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Burns management.

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Burns D.Tissue damage occurs by thermal, electrical or chemical injury. A: Contact with hot object, liquids, electricity, UV light and irradiation, chemicals. A/R: Young children and elderly at most risk and suffer " mortality. E: Common, >12 000 admissions in England and Wales annually. H: Circumstances of burn, note time, temperature of and length of contact with agent. Consider risk of inhalation of smoke and toxic gas poisoning (carbon monoxide). EXAMINATION. Look for signs of inhalational injury or airway compromise: stridor, shortness of breath, hoarse voice, soot in nose, singed nose hairs, carbonaceous sputum. Examine :site, depth and distribution of burn. Partial thickness: Subdivided into superficial and deep. Red and oedematous skin in a superficial burn; blistering and mottling in deep dermal burns; both are painful. Full thickness: Destruction of both epidermis and dermis. Charred leathery eschar, firm and painless with loss of sensation. Size of burn: Described as % body surface area and calculated by Wallace’s‘Rule of Nines’: arm or head 9%, anterior or posterior trunk 18%, leg 18%, palm area 1%, perineum 1%. Alternatively, there is the Lund–Browder Char Pathology Superficial partial thickness burns involve damage to the epidermis, healing occurs within 7 days with subsequent peeling of dead skin. Deep partial burns extend into dermis, but sweat and sebaceous glands are spared and healing occurs by epithelial regrowth over 3 weeks, usually with ...
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