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Burns Initial Evaluation and Management PowerPoint Presentation

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Description : Check out this medical titled "BURNS Initial Evaluation & Management" by Christopher P. Brandt MD.

This medical talks about initial evaluation and management of burns.

Burns are injuries to the skin caused by heat, chemicals, electricity, or radiation. They can range from mild to severe and require prompt evaluation and management to minimize tissue damage and prevent complications.

Tags : burns, injuries to the skin, tissue damage, Emergency Medicine, Emergency Medicine

Published on : Apr 14, 2023 | Views : 1643 | Downloads : 2

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Slide 1-

Christopher P. Brandt M.D. Associate Professor of Surgery Case Western Reserve University BURNSInitial Evaluation & Management
Slide 2-

Joseph B. Your patient is brought to the E.D. by the EMS service. He is a 14 year-old male who was involved in a house fire
Slide 3-

History What other points of history do you want to know?
Slide 4-

History, Joseph B. Neighbors heard an explosion Patient found confused, outside of the house Cannot remember what occurred Denies shortness of breath Transport time of twenty minutes PMH of ADHD Tetanus – up to date
Slide 5-

Physical Examination What would you look for?
Slide 6-

Physical Examination VS T=96.5 P=140 R=24 BP=90/60 Awake; No hoarseness or stridor Soot in mouth Clear breath sounds Burns involving face, neck, trunk, arms and upper legs (see photos) Doppler pulses in all extremities
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Slide 9-

Physical Examination How do you determine the extent and depth of the burn injuries? What findings suggest inhalation injury?
Slide 10-

18 Extent of burn % total body surface area
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Burn Depth Color Moistness Capillary refill/Blanching Sensation Blistering
Slide 12-

Superficial Second Degree Deeper second degree Third Degree
Slide 13-

Inhalation injury Occurred in closed space Cough, dyspnea, wheezing, hoarseness, stridor Facial burns / Singed facial hair Carbonaceous sputum Hypoxia Indicators
Slide 14-

Labs What would you obtain?
Slide 15-

Lab Results CBC - WBC-12.0 Hct-49% Electrolytes -Na-147 Cl-100 K-4.5 BUN-12 ABG - 7.31/35/125 on 50%VM Carboxyhemoglobin- 21% Tox. Screen - Negative U/A - Normal
Slide 16-

Interventions at this point?
Slide 17-

Interventions at this point? Assess airway; Intubation ? Oxygen Fluid resuscitation Foley Catheter NG tube Wound care Pain medication
Slide 18-

Interventions Why is fluid resuscitation important? How do you estimate fluid requirements? How do you monitor response to initial fluid therapy? What complications can occur from over- or under- resuscitation?
Slide 19-

Fluid Management Edema formation Systemic inflammatory response Capillary leak/ Increased vascular permeability Loss of skin barrier Zones of injury Parkland formula Crystalloid 4 x %TBSA x wt (kg) ½ of total in first eight hours Goal of ½ - 1 cc/kg/hr U.O.
Slide 20-

Studies What further studies/tests would you want at this time?
Slide 21-

Studies CXR – Basilar atelectasis EKG – Sinus tachycardia ? Bronchoscopy
Slide 22-

Management Low urine output Loss of Doppler signals in the hands Inadequate ventilation with high airway pressures? What would you do in the following scenarios?
Slide 23-

Management Escharotomy
Slide 24-

Management What are the principles of management of the inhalation injury? What will be the basic strategies for management of the burn wounds?
Slide 25-

Questions?
Slide 26-

Acknowledgment The preceding educational materials were made available through theASSOCIATION FOR SURGICAL EDUCATION In order to improve our educational materials wewelcome your comments/ suggestions at: feedbackPPTM@surgicaleducation.com