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Thermal and chemical burns

Code according to MKB-10 T20 - T32
Diagnostics
When diagnosed

Mandatory
Level of consciousness, efficiency and respiratory rate, blood pressure, heart rate, medical history, physical examination, burn surface area
Consultation of a combiologist (traumatologist, surgeon)
Laboratory studies: hemoglobin, blood gases, carboxyhemoglobin, electrolytes (Na, K, Cl), coagulation indicators (APTT, PTV, platelets), leukocytes, blood count, in case of electrical injury - enzymes (CPK)

Additional (according to indications)
R-graph of the chest organs Fibrobronchoscopy
Bacteriological cultures of blood, separated burn surfaces

During treatment
Monitoring according to clause 1.5
Hourly Diuresis
Laboratory and bacteriological studies - according to indications

Treatment
Ensuring adequate ventilation of the lungs, in case of suspected burns of the respiratory tract - oxygen inhalation, tracheal intubation and mechanical ventilation
Venous access (2 large-diameter catheters) Calculation of the required volume of fluid in adults: V = 4 ml * burn surface area (%) * body weight (kg)
In children: 5000 ml per 1 m of body surface * fraction of the burn surface area + maintenance fluid (2000 ml / m of body surface per day).
It is introduced in the form of a 9% solution: And of the calculated volume - for the first 8 hours, the remaining half - for the next 16. The purpose of infusion therapy: to maintain diuresis in adults at least 0.5 ml / kg per hour, in children - 1 ml / kg per hour.
Anesthesia:
Morphine, the initial dose in adults is 0.1-0.2 mg / kg, iv, i / m or s / c, a maintenance dose of 5-20 mg every 2-4 hours
In children, 0.05-0.2 mg / kg every 2-4 hours
Use of other narcotic analgesics in equivalent doses is possible.
Washing, surgical treatment of a wound (performed by a surgeon or combiologist)
Local antibacterial prophylaxis - neosporin (a drug of neomycin and polymyxin B) 1-4 r / day., 1% silver sulfadiazine.
The dressing is an internal non-adhesive porous layer, a middle adsorbing, external fixing layer. Bandage change 1-2 r / day.
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Thermal and chemical burns

  1. THERMAL AND CHEMICAL BURNS
    Animals with thermal or chemical burns are killed for meat when they are in an incurable condition or their treatment and maintenance are not economically feasible in the future. Thermal burns in animals are the result of exposure to tissue of high temperature (fire, hot water, hot air), radiation energy, and electric current. As a result of thermal burns in animals,
  2. Thermal and chemical burns of the respiratory tract
    ICD-10 code T27 Diagnostics Diagnosis Mandatory Level of consciousness, effectiveness and respiratory rate, blood pressure, heart rate, medical history, physical examination R-graph of chest organs Bronchoscopy Laboratory tests: bacterial culture 2-3 days after a burn, hemoglobin, gases blood, carboxyhemoglobin, methemoglobin, electrolytes (Na, K, Cl), coagulation
  3. Thermal tracheal burns
    Thermal burns of the trachea and other respiratory tract occur when inhaling the flame, hot air, smoke, steam. Purely thermal factors can be accompanied by chemical - toxic combustion products in smoke. A burn of the airways should be suspected in all cases when the damage was received indoors (fire in the house, basement, transport, mine, in the battle
  4. Thermal burns
    Thermal burns - traumatic damage to the surface and deep tissues of the body under the influence of high temperature, accompanied by a general reaction with disruption of the activity of various organs and systems. Among the causes of death in childhood (up to 4 years), burns occupy the 2nd most frequent place (after road traffic injuries). Pathophysiology. Exposure to heat
  5. Thermal burns
    Thermal burns are a type of injury that occurs as a result of exposure to body tissues of high temperature (flame, steam, boiling water, hot metals, gases, electromagnetic radiation of the optical range). Clinical diagnosis The severity of the condition of the affected child is determined by the depth and prevalence of tissue damage and manifestations of burn shock. Distinguish
  6. CHEMICAL BURNS
    Chemical burns can be caused by organic and non-organic substances in the solid, liquid and gaseous state. The degree of damage depends on the amount of substance, its concentration and time of contact with the skin. The pathogenesis of chemical burns differs from the pathogenesis of thermal lesions. When concentrated acids act on the skin, tissue proteins coagulate (with the formation of
  7. Chemical burns of the esophagus
    Esophageal burns are usually of a chemical nature, with the exception of the rarest cases of thermal burns. Chemical burns of the esophagus occur with the accidental or deliberate (with suicidal purpose) intake of aggressive fluids inside. Currently, the most common cause of such burns is acetic essence (80% solution of acetic acid). The pathogenesis of a chemical burn of the esophagus is quite typical.
  8. Chemical burns
    Scope of the examination 1. Chemical burns cause corrosive liquids - concentrated acids and caustic alkalis. 2. Acids have a cauterizing and necrotic effect, coagulation of tissue proteins; alkalis dissolve proteins and cause kallikvatsionny necrosis. 3. Signs of a chemical burn if liquid gets inside are: burns on the face, lip mucosa, oropharynx, hoarseness
  9. Chemical burns of the respiratory and esophageal tract
    Chemical burns of the respiratory tract Chemical burns occur as a result of ingestion or inhalation of concentrated chemical solutions (acids, alkalis, etc.). Most often, the vestibular part of the larynx is affected (epiglottis, scoop-epiglottis and vestibular folds, arytenoid cartilage). At the site of contact of the chemical agent with the mucous membrane, a local burn occurs
  10. CHEMICAL COMPOSITION OF A CELL AND ITS PHYSICAL AND CHEMICAL PROPERTIES
    The elemental composition of the cell (protoplasm). To clearly imagine the biological and physicochemical properties of tissues, it is necessary to know the chemical composition of the protoplasm of the cell. In addition to water, there are a large number of elements in the protoplasm. The finest chemical studies have found that out of 104 elements of the periodic system of D. I. Mendeleev, protoplasm contains 96. Four
  11. Therapeutic tactics for thermal lesions
    Thermal damage occurs as a result of exposure to thermal energy (burns) or low temperature (frostbite). Burns (burn disease) - tissue damage resulting from local thermal, chemical, electrical or radiation exposure. In depth, 4 degrees of damage are distinguished. I degree - erythema, swelling and pain of reddened skin is noted. Phenomena pass through 3-5
  12. The chemical composition of water. Water pollution: physical, chemical, bacteriological. Self-cleaning ability of water sources
    The chemical composition of water. In nature, water almost always contains more or less mineral salts dissolved in it. The degree and mineral composition of water is determined by the nature of the soil or soils adjacent to aquifers or surface water sources. The amount of mineral salts contained in the water is expressed in mg / L. Organic matter Of these, the most important
  13. Thermal oxidation and degradation
    From a hygienic standpoint, processes associated with thermal degradation (thermal oxidation and destruction) of polymer materials deserve special attention. It is known that most of them are not sufficiently resistant to high temperatures; when exposed to heat and flame, they melt and burn, releasing highly toxic fumes and gases. Thermooxidative degradation products of polymers vary in
  14. Burns
    A burn is an injury that occurs when a body is exposed to high temperature, aggressive chemicals, electric current, and ionizing radiation. Burned is a person who has suffered a thermal injury. The frequency of burns is 5-10% of the total number of peacetime injuries. In the structure of burn injury, household burns prevail. A third of the number of burned are children.
  15. Thermal damage
    A burn of the nose (combustio nasi) is usually part of a general burn of the face. The causes of such burns are very diverse, in particular the sun's rays, strong alkalis and acids, hot water, etc. Klinsky kartina of the 1st degree burn is characterized by the appearance of painful hyperemia of the skin, a sensation of swelling. After 4-5 days, the pain disappears, the skin becomes dark in color. In subsequent
  16. Burns
    A burn is tissue damage due to careless handling of fire, chemicals, and electricity. Pathophysiology • Burn damage - open damage or destruction of the skin, its appendages, mucous membranes by thermal, chemical, electrical factors, radiation energy, or a combination thereof. For burns, not only the type of lesion factor matters, but also the duration (exposure) of it
  17. Burns
    Burns (burnio) - damage to body tissues resulting from local effects of high temperature, chemicals, electric current or ionizing radiation. On the etiological basis, thermal, chemical, electrical and radiation burns are distinguished. Thermal burns are I-IV degrees. A degree I burn, or superficial burn, is characterized by the appearance of pain
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