scald
Introduction
Introduction to burns Burns are often low-calorie burns, and low-calorie burns can be called low-temperature burns. It is caused by burns caused by prolonged skin contact with low-temperature objects above body temperature. Exposure to a temperature of 70 ° C for one minute, the skin may be burned; and when the skin contact temperature of nearly 60 ° C for more than five minutes, it may also cause burns, this kind of burn is called low temperature burn. basic knowledge The proportion of sickness: 0.2% Susceptible people: no specific population Mode of infection: non-infectious Complications: shock sepsis acute respiratory failure acute renal failure stress ulcer sepsis
Cause
Cause of burns
People who are burned by low temperature are generally people who are not easy to wake up at night and those who feel dull, so that the burns are not conscious, and many burns are discovered to a very serious degree.
Prevention
Burn prevention
1. When using a hot water bottle to keep warm in the cold winter, the hot water bottle is wrapped with a towel outside, and the hand is not hot. Note that the lid of the hot water bottle must be tightened, and it can be placed outside the bag after inspection. It is necessary to change the warm water regularly to keep warm and not burn the baby.
2, when bathing your baby, you should first put cold water and then hot water, the water temperature is not higher than 40 °C. The temperature of the water heater should be adjusted to below 50 °C. Because the water temperature is 65-70 °C, the baby can be seriously burned within two seconds.
3. There must be a fence around the heating and the stove to prevent the child from entering.
4, lock the kitchen door, do not let the baby easily enter the kitchen.
5. Remove dangerous goods that may cause burns or add protective measures. If the hot water bottle is not placed on the table, the electrical appliances such as the iron should be placed out of reach of the child. Do not place tablecloths on the table to prevent children from pulling down the tablecloth, knocking down the rice bowl and thermos on the table and ironing themselves.
6. Family members should regularly conduct first-aid knowledge training and check the implementation. Always remind your child to prevent burns. If you see your child want to touch the heating, hot rice bowl, stove, etc., adults can quickly touch their fingers first, then hurriedly retract, while holding a very hot look, shouting "hot" and "pain", the child After watching it, I dare not touch it.
Complication
Burn complication Complications, shock, sepsis, acute respiratory failure, acute renal failure, stress ulcer, sepsis
1, shock
Most of the early stage was hypovolemic shock. In the case of concurrent infection, septic shock can occur. Extraordinary burns are stimulated by intense damage and can be immediately shocked.
2, sepsis
Burns cause defects in the skin's barrier to bacteria; heavier patients also have weakened white blood cell function and immune function. Therefore, infection is easy to occur. The pathogenic bacteria are bacteria (such as Staphylococcus aureus, etc.) or exogenously contaminated bacteria (such as Pseudomonas aeruginosa). Suppurative infections can occur on the wound surface and under the eschar. The infection may also develop into sepsis and septic shock. In addition, after the use of broad-spectrum antibiotics, especially in patients with systemic weakness, fungal infections can be secondary.
3. Pulmonary infection and acute respiratory failure
There may be multiple causes of pulmonary infection, such as respiratory mucosal burns, pulmonary edema, atelectasis, and sepsis. Adult respiratory distress syndrome or pulmonary infarction may also occur, leading to acute respiratory failure.
4, acute renal failure
Renal ischemia occurs before and after shock, and renal capsule and renal tubules deteriorate when severe; hemoglobin, myoglobin, and infectious toxin can damage the kidney, which can lead to acute renal failure.
5, stress ulcers and gastric dilatation
After the burn, the duodenal mucosa erosion, ulcer, bleeding, etc., called Curling ulcer, may be related to the damage of the mucous membrane caused by hydrogen ion countercurrent ischemia and reperfusion. Gastric dilatation is often caused by a large amount of water in the diseased population when the early gastric peristalsis is weakened.
6, other
The myocardial function is reduced, the stroke volume can be reduced, and it is related to the production of myocardial inhibitory factor, infectious toxin or myocardial hypoxia after burn. Brain edema or hepatic necrosis is also associated with hypoxia, infectious toxins, and the like. It is worth noting that the death of burns is often caused by multiple system organ failure.
Symptom
Symptoms of burns Common symptoms Blister skin pain Skin necrosis Burns foaming
Because of the low heat burns often occur in the lower limbs of the human body. Under normal circumstances, the skin and low-temperature heat source for a short time contact, only caused by blister-type scald scald, but if the low-temperature heat source continues to function, it will gradually develop into deep dermis and subcutaneous tissue burns. Low temperature burns and scald caused by high temperature, wound pain is not very obvious, only redness, blisters, peeling or whitish on the skin, the area is not large, the surface of the burned skin looks less burnt, but the wound is deep Severe cases may even cause deep tissue necrosis. If not treated properly, ulceration will occur severely and it will not heal for a long time.
Examine
Scalding inspection
The severity of burns is mainly determined by the location of the burn, the size of the area, and the depth of the burn. Burns on the head and face, or not on the head and face, but the burned area is large, deep, are serious. In case of severe burns, there may be shock or breathing or heartbeat stop during the transfer. Artificial respiration or chest massage should be performed immediately. When the casualty is polydipsia, a small amount of hot tea or light salt water can be taken. It is impossible to drink a large amount of boiling water in a short time, and the injured person has cerebral edema.
Diagnosis
Scaling diagnosis
diagnosis:
The degree of burns is divided into three degrees.
Once injury, scald only damage the surface of the skin, local mild redness, no water bubble, obvious pain, should immediately remove the clothing socks, the wound into the cold water dipping for half an hour, and then rub the wound with sesame oil, vegetable oil.
Second injury, scald is dermal damage, local redness and pain, there are blisters of different sizes, large blisters can be used to sterilize the edge of the blisters to release water, coated with scald cream, and tightly tightened.
Three-degree injury and burns are subcutaneous, fat, muscle and bone are damaged, and they are gray or reddish brown. At this time, the wound is wrapped in clean cloth and sent to the hospital in time. Do not apply purple syrup or cream on the wound surface to affect the observation and treatment of the disease.
Differential diagnosis: The principle of water and fire burn treatment is to first remove the heat source, quickly leave the scene, use various fire-fighting methods, such as water immersion, water drenching, tumbling on the spot, immediately remove the wet clothes or cut, drench the water, and limbs Soak in cold water until the pain disappears. You can also cover the wound with a wet towel or bed sheet and spray cold water up. Don't break the blisters.
Water and fire burns can be divided into one-degree burns (erythetic, reddened skin, and hot tingling), second degree burn (bubble, blisters in the affected area), third degree burn (necrosis, skin peeling). For mild burns on a small area, it can be treated at home. After cleaning the wound, it can be coated with Jingwanhong and MEBO moisturizing burn cream. For large-scale burns, it is advisable to send them to the hospital as soon as possible.
