Thirsty after burn
Introduction
Introduction Thirst after burns is caused by a large amount of fluid exudation of Jiang Yang after severe burns, which reduces blood volume, resulting in insufficient circulating blood volume. The larger the burn area, the more severe the exudation and the more obvious the thirst, which is the clinical manifestation of the early occurrence of burn shock.
Cause
Cause
Patients with burns and scalds have thirst, resulting in insufficient blood volume. Because the human body has a certain regulating function, usually a small area of burn patients will not have obvious thirst. In a large area of burn patients, due to the large amount of exudate caused by severe dehydration, there will be obvious thirst, and the burn area will be more oozing. The more serious it is, the more obvious the thirst. If you drink water or drink to the patient at this time, it may cause water poisoning or acute gastric dilatation.
Examine
an examination
Related inspection
White blood cell count (WBC) blood routine
(1) Features
1. The shock period of shock is longer and obvious. This is because the reduction of body fluid extravasation and effective circulating blood volume after burn is gradually occurring. The wounded are excited, irritated, pulse fast and powerful, blood pressure can maintain normal or high, this is the performance of burn shock during the excitement period, to pay close attention to treatment, do not be confused by temporary illusion and ignore the diagnosis and treatment of shock.
2. The shock period is long. The time and severity of burn shock are closely related to burn area and depth of burn. The larger the burn area, the wider the depth area, the earlier and the more severe the shock occurs, and the longer the duration. Usually 2-3 days. During this period, the blood volume is constantly changing. Therefore, it is necessary to closely observe the condition, analyze the condition in time, and actively adhere to anti-shock treatment.
3. There are significant electrolyte disturbances and changes in plasma osmotic pressure. Mainly manifested as blood concentration, hyponatremia, acidosis or hypoproteinemia.
(2) Main performance
1. Pulse (heart rate) growth rate: This is due to the increase of catecholamine secretion after burn, which makes the heart rate speed up. In severe cases, it can increase to 130 beats / min or more, the pulse is weak, the auscultation heart sound is far away, and the first sound is weakened.
2. Reduced urine output (generally refers to adult urine volume below 20 ml per hour): It is an important and early manifestation of burn shock. If kidney function is not seriously damaged, urine can generally reflect tissue blood perfusion and severe shock. degree. The main cause of oliguria is insufficient blood volume and reduced renal blood flow. Of course, it is still associated with increased levels of anti-urinary hormones and aldosterone. If there is no urine, the systolic blood pressure is below 10.7 kPa.
3. Thirst: Early performance for burn shock. After rehydration treatment, mild casualties can be relieved, while severely injured patients are difficult to disappear and can continue until after the recovery period.
4. irritability: appears earlier, is the performance of brain cells due to poor blood perfusion, hypoxia.
5. nausea and vomiting: appear earlier, such as frequent vomiting often indicates that shock is heavier. The reason is also brain hypoxia.
6. The end of the cycle is poor: the earlier performance is poor superficial vein filling. The skin is white and the body is cold. In severe cases, blemishes and capillary filling may occur.
7. Changes in blood pressure and pulse pressure: In the early stage of burns, due to compensation, vasoconstriction, increased peripheral resistance, blood pressure tends to increase, especially diastolic blood pressure, so small pulse pressure is an early manifestation of shock. In the future, when the compensation is incomplete, the capillary bed is enlarged, the blood stagnant, and the effective circulating blood volume is significantly reduced, the systolic blood pressure begins to decrease. Therefore, the decline in systolic blood pressure is not an early manifestation of burn shock. If it has fallen, it indicates that shock is more serious. In severely burned wounded. If the condition is measured, the central venous pressure.
8. Laboratory tests: Generally, the diagnosis of burn shock can be made according to clinical manifestations. If conditions permit. The necessary laboratory tests such as plasma osmotic pressure, hematocrit, red blood cell count, hemoglobin count, hemoglobin, etc., are helpful for early diagnosis of burn shock and can also be used as a therapeutic reference.
Diagnosis
Differential diagnosis
Reduced urine volume after burns (generally refers to adult urine volume below 20 ml per hour): It is an important and early manifestation of burn shock. If kidney function is not seriously damaged, urinary oliguria can generally reflect tissue blood perfusion and severe shock. degree. The main cause of oliguria is insufficient blood volume and reduced renal blood flow. Of course, it is still associated with increased levels of anti-urinary hormones and aldosterone. If there is no urine, the systolic blood pressure is below 10.7 kPa.
Pulse growth after burns: one of the symptoms of burn shock. The majority of burn shock is secondary shock, usually occurring in the first few hours or more than 10 hours after burn. It belongs to hypovolemic shock because of the large amount of plasma in the wound from the capillaries to the wound and tissue. The gap causes a reduction in effective circulating blood volume.
