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Thermal and chemical burns of the respiratory tract

ICD-10 code
When diagnosed
Level of consciousness, effectiveness and respiratory rate, blood pressure, heart rate, history, physical examination
R-graph of the chest
Laboratory studies: bacterial culture 2-3 days after a burn, hemoglobin, blood gases, carboxyhemoglobin, methemoglobin, electrolytes (Na, K, Cl), coagulation indicators (APTT, PTV, platelets), white blood cells, blood count

During treatment
Monitoring according to clause 1.5
Hourly Diuresis
Hemoglobin Saturation
Repeated R-graphy
Laboratory and bacteriological studies - according to indications

Inhalation of oxygen, in the presence of signs of a burn of the respiratory tract - intubation of the trachea and mechanical ventilation with high pressure at the end of expiration (515 cm water), with severe swelling of the mucous membrane of the respiratory tract, vocal cords - conicotomy or emergency tracheostomy
In the presence of lung atelectasis - repeated bronchoscopy
Regular aspiration of the contents of the trachea
In case of CO poisoning - inhalation of 100% oxygen, if possible hyperbarotherapy at 3 atm.

With methemoglobinemia of more than 30%, depression of consciousness, myocardial ischemia - methylene blue 1-2 mg / kg in 5 minutes - the effect is within 30 minutes. With the manifestation of bronchospasm - p2 adrenomimetics, albuterol, 2.5 mg per 3 ml of solution, inhalation, 4-6 p / day.
With the development of bacterial complications - antibiotic therapy in accordance with the antibioticogram
Maintenance therapy, replenishment of hypovolemia, daily fluid requirements, treatment of concomitant pathology
The use of glucocorticoids does not improve treatment outcomes and is associated with an increase in bacterial complications. In the absence of signs of a burn of the respiratory tract - observation for at least 9 hours

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Thermal and chemical burns of the respiratory tract

  1. 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
    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,
  3. Thermal and chemical burns
    ICD-10 code T20 - T32 Diagnosis Diagnosis Mandatory Level of consciousness, respiratory rate and effectiveness, blood pressure, heart rate, medical history, physical examination, burn surface area Consultation of a combiologist (traumatologist, surgeon) Laboratory tests: hemoglobin, blood gases, carboxyhemoglobin electrolytes (Na, K, Cl), coagulation indicators (APTT, PTV,
  4. 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
  5. 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
  6. 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
    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
  8. 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.
  9. The mechanisms of respiratory failure in the pathology of the respiratory tract
    The development of DN in diseases of the respiratory tract is due to an increase in resistive resistance to air flow (RL). In this case, the ventilation of the affected areas of the lung is disturbed, the resistive work of breathing increases, and fatigue and weakness of the respiratory muscles can be the result of irreparable obstruction of the DP. Due to the fact that airway resistance (according to Poiseuille's law)
  10. 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
    Definition Rupture of the airways is called traumatic perforation or rupture of any part of the airways. Etiology Ruptures of the walls of the respiratory tract under the influence of thermal or mechanical energy. Neck hyperextension combined with direct exposure to an unprotected trachea. Penetrating chest wounds. Erosion of the tracheobronchial wall with an ETT cuff.
    Definition A burn of the respiratory tract is a thermal or chemical lesion of the mucous membrane of the respiratory tract from the mouth to the alveoli. Etiology Ignition of ETT during laser surgery. Inhalation of hot gases: the inhaled gases are too hot; there is a direct effect of fire; exposure to smoke or toxic gases.
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