The treatment of burn disease

Lethality. Superficial burns give a low mortality. Therefore, it is advisable to calculate mortality depending on the area of deep lesions. Here are the data of burn branch of the Institute of surgery. A. Century Vishnevsky.
The data show that the forecast with burn disease is primarily determined by the area of deep lesions.
Treatment. First aid. Probably faster to put out the fire (tight embrace burning sections of the blankets, clothing and so on). Smoldering clothes to pour water. Enter under the skin drugs, kordiamin, caffeine, lobelias. Burnt surface cover dry sterile bandages, enter 3000 AE tetanus toxoid. When fires in enclosed areas, possibly associated carbon monoxide poisoning. In these cases, you need to provide access to clean air (inhalation of oxygen).
Treatment at the period of burn shock. Each arriving in the hospital in a state of burn shock or with extensive burns, during which the shock can develop later placed in a chamber with temperature 22-24 degrees. Contact warm-fired heaters is not recommended. Burnt undress and produce procaine blockade Century A. Vishnevskaya: when Acting upper half of the body - vagosimpatical, one or both depending on the location of the lesion; with burns of the lower half of the body - perirenal, when local O. limb - casing (see the Blockade procaine). If necessary novocaine you can enter through the burned surface (with fresh O.), making toilet skin in a limited area at the site of injection. Blockade acting analgesic and contribute to the normalization of capillary permeability. Victims injected during the day on average 3-4 liters: 250-500 ml of banked blood same group, 500 - 700 ml of plasma, 1000-1500 needles poliglyukina, 300-500 ml of 0.1% solution novokaina physiological solution. The lack of banked blood or plasma them replace partially heterogeneous protein plasma substitutes (BK-8 and others). The number pour a day of liquid in each case is determined depending on the age and severity of the annealed condition, degree of hemoconcentration and value of the hourly diuresis, the measurement of which is obligatory (healthy adult person produces in an hour 50-60 ml of urine). Pour in the liquid infusion at a rate of 30-40 drops per 1 min. With sharply expressed oliguria fluid injected jet, but not more than 1 liter, and then move on to a drip. Massive jet injections can cause an overflow of a small circle of blood circulation, acute heart failure and edema of the lungs. If during the first days burnt allocates 25 - 30 ml of urine in 1 hour, it is (in conjunction with other data) indicates favorable for shock.
In the second day of the disease in the presence of shock continue transfusion therapy according to the scheme given above. If phenomenon of shock weaken and growing hourly diuresis, it allows to decrease (by 1/3 or twice daily quantity of fluid. When a persistent oliguria and hypotension should be entered in the non-drip glucocorticoids (hydrocortisone 100-200 mg or prednisolone 30-60 mg per day). According to the testimony is administered intravenously korglykonum (0.5-1 ml of 1 to 2 times a day) or strofantin To (0.05% solution, 0.5-1 ml 1-2 times a day). Both of the drug dissolved in 20 ml of 40% glucose solution. For anesthesia injected 1% solution of morphine (omnopon) and 1 ml 2-3 times a day. Periodically give humidified oxygen. With repeated vomiting washed stomach and sucked off periodically stomach contents through the ongoing probe. When expressed shock limit drink by mouth, as it contributes to vomiting. With burns of respiratory tract produce bilateral vagosimpatical blockade, swelling of the Airways impose tracheostomy and the cannula periodically suck the contents of the bronchi. In these patients it is necessary to reduce the dose in the vein of liquids and infusion producing only drip.