Transcript Degree of Burns - Blue Valley Schools

EHP
Mini unit: Burns, Poisons, Drugs
BURNS
• Effects of burns:
• tissue destroyed,
• open wound,
• change in body (shock),
• scarring,
• mortality factor: immediate- 30% fatal and
delayed – results from infections
Anatomy of skin
• Epidermis: top layer
• Dermis: true skin (blood vessels and
nerves)
• Subcutaneous: fat tissue
Degree of Burns
• First Degree – red – epidermis
• Second – blisters – epidermis and
dermis
• Third – charred – all 3 layers – loss of
plasma
First Degree Burn
• First-degree burns are red and painful.
They swell a little. They turn white
when you press on the skin. The skin
over the burn may peel off after 1 or 2
days.
2nd Degree Burn
• Thicker burns, called second-degree
burns, have blisters and are painful.
The skin is very red or splotchy, and it
may swell a lot.
Third Degree Burn
• Third-degree burns cause damage to
all layers of the skin. The burned skin
looks white or charred. These burns
may cause little or no pain because
the nerves in the skin are damaged
Causes of Burns
Burn experts find it useful to divide burns into
six major groups:
• Scalds, including immersion in or splashing
by hot liquids, grease, and steam.
• Contact burns, i.e., touching a hot object or
substance.
• Fires
• Chemical burns
• Electrical burns
• Radiation
Most Common Causes
• scalds, the number-one culprit (from steam, hot bath
water, tipped-over coffee cups, cooking fluids, etc.)
• contact with flames or hot objects (from the stove,
fireplace, curling iron, etc.)
• chemical burns (from swallowing things, like drain
cleaner or watch batteries, or spilling chemicals, such
as bleach, onto the skin)
• electrical burns (from biting on electrical cords or
sticking fingers or objects in electrical outlets, etc.)
• overexposure to the sun
Burns and Scalds: Words to
Know
• BSA:
• A unit used in the treatment of burns to express the amount of the total
body surface area covered by the burn.
• Debridement:
• The surgical removal of dead skin.
• Scald:
• A burn caused by a hot liquid or steam.
• Shock:
• A life-threatening condition that results from low blood volume due to loss
of blood or other fluids.
• Skin graft:
• A surgical procedure in which dead skin is removed and replaced by
healthy skin, usually taken from the patient's own body.
• Thermal burns:
• Burns caused by hot objects.
Treatment of Burns
• Specialized treatment for severe burn cases may also include:
• Installation of a breathing tube if the patient's airways or lungs
have been damaged
• Administration of fluids through an intravenous tube
• Immunization with tetanus vaccine to prevent infection
• Covering the burned area with antibiotic ointments and
bandages
• Debridement, or removal of dead tissue
• Removal of scars as healing occurs in order to improve blood
flow
• Physical and occupational therapy to keep burn areas flexible
and prevent scarring
Thermal Burn Treatment
• Thermal burns are burns caused by
heat, hot liquids, steam, fire, or other
hot objects. The first objective in
treating thermal burns is to cool the
burned
Treatment
A burn victim receiving debridement treatment, or removal of dead skin, for severe burns. (Photograph by Ann Chawatsky
. Reproduced by permission of Phototake NYC
Chemical Burn Treatment
• The first step in treating a chemical burn is to
remove the material causing the burn. If the
material is a dry powder, it can be brushed
off. If the material is a liquid, it can be flushed
away with water. If the chemical that caused
the burn is known, it may be neutralized with
some other chemical. For example, if the burn
is caused by an acid, a weak base can be used
to neutralize the acid. The burned area can
then be covered with a clean gauze and, if
necessary, treated further by a doctor.
Example: International
Chemical Safety Cards
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BORON BROMIDE10294-33-4231
BORON TRIFLUORIDE7637-07-2107
BROMINE7726-95-61194
CHROMIUM (VI) OXIDE1333-82-0854
CHROMYL CHLORIDE14977-61-8868
DICHLOROACETIC ACID79-43-6869
2,2-DICHLOROACETYL CHLORIDE79-36-746
FLUORINE7782-41-4485
FORMIC ACID64-18-6282
HYDROGEN BROMIDE10035-10-6163
HYDROGEN CHLORIDE7647-01-0283
HYDROGEN FLUORIDE7664-39-3183
NITRIC ACID7697-37-2628
PHOSPHORUS (YELLOW)7723-14-0545
PHOSPHORUS PENTOXIDE1314-56-3357
POTASSIUM HYDROXIDE1310-58-3942
PROPYLENEDIAMINE78-90-0360
SODIUM HYDROXIDE1310-73-2362
SULFURIC ACID7664-93-9
Electrical Burn Treatment
As with severe thermal burns, the first step in
treating electrical burns usually involves
saving the patient's life. An electrical charge
large enough to burn the skin may also
produce life-threatening symptoms. The
source of electricity must be removed and life
support treatment provided to the patient.
When the patient's condition is stable, the
burn can be covered with a clean gauze and
medical treatment sought.
Alternative Treatment
Serious burns should always be treated by a
medical doctor.
Less serious burns may benefit from a variety of
alternative treatments. Some herbs that can be
used to treat burns include
• aloe
• oil of St. John's wort
• calendula (pronounced KUH-len-juh-luh)
• Comfrey tea tree oil.
Supplementing one's diet with vitamins C and E and
the mineral zinc may help a wound to heal faster.
Poisons
• Poison is anything that kills or injures
through its chemical actions. Most
poisons are ingested (swallowed). The
word poison comes from the Latin
word—potare—meaning to drink. But
poisons can also enter the body in other
ways:
Poisoning: Causes
• By breathing (Inhalation)
• Carbon monoxide (sign – skin is a bright red or
cherry color
• Through the skin (absorption)
• Poison ivy, oak, sumac
• By IV injection (bites, stings, drugs)
• From exposure to radiation
• Ingestion (mouth)-overdose
Poisoning: Signs and Symptoms
Almost every possible sign or symptom of a poisoning can also be
caused by a non–poison-related medical problem.
The signs and symptoms seen in poisoning are so wide and
variable that there is no easy way to classify them.
• Some poisons enlarge the pupils, while some shrink them.
• Some result in excessive drooling, while some dry the mouth
and skin.
• Some speed the heart, while others slow the heart.
• Some increase the breathing rate, while others slow it.
• Some cause pain, while some are painless.
• Some cause hyperactivity, while others cause drowsiness.
Confusion is often seen with these symptoms.
Check for any odor around the mouth or a sign of a burn on the
lips or in the mouth – caused by toxic substances
Poisoning: Treatment
• Check with the Poison Control Center at (800)
222-1222 (in the United States) before giving
anything to the affected person.
What NOT to do
• Don't administer ipecac syrup or do anything to
induce vomiting. In 2003, the American Academy of
Pediatrics advised discarding ipecac in the home,
saying there's no good evidence of effectiveness and
that it can do more harm than good
• Do not induce vomiting if the poison was an acid or a
base
• Do not induce vomiting if the person is unconscious.
Universal Antidote to neutralize
acidic poisons (does not induce
vomiting)
• 2 parts burnt toast
• 1 part milk of magnesia
• 1 part tea
Poisoning: More RX
Call 911 if the patient is:
• Drowsy or unconscious
• Having difficulty breathing or has
stopped breathing
• Having seizures
Open the airway and begin CPR if not
breathing
Common Household Poisons
• Gasoline
• Anti-freeze
• Toilette cleaner
• Lighter fluid
• Paint
• Paint Thinner
• Drano Drain Clean
Snake Bites
• Poisonous snakes found in
the Midwest that affect the
circulatory system
• Rattlesnake
• Copperhead
• Water moccasin
• Cotton mouth
• Other poisonous snakes
• Coral snake- neurotoxic
Poisoning: Snake Bites
A number of old first aid techniques have fallen out of favor.
Medical research supports the following warnings:
• Do NOT cut and suck. Cutting into the bite site can damage
underlying organs, increase the risk of infection, and does not
result in venom removal.
• Do NOT use ice. Ice does not deactivate the venom and can cause
frostbite.
• Do NOT use electric shocks. The shocks are not effective and could
cause burns or electrical problems to the heart.
• Do NOT use alcohol. Alcohol may deaden the pain, but it also
makes the local blood vessels bigger, which can increase venom
absorption.
• Do NOT use tourniquets or constriction bands. These have not
been proven effective, may cause increased tissue damage, and
could cost the victim a limb.
Snake Bite Treatment
The two guiding principles for care often
conflict during evacuation from remote areas.
First, the victim should get to an emergency
care facility as quickly as possible
Second, the affected limb should be used as
little as possible to delay absorption of the
venom
Snake Treatment
Provide emergency medical care within the limits of
your training.
• If swelling: Remove constricting items on the victim
• If in a remote area, splint.
• If you have been bitten by a dangerous elapid and have no
major local wound effects, you may apply a pressure
immobilizer..
• While applying mechanical suction (such as with a Sawyer
Extractor) has been recommended by many authorities in
the past, it is highly unlikely that it will remove any
significant amount of venom, and it is possible that suction
could actually increase local tissue damage.
Snake Bites
Examples
Other Bites
• Black widow spider – red or yellow
hour glass shape on its abdomen
• Brown Recluse – brown with a fiddle
shaped outline on its back
• Necrosis around the bite occurs
Treatment for Spider bites
• Wash the area well with soap and water.
• Apply a cold or ice pack wrapped in a cloth, or a cold, wet washcloth
to the site.
• To protect against infection, particularly in children, apply an antibiotic
lotion or cream.
• Give acetaminophen for pain.
• Seek immediate emergency care for further treatment. Depending on
the severity of the bite, treatment may include muscle relaxants, pain
relievers and other medications, and supportive care. Antivenin may
be needed, although it is usually not required. Hospitalization may be
needed.
• Prompt treatment is essential to avoid more serious complications,
especially in children.
Other Bites
• Stings:
• Remove stinger
• Apply ice
• Get medical help ASAP
Other bites
• Animals
• Wash area if possible
• Get a description of what bit the patient
• Get medical help
• Tetanus shot (?)
• Rabies (?)
Drug Definitions to know
• Misuse – used for purposes which they
are unsuited or not used properly
• Abuse – excessive persistent use of a
drug in terms of accepted medical
practice
• Dependence – condition that results
from abuse: physical and psychological.
(medication, hospital, or Rx drugs)
Classification of Drugs
• Alcohol – most abundant
• Cannabis – marijuana ,hashish, hash oil
• Depressants – downers- methaquoalone,
valium, Phenobarbital, xanax
• Hallucinogens- LSD and PCP
• Inhalants – glue
• Narcotics – opium, heroin, dilaudid,
methadone
• Stimulants – uppers (speed) crack, powdered
cocaine, methamphetamine
Basic first aid for Abuse of
Drugs
• Open Airway if needed
• ABC’s of CPR if needed
• Refrain if needed
• Call 911
Miscellaneous comment
The difference between an alcoholic in
shock and a diabetic in shock is the
breath odor!!
Most Harmful Drugs
Sources
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http://familydoctor.org/638.xml
http://www.thedoctorwillseeyounow.com/articles/other/burns_23/
http://www.thedoctorwillseeyounow.com/articles/other/burns_23/
http://www.kidshealth.org/parent/firstaid_safe/emergencies/burns.html
http://www.faqs.org/health/Sick-V1/Burns-and-Scalds.html
http://www.itcilo.it/english/actrav/telearn/osh/ip/r35.htm
http://www.emedicinehealth.com/poisoning/
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http://www.mayoclinic.com/health/first-aid-poisoning/FA00029
http://www.wf.net/~snake/rattlesn.htm
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http://news.bbc.co.uk/2/hi/uk_news/politics/5230006.stm