外科急诊创伤--烧伤 (英文).ppt

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1、BURNSLeaugeayWebreBS,CCEMT-P,NREMT-PScenarioParamediciscalledtothesceneofastructurefire.FDhasremovedavictimfromthehouse.BSIScenesafe1patientA/CstandbyFD/PDonsceneNowwhat?GeneralImpression33yomaleptwrithinginpain.Screamsandbegsforpainmedicationhoweverpoorhistorian.S-blisteringtobackandchest,Rupperven

2、tralarealegexposedmuscle;eyebrowssingedA-PCN,codeineM-noneP-noneL-earliertodayE-wokeuponfireA-B-C-Transportdecision?%BSAburned?Tx?ObjectivesDescribethestructureandfunctionofskinDiscussthetypesofburns.Explainthedegreesofthermalburns.Discusscausesandtreatmentsofinhalationinjuries.Identifymethodsofappr

3、oximatingburninjuries.Describeandapplytreatmentmodalitiesfortheburnpatient.Burns,thermal.Escharotomytoreleasechestwallandallowforventilationofthepatient.SkinLargestorganofthebodyAnatomyEpidermisDermisSubcutaneoustissueLayersEpidermisDermisSubcutaneosUnderlyingStructuresFasciaNervesTendonsLigamentsMu

4、sclesOrgansAnatomy&PhysiologyoftheSkinFunctionProtectionRegulationPreventionSensoryEpidermisOuter,thinnerlayerConsistsofdeadkeratinizedcellsProtectsdehydrationtraumalightinfectionDermisGellikematrixConsistsofcollagenandelastinContainsbloodvessels,lymphatics,sweatglands,hairfollicles,sensoryfibersSu

5、bcutaneousConnectivetissueAdiposetissuecushioninginsulationCausesThermalElectricalChemicalRadiationThermalMajorityflamescaldcontactwithhotobjectsChildwithburnsfromascaldDeterminingSeverity1stdegree2nddegree3rddegree(4thdegree)DepthofBurnSuperficialBurnPartialThicknessBurnFullThicknessBurnFirstDegree

6、SuperficialinvolveonlyepidermisLocalpainandrednessNoblisteringpresentHealspontaneously2-5dayswithoutscarringNotincludedwhencalculating%TBSABurnDepthSuperficialBurn:1stDegreeBurnSigns&SymptomsReddenedskinPainatburnsiteInvolvesonlyepidermisSecondDegreeInvolveepidermisanddermisPartialthicknesssuperfic

7、ialpartialthicknessred,painful,blistereddeeppartialthicknesspale,mottledVerypainfulInfectionmayevolveinto3rddegreeBurnDepthPartial-ThicknessBurn:2ndDegreeBurnSigns&SymptomsIntensepainWhitetoredskinBli