = hemoconcentration - increase hematocrit (because liquid blood component is lost) % of Burns (Rule of Nine) Second Stage Head, face, neck = 9% - Diuretic/ Fluid Remobilization Phase Anterior trunk = 18% Posterior trunk = 18% - after 48 hours (3-4 days) Upper extremities (each) = 9% - hypervolemia Lower extremities (each) = 18% - diuresis – increased urine output Genital = 1% - Hyponatremia, hypokalemia 100% - CBC results – hemodilution, decrease hematocrit Parkland Formula Third Stage - A calculation used to calculate the total volume of fluids - Recovery (5th day onwards) that a patient is going to need about 24 hours after - Hypocalcemia receiving a severe burn - utilized in granulation tissue formation - widest and easy to use to immediately initiate replace - Negative Nitrogen balance fluids and electrolytes losses - increase CHON intake - Volume LR = 4mL x BSA % x kg Management of Burns - Common solution used: Lactated ringers- is an isotonic Stop the burning process solution that will help expand the intravascular a) immersed affected part in cold water/running water compartment b) advised client to roll on the ground if clothing is - 4ml x 63% x 83 kg = 20,916 ml flaming 1st 8hrs (half) VLR x.50 = 10,458 to run for first 8 c) throw a blanket over to the client to smother the flame hours with drop factor of 20 = 436 - 437gtts/min d) neutralized the chemical 2nd 8hrs VLR (one fourth) x 0.25 = 5,229 ml Promoting respiratory function flow rate: 5229 to run for second 8 hours x drop factor a) establish airway of 20 = 218 - 219 gtts/min b) oxygen therapy 3rd 8hrs VLR (one fourth) x 0.25 = 5,229ml, flow rate: Promoting fluid, electrolytes, acid base balance 5229 to run for third 8 hours x drop factor of 20 = 218 – a) Colloids – blood, plasma expanders 219 gtts/min b) Electrolytes – Lactated ringers 20,916 ml for the first 24 hours Burn Injury 1 of 1

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