外科急诊创伤(英文)-烧伤PPT.ppt

BURNS;Scenario;General Impression;A- B- C- Transport decision? % BSA burned? Tx?;Objectives;Anatomy;Layers Epidermis Dermis Subcutaneos Underlying Structures Fascia Nerves Tendons Ligaments Muscles Organs;Function;Epidermis;Dermis;Subcutaneous;Causes;Thermal;Child with burns from a scald;Determining Severity;Depth of Burn;First Degree;Burn Depth;Second Degree;Burn Depth;;Third Degree;Burn Depth;;Fourth Degree;Pathophysiology;Area of Damage;Jackson’s Theory of Thermal Wounds Zone of Coagulation Area in a burn nearest the heat source that suffers the most damage as evidenced by clotted blood and thrombosed blood vessels Zone of Stasis Area surrounding zone of coagulation characterized by decreased blood flow. Zone of Hyperemia Peripheral area around burn that has an increased blood flow.;Jackson’s Theory of Thermal Wounds;Zone of Coagulation;Zone of Stasis;Zone of Hyperemia;Body’s Response to Burns;Systemic Changes;Fluid Shifts;Cardiovascular;Renal;Gastrointestinal;Immune System;sepsis;Body’s Response to Burns;Hypermetabolism;Systemic Complications;Systemic Complications;Critical Burn Areas;Inhalation Injuries;Burns, thermal. Partial- and full-thickness burns from structure fire. Note facial involvement.;Inhalation Injury;;Other Evidence;Inhalation Injury;Types of Injuries;CO Poisoning;100% O2 ? time for elimination 40 min 21% O2 ? time elimination 250 minutes;Carboxyhemoglobin;Injury Above Glottis;Injury Below Glottis;Estimating % BSA Burned;Body Surface Area;Rules of Nines;Rule of Palms;Treatment;Airway;Circulation;Parkland Formula;Fluid Resuscitation;Cool Burn;Con’t;Hypothermia Infection;Pain Control;Special Considerations;Burn Center;Scene Size-up Fire Department SCBA and protective clothing Initial Assessment ABC’s MUST be intact Consider ET or RSI Rapid evacuation of patient if scene is unstable ;Focused and Rapid Trauma Assessment Accurately approximate extent of burn injury Rule of Nines or Rule of Palms Depth of burn Area of body effected Any burn