Burn
A burn is a violation of the anatomical integrity of tissues caused by the action of chemical or physical factors.
CAUSES OF BURNS
Among the physical factors, burns can cause:
High temperatures are the most common cause. Burns caused by the action of high temperatures are called thermal.
Electric current – causes electrical burns.
Ionizing radiation – causes radiation burns.
Chemical factors – such as acids and alkalis – are the cause of chemical burns.
SYMPTOMS
The manifestations of the burn depend on the depth of penetration of the damaging factor. According to this, there are four main degrees of burns.
A first-degree burn is characterized by hyperemia and swelling of damaged tissues.
When the epidermis is detached, accompanied by the formation of blisters filled with pale yellow opalescent fluid, the burn is assigned the second degree.
Third-degree burns are divided into two groups.
The third “a” degree is characterized by the formation of large blisters with a stressed surface and various contents (including bloody). Blisters are located against the background of tense, edematous skin, which may be covered with golden scab crusts.
With the formation of a darker (from gray to dark brown or purple) scab and the appearance of bubbles with dark bloody contents and a whitish-gray bottom, burns are assigned the third “b” degree of severity.
For burns of the last, fourth, degree, the formation of a dense scab of gray or black color is characteristic, under which or through which dense thrombosed veins are visible.
As a rule, extensive burns are characterized by the formation of areas of varying degrees of damage. Therefore, when determining the severity of the injury, the area of burns of varying degrees is taken into account. When determining the area, most often combustiologists use the rule of nines or the rule of palms. The area of one palm of the patient is conventionally taken as 1% of the area of his body. At the same time, the head and neck together, as well as each arm, make up 9%, the front, back surface of the trunk and each leg – 18%.
When receiving burns with an area of more than 10%, the patient develops burn disease, which begins with the development of burn shock.
Signs of mild burn shock are chills, small tremors, pallor of the skin, increased pulse. Severe shock is characterized by motor excitement, turning into lethargy, thirst, nausea, vomiting, increased pulse rate against the background of lowering blood pressure, rapid breathing. Extremely severe shock is manifested by a violation of consciousness, vomiting of “coffee grounds”, cold skin, weak pulse filling, low blood pressure and a decrease in body temperature.
diagnostics
Making a diagnosis is not difficult. The patient’s complaints, information about the nature of the injury received, and objective examination data are taken into account.
BASIC PRINCIPLES OF TREATMENT
First aid consists in stopping the action of the damaging factor, exposing the affected area of the skin, immersion in cold water. It is advisable to use analgesics, alkaline and hot drinking. The burn surface is treated with a multicomponent aerosol, bandaged with an aseptic bandage, after which the patient is transported to a trauma center or hospitalized.
Shallow burns with a small lesion area are subject to outpatient treatment. In case of severe injuries, the development of shock, the patient is transferred to a specialized (kombustiologicheskoe) department. Treatment is reduced to maintaining the volume of circulating blood, healing the burn surface, and combating scar tissue deformities. In case of severe burn injuries, complex rehabilitation measures and plastic surgery are indicated.
