外科急诊创伤(英文)-烧伤.ppt

BURNS Leaugeay Webre BS, CCEMT-P, NREMT-P Scenario Paramedic is called to the scene of a structure fire. FD has removed a victim from the house. BSI Scene safe 1 patient A/C standby FD/ PD on scene Now what? General Impression 33 yo male pt writhing in pain. Screams and begs for pain medication however poor historian. S- blistering to back and chest, R upper ventral area leg exposed muscle; eyebrows singed A- PCN, codeine M- none P- none L- earlier today E- woke up on fire Objectives Describe the structure and function of skin Discuss the types of burns. Explain the degrees of thermal burns. Discuss causes and treatments of inhalation injuries. Identify methods of approximating burn injuries. Describe and apply treatment modalities for the burn patient. Skin Largest organ of the body Anatomy Epidermis Dermis Subcutaneous tissue Anatomy Physiology of the Skin Layers Epidermis Dermis Subcutaneos Underlying Structures Fascia Nerves Tendons Ligaments Muscles Organs Function Protection Regulation Prevention Sensory Epidermis Outer, thinner layer Consists of dead keratinized cells Protects dehydration trauma light infection Dermis Gel like matrix Consists of collagen and elastin Contains blood vessels, lymphatics, sweat glands, hair follicles, sensory fibers Subcutaneous Connective tissue Adipose tissue cushioning insulation Causes Thermal Electrical Chemical Radiation Thermal Majority flame scald contact with hot objects Determining Severity 1st degree 2nd degree 3rd degree (4th degree) Depth of Burn Superficial Burn Partial Thickness Burn Full Thickness Burn First Degree Superficial involve only epidermis Local pain and redness No blistering present Heal spontaneously 2-5 days without scarring Not included when calculating % TBSA Burn Depth Superficial Burn:1st Degree Burn Signs Symptoms Reddened skin Pain at burn site Involves only epidermis Second Degree Involve epidermis and dermis Partial thickness super