Burns Skin Fxn: Maintenance of the fluid balance Protection Sensory perception Elimination of metabolic waste Regulation of body

temperature Rapid assessment: A-ge B-urn location C-overage and classification FORMULA:parklan 4 X TBSA% X kg=______ RULE OF 9S 9% 9% 18% 36%

HEAD AND NECK UPPER EXTREMITIES FOR EACH LOWER EXTREMITIES FOR EACH TRUNK [ANTERIOR & POSTERIOR

1%

PALM & GENITALS

CLASSIFICATION OF DEPTH PARTIAL THICKNESS SUPERFICIAL Epidermis Erythema Edema DRY 1st degree DEEP Dermis Painful Blisters MOIST 2nd degree FULL THICKNESS Painless Damage to the entire skin Underlying tissue expose Eschar formation

CLASSIFICATION TO EXTENT MAJOR MODERATE MINOR PHASES OF BURN PARTIAL T. >25% 15-25% <15% FULL T. >10% 2-10% <2%

1-EMERGENT-from the time until stat post Focus: R-emove the pt. Thermal-roll or cover the pt. c blanket Chem.-irrigate at longer time *in case of fire CRAWL C-over the burned surface(C2-cool and clean)*cool decreases nerve conduction thereby dec. pain T-ransfer to nearest hosp. 2-SHOCK-24 to 48 hrs. Main prob:FVD S/sx: ALOC Dec. BP,incre.HR/RR Dec. UO DX: BUN,crea,hct Mngt: Fluid replacement/fluid resuscitation-ISOTONIC(LRS,NSS-if BT) *success if UO 3-DIURESIS *K-OLYGURIA-acid

-K,Na 4-CONVALESCENCE-Incubation 5 Ps P-romote healing a. Diet:calories,CHON,CHO,Vit.C b. Wound care: moist dressing then dry c. Surgery: -debridement -grafting -escharotomy *get PR distally P-revent infection -strict asepsis -protective isolation/reverse isolation -handwashinh -topical antibiotics SILVER SULFADIAZINE(flamazine)

*WOF agranulocytosis-sorethroat

*(-) eschar P-ain mngt/promote comfort NARCOTICS-MORPHINE IV

*check RR,f low withhold the dose

P-romote joint mobility ROM *=CONTRACTURES=DEFORMITY P-revent complication A. KELOID FORMATION-apply elastic wraps for evenly distribution of the healing B. STRESS ULCER/CURLINGS ULCER- blood supply to GIT Drugs: OMEPRAZOLE