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Burns, Secondary Survey - other body systems burns affect, Resuscitative…
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Medications
Topical treatment
Mafenide acetate cream
bread spectrum, penetrates eschar
painful application, rare acid base imbalances
provide adequate analgesia, monitor ABG, observe for hyperventilation
Bacitracin
keeps tissue supple, painless
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Silver Sulfadiazine
Painless and broad spec
may produce leukopenia by bone marrow suppression, minimal eschar penetration, some gram - resistance
Monitor WBCs, monitor culture reports and for signs of infection
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Depth of the burn
Full thickness
may be reddened, doesn't blanch
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dark and leather from char/dead, and/or translucent or waxy
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Partial thickness
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Management
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if blister breaks, wash with antiseptic and cover with non adherent drsg
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Superficial
Epidermis only
Erythema, pain, no blisters, not life threatening
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Management
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Biologic dressing
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heterograft/xenograft - form another species (pig, tilapia)
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Wound management
Debridement
Remove dead and contaminated tissue, can combine with hydro
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Special burns
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Chemical burns
Chemical burns should be immediately washed with large amounts of water for at least 20-30 minutes (alkali may need more)
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May be due to acid, alkaline (worst/deeper), or petroleum products
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Stages
Rehab
Compression garments - jobst stockings (prevent scarring, worn 23 hours a day for months)
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Circumferential burns
Extremities/abdomen
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May need to perform escharotomy in order to maintain circulation to extremity and prevent compartment syndrome