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    Trigger Case: Luka Bakar: Muhammad Iqbal

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    akreditasirsur
    This document discusses the management of burn injuries. It covers the epidemiology of burns, noting high-risk groups. The pathophysiology of local and systemic burn responses are described. Initial management involves assessing the patient's airway, breathing, circulation, disability and exposure. Investigations may include blood tests and imaging depending on the injury mechanism. Burns are assessed based on depth, size and site. Severe burns require referral to a specialized burn unit based on certain criteria. Ongoing management differs based on burn depth, and may involve surgery, dressing changes or rehabilitation services.

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    Trigger Case: Luka Bakar: Muhammad Iqbal

    Uploaded by

    akreditasirsur
    40 views12 pages
    This document discusses the management of burn injuries. It covers the epidemiology of burns, noting high-risk groups. The pathophysiology of local and systemic burn responses are described. Initial management involves assessing the patient's airway, breathing, circulation, disability and exposure. Investigations may include blood tests and imaging depending on the injury mechanism. Burns are assessed based on depth, size and site. Severe burns require referral to a specialized burn unit based on certain criteria. Ongoing management differs based on burn depth, and may involve surgery, dressing changes or rehabilitation services.

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    This document discusses the management of burn injuries. It covers the epidemiology of burns, noting high-risk groups. The pathophysiology of local and systemic burn responses are described. Initial management involves assessing the patient's airway, breathing, circulation, disability and exposure. Investigations may include blood tests and imaging depending on the injury mechanism. Burns are assessed based on depth, size and site. Severe burns require referral to a specialized burn unit based on certain criteria. Ongoing management differs based on burn depth, and may involve surgery, dressing changes or rehabilitation services.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    40 views12 pages

    Trigger Case: Luka Bakar: Muhammad Iqbal

    Uploaded by

    akreditasirsur
    This document discusses the management of burn injuries. It covers the epidemiology of burns, noting high-risk groups. The pathophysiology of local and systemic burn responses are described. Initial management involves assessing the patient's airway, breathing, circulation, disability and exposure. Investigations may include blood tests and imaging depending on the injury mechanism. Burns are assessed based on depth, size and site. Severe burns require referral to a specialized burn unit based on certain criteria. Ongoing management differs based on burn depth, and may involve surgery, dressing changes or rehabilitation services.

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    © All Rights Reserved
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    of 12

    Trigger Case : Luka

    Bakar
    MUHAMMAD IQBAL
    PPDS I ILMU BEDAH FK UNAND/RSMDJAMIL
    DR. BENNY RAYMOND, SPBP-RE
    A 22-year-old man s brought to the emergency
    room after a house fire. He has burns around his
    mouth and his voice is hoarse, but breathing is
    unlabored. What most appropriate next step in
    management?
    Epidemiology
    UK:13,000 adm, 300 burn-related deaths
    Vulnerable : young, old, debilitated
    Chldren between 1 and 5 : high risk
    Other fact : alcoholism, epilepsy, psychiatric illness
    Pathophysiology (Local response)
    Systemic response
    once then burn reaches 30%
    cardiovascular, respiratory, metabolic and
    immunological changes.
    Mechanisms of injury
    Thermal injuries : Scalds, Flame, Contact
    Electrical injuries : low/high voltage
    Chemical Injuries : industrial
    accident/household
    Initial management
    History
    Primary survey : ATLS –ABCDEF
    Analgesia
    Escharotomy
    Investigations
    full blood count, haematocrit, urea and electrolytes;
    group and save/cross-match;
    microbiology swabs of burn wounds.
    Electrical injuries also require:
    • 12-lead ECG;
    • cardiac enzymes (high-tension injury).
    Inhalational injuries require:
    • chest X-ray;
    • arterial blood gases (can be useful in any burn because base
    excess is predictive of amount of resuscitation required).
    Burn assessment
    Referral to burn unit
    • Age < 5 or > 60 years
    • Site: face, hands, feet, perineum, flexure (neck/axilla/groin),
    circumferential
    • Inhalational injury
    • Mechanism: chemical (> 5% total body surface area), ionizing
    radiation, high-pressure steam, high-tension electrical, hydrofluoric
    acid (> 1% total body surface area), non-accidental injury
    • Size: paediatric (age < 16 years), > 5% total body surface area;
    adult > 10% total body surface area
    • Coexisting medical conditions or associated injuries
    Subsequent management
    Management
    Superficial
    • Heals spontaneously in 14 days
    • Needs dressing (tulle gras, retention dressing, interface
    dressing, topical antibacterial cream) to keep wound clean
    Deep dermal/full thickness
    • Surgery
    • Resurfacing
    Rehabilitation
    Physiotherapy (pulmonary problems and
    mobilization)
    Occupational therapy (contractures)
    Clinical psychology (psychological trauma)

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