BURNS. James Taclin C. Banez M.D., FPSGS, FPCS. Etiology. Cutaneous burns caused by application of: Heat Cold Caustic chemical Electricity Depth of injury is proportional to: Temperature applied Duration of contact Thickness of skin. Etiology. Scald Burns:
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James Taclin C. Banez M.D., FPSGS, FPCS
Severity is related to:
rule of 9 for adults
For children: Lund-Browder burn chart
child assumes adult once reach adolescence
Determinant of mortality and long-term appearance and functional outcome.
Burns leaving a part of the dermis leaves behind epithelium lined skin appendages
Epithelial cells swarm from the surface of each appendages to meet adjacent swarming cells
- 12-24hrs in major burns
Metabolic Response to Burn Injury
100% O2 via a nonrebreather mask if there is any suspicion of smoke inhalation
If unconscious or in respiratory distress ----> endotracheal intubation
Emergency Room Care:
20ml/kg/hr in children
>65% TBSA--> burn center
Fresh frozen plasma 75ml/kg/24hr
Colloid generates inward oncotic force to counteracts outward intravascular hydrostatic force.Other formulas estimating adult burn pt resuscitation fluid needs:
Local anesthesia is not needed; but IV opiates or anxiolytics is given.
- associated air turbulence
- mucosal fluid lining that acts as a heat