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Burns

To approximate the burn area in the provision of first aid can serve as the calculation of the so-called rule of nines (Fig. 1). If the entire surface of the human skin is taken for 100%, then on the head and neck accounts for 9%, in upper limb - 9%, lower - 18%, on the back and the front surface of a body - on 18%, in the crotch and genitals - 1 %. The calculation of this is very approximate, but objectively, albeit crudely, to appreciate the vastness of the burn.

Fig. 1. The scheme is to determine the area of a burn on the "rule of nines" (in percentage of total body surface).
Fig. 2. The designation scheme of the location and nature of burns: 1 - III degree; 2 - IV degree

When admitted to hospital for burnt determine blood pressure, take blood samples, produce accurate calculation of burnt surface, the data are entered in the sheet-map and sketching in the diagram (Fig. 2). If fired both hands, the blood pressure is determined by mechanoregulation, and take blood from the ear lobe or from a vein in the leg. Immediately begin recording the number entered patient fluid leakage of urine (for every 1-3 hours for the day). The involuntary urination urine should be collected catheter.
Treatment burnt in the hospital primarily includes the measures of fight with shock (see). The important place among them is intravenous fluids (blood, plasma, serum, blood substitutes, glucose), mainly in the drop way. Apply procaine blockade (see Blockade procaine). After the liquidation of the shock in the indications treatment with antibiotics. Local treatment of extensive burns of II degree spend with bandages or open way - under the frame with light bulbs, patient warming and drying burnt surface. Burns III and IV degree operative treatment: excision of non-viable tissues (see Necrectomie) and plastic replacement of defects formed one of the modern methods of skin plastics (see), with the skin of the patient (autoplastika)taken with not affected parts of the body. Skin grafts from another person (homoplastic) prevents the outer plasma loss. Gomotransplantation prizivaut temporarily and after 2-3 weeks rejected. Homoplastic granulating burn wounds improves the condition of patients and prepares them for autoplastika. Early plastic replacement of burn wounds by autotransplants sharply accelerated recovery, warns burn depletion and formation of scars. In the future, when the burns heal, may require reconstructive surgery to correct deformities of the nose, eyelids, ears, contractures neck, joints, a brush.
Care burnt complicated. Many of them - the elderly, children and people suffering acute psychosis need for personal assistance. Pay attention to the prevention of bedsores and hygienic bath, who appoint burnt in conventional terms. Often a patient after a bath taken away right in the dressing room; in this case it is well to cover the patient, as well as burnt especially sensitive to the cooling. Bandaging often so painful that make them falls under General anesthesia. It is necessary to consider and do not feed the sick before bandage.
Power burnt must be easily digestible, high-calorie, rich in vitamins. Seriously ill, lost appetite, need to be fed with a spoon, to persuade there, and so on Normal food is complemented by the introduction of liquid nutrient mixtures by means of a probe conducted through the nose and fixed sticky patch to the skin of the face. The child or debilitated patient can swallow the probe if it is fixed weak, so mount the probe must constantly check. Long stay in the mouth and esophagus compromises the strength of the transmitter and part of it may otlojitsa. Therefore, the sensor must change every 10-15 days. In the struggle with burns depleted use and parenteral nutrition infusion of protein blood substitutes (see Protein hydrolysates), glucose, blood transfusions.