Emergency management of burn

PREPARED BY

MR. ARUN. S. ANGADI.

Emergency

Management of Burns

Pathophysiology

• Tissue damage occurs in two stages:

– Initial thermal injury

– Secondary injury from ongoing dermal

ischaemia or trauma

• Early management is aimed at

minimizing secondary damage

Jackson Burn Wound Model

Zone of Survival

Zone of Damage

Zone of Necrosis

Hyperaemia

Stasis

Coagulation

• Airway

• Breathing

• Circulation

• Disability

• Exposure

• Fluids

AIRWAY and BREATHING Early Symptoms: • Sore throat • Singing of nasal hairs/eyebrows/eyelashes • Hoarseness Late Symptoms: • Shortness of breath • Stridor • Indrawing

IF IN DOUBT INTUBATE

CIRCULATION

BURN SHOCK • Management focuses on fluid resuscitation,

pulmonary, cardiovascular and renal support.

Ends with mobilization of fluid and establishment

of cardiopulmonary and renal stability (lasts up

to 48 hours or several days)

• FLUID RESUSCITATION – Parklands Formula

DISABILITY

• Beware the Confused Patient

• Intoxicated Or Hypoxic?

• Electrolyte Imbalances

• Shock

EXPOSURE

• REMOVAL OF ALL JEWELLERY AND CLOTHING

WHILE KEEPING THE PATIENT WARM

• ASSESSMENT OF BURN SEVERITY AND EXTENT

• MANAGEMENT

Calculation of fluid

commences from the time of

burn

NOT

from the time of presentation

Limbs: Signs of Circulatory

Obstruction

• Loss of distal circulation

• pallor

• coolness

• absent pulse

• loss capillary refill

• decreased oxygen saturation

• Pain on passive extension

• Deep pain at rest

Escharotomy

After Consultation with Burns Unit:

• Chest: To allow respiratory movement

• Limb: To restore circulation in limb

with excess swelling under rigid eschar

THANK YOU….