Thermal burn

열상 드레싱 cleansing with saline blister의 제거 크기가 2cm 이상의 큰 물집은 제거 물집은 반드시 제거 할 필요가 없으나 2차 감염이 우려된다면 반드시 제거 물집을 제거한 후라야 창상의 깊이를 정확히 판단 Dressing

열상 드레싱 ◈ 드레싱의 교환 바깥쪽으로 삼출물이 배어 나오거나 환자가 불편하다고 느끼거나 환부에서 악취가 나는 경우 악취가 나는 경우는 창상 감염의 가능성이 많으므로 환부를 깨끗이 소독한 후 항생제의 사용고려

열상 드레싱 출혈이 생기지 않도록 조심. 거즈가 너무 말라있거나 제거하기 어려울 정도로 창상에 붙어 있으면 다시 적셔서 제거. 이 경우 통증이 아주 심하여 진통제가 필요함. 수 치료는 거즈 드레싱보다는 비교적 쉽게 괴사조직을 제거할 수 있으며 수압을 이용하면 보다 쉽게 괴사조직을 제거할 수도 있다.

화상처치

Burns Clean with soap, water Saline irrigation Grade 1 and Grade 2 burns- DuoDerm or medifoam. Do not put anything over Grade 3 burns

Burn Grade 2 burn Soap and other products

4 day old burn. Red and white 2nd degree Burns 4 day old burn. Red and white 10 day old, 2nd degree burn completely healed. Some sort of soft tissue protection

conventional dressing / Burns 4 days old. conventional dressing

The ABAACS Ix to referral to a burn center PTB and FTB >10% of the BSA < 10 세 or > 50 세   PTB and FTB burns > 20% BSA in other age groups. PTB and FTB burns involving the face, eyes, ears, hands, feet, genitalia, or perineum or those that involve skin overlying major joints. FTB burns > 5% BSA in any age group.

The ABAACS Ix to referral to a burn center

The ABAACS Ix to referral to a burn center Electrical burns chemical burns. Inhalation injury. Burn with pre-existing illness Burn with concomitant trauma Children Burn who will require special social and emotional or long-term rehabilitative support

TRANSFER PROCEDURE coordinated with the burn-center physician. All pertinent information tests, temperature, pulse, fluids administered, and U/O

HOT WATER ( SUPERFICIAL to MID 2도화상) TREATMENT 1) Cold compress 2) Gentle wash 3) Xeroform- bacitracin (or biobrane) followed by thick layer of gauze (except face) 4) flexnet or Surgifix

FLASH BURN (SUPERFICIAL 2nd Degree) HOT WATER BURN TREATMENT  1) Wash 2) Debride blisters and loose skin 3) Closed dressing with Xeroform and bacitracin (or biobrane) followed by gauze 4)daily f/u

MID PARTIAL THICKNESS SCALD BURN (Dorsum of Hand) TREATMENT 1) admission 고려 2) elevation, 3)debridement, 4) pain control 5) Admit if both hands 6) cold compresses 7) xeroform, bacitracin 8) daily f/u

MID TO DEEP PARTIAL THICKNESS BURN DUE TO FLASH EXPOSURE TREATMENT  1) Transfer to Burn Center due to size, i.e. > 15% TBS 2) NO cold dressings 3) xeroform and gauze after cleansing,or just cover 4) transfer to Burn Center

MID AND DEEP 2nd BURN TO CRITICAL AREA TREATMENT 1) clean with mild soap 2) topical antibiotic ointment or cream 3) xeroform and soft gauze 4) transfer to Burn Center

VISUALLY DECEIVING BURN FLAME BURN DIRECT CONTACT Looks superficial with blisters deep burn a combination of deep second and third degree burn