Recording-support 2025-02-13T14:37:24.846Z

Types of Burns

• First Degree Burns

  • Affects: Epidermis (outer layer of skin)

  • Pain: Yes, there is pain

  • Symptoms: Redness, swelling, and pain, like sunburn

• Second Degree Burns

  • Affects: Epidermis and part of the dermis (second layer of skin)

  • Pain: Yes, there is significant pain

  • Symptoms: Blisters, swelling, and severe pain, red or splotchy skin

• Third Degree Burns

  • Affects: All layers of the skin (epidermis, dermis, and deeper tissues)

  • Pain: No immediate pain; nerves might be damaged

  • Symptoms: White, charred, or leathery appearance; may require skin grafts

• Fourth Degree Burns

  • Affects: Beyond skin into deeper tissues (muscle, tendons, and bones)

  • Pain: No, as nerves are destroyed

  • Symptoms: Blackened or charred skin; requires extensive surgical intervention

Diagnostic Methods

• Assessing Hemoglobin and Hematocrit (H and H):

  • Elevated levels may indicate fluid loss in burns.

• Arterial Blood Gases (ABGs):

  • Measure blood acidity and levels of oxygen and carbon dioxide; monitor respiratory status.

• Serum Electrolytes:

  • Elevation in potassium levels may occur due to cell lysis post-burn.

  • Dehydration may lower sodium levels.

• Creatinine Levels:

  • Elevated levels indicate potential kidney damage, particularly in shock situations.

• Central Venous Pressure (CVP):

  • Normal CVP is essential for assessing volume status. Low CVP indicates hypovolemic shock; high CVP indicates fluid overload or cardiogenic shock.

Burn Management

• Fluid Resuscitation:

  • Parkland Formula:

    • Formula: 4 mL X Total Body Surface Area (TBSA) % X Weight (kg)

    • Used to calculate fluid needs in the first 24 hours post-burn.

• Rule of Nines:

  • Utilized to determine TBSA burned:

  • Head = 9%, Each Arm = 9%, Each Leg = 18%, Anterior Trunk = 18%, Posterior Trunk = 18%.

• Escharotomy:

  • Performed in second-degree burns in the emergent phase to relieve pressure and promote healing.

• Debridement and Grafting:

  • Surgical procedures performed during the intermediate phase for healing.

Medications in Burn Management

• Fluid Replacement: Crystalloids and colloids are used.

• Narcotics: For pain management.

• Topical Antimicrobial:

  • Example: Silver sulfadiazine (Silvadine cream)

• Histamine Blockers: To prevent stress ulcers (Curling's ulcer).

• Corticosteroids: Reduce inflammation.

• Broad Spectrum Antibiotics: For infection control.

Psychosocial Considerations

• Rehabilitation Stage:

  • Addressing psychological effects of burns and the long-term healing process.

• Mobilization:

  • Critical for preventing complications; keep patient in an elevated position.

Immune Response and HIV

Stages of HIV

• Stage 1: CD4 count 600+.

• Stage 2: CD4 count between 499-200.

• Stage 3 (AIDS): CD4 count less than 200; opportunistic infections present.

CD4 Count and Viral Load

• Viral Load Testing: Determines treatment success; low viral loads indicate effective antiretroviral therapy (ART).

Cancer Overview

• Risk Factors: Age, environmental exposures, and genetics.

• TNM Staging:

  • T: Size of the Tumor

  • N: Lymph Node Involvement

  • M: Metastasis

Cancer SymptomsCaution Signs

• Changes in bowel habits, sores that do not heal, unexplained bleeding, lumps, difficulty swallowing, persistent cough.

Conclusion

• Importance of understanding burn types, management, diagnostic methods, immune responses, cancer staging, and psychosocial care for effective nursing practice.