1st degree burn chart11/19/2023 Take routine blood tests including FBC, U&Es, LFTs, capillary blood glucose, group and save, a coagulation screen and creatine kinase levels. from significant haemorrhage, cardiac tamponade).Īssess blood pressure before inserting two large bore cannulas through unburnt skin and immediately correct any hypotensive shock with warm, intravenous fluids (further details later in this article). 2 It is also important to remember that non-burn injuries may also cause circulatory compromise (e.g. Severe burns may cause circulatory shock secondary to large fluid losses and systemic inflammatory response. ![]() Take an arterial blood gas (ABG) to assess oxygenation and carboxyhaemoglobin levels to exclude carbon monoxide poisoning. Monitor oxygen saturations with a pulse oximeter and administer 100% high-flow humidified oxygen through a non-rebreather mask as required. 6Įxpose the chest to assess the adequacy of ventilation and look for further injuries. ![]() If eschar forms around the chest it may prevent adequate chest expansion and cause respiratory distress. When a constrictive eschar forms around the circumference of a limb it may constrict distal circulation causing limb ischaemia. tension pneumothorax, haemothorax, flail chest)Įschar is a collection of tight and leathery dead tissue caused by deep partial or full-thickness burns. Burnt tissue on the chest or neck creating a constrictive eschar and reducing chest expansion.Direct damage from an inhalation injury to the lower airways.BreathingĬompromised gas exchange may occur secondary to: 2 If in doubt, immobilise the cervical spine. 5Ī C-spine injury should also be excluded. Early intubation with an uncut endotracheal tube may be indicated to protect the patient’s airway. If an inhalation injury is recognised or likely given the history, the patient should be sat upright and receive an urgent senior anaesthetic review. A history of burns in an enclosed space.3įactors that may increase the likelihood or are suggestive of an inhalation injury include: 3 from facial trauma, a foreign body or vomit in the mouth). There may also be another cause of airway obstruction that is not directly related to the burn (e.g. Airway and C-spineĮvaluate the airway and look for signs of an inhalation injury.Īn inhalation injury may occur after inhaling hot air, smoke or toxic fumes and can cause swelling of the airway leading to airway obstruction. This guide has been created to assist students in preparing for emergency simulation sessions as part of their training, it is not intended to be relied upon for patient care. There are areas within the ABCDE assessment that should be focused on in burn patients, and these are detailed below. Problems are addressed as they are identified, and the patient is re-assessed regularly to monitor their response to treatment. Patients with burn injuries should undergo a systematic ABCDE assessment. ![]() Underlying medical conditions: epilepsy, peripheral neuropathy, cerebral palsy, or cognitive disabilities.Occupation with increased exposure to fire.Young children: these injuries are often caused by spilling scalding drinks or from touching oven hobs or irons.Risk factors which increase the likelihood of a person suffering a burn include: 4 You might also be interested in our surgical flashcard collection which contains over 500 flashcards that cover key surgical topics.
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