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Author(s): Patrick Carter, Daniel Wachter, Rockefeller Oteng, Carl Seger, 2009-2010. License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution 3.0 License: http://creativecommons.org/licenses/by/3.0/ We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact [email protected] with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit http://open.umich.edu/education/about/terms-of-use. Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.

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Page 1: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Author(s):PatrickCarter,DanielWachter,RockefellerOteng,CarlSeger,2009-2010.License:Unlessotherwisenoted,thismaterialismadeavailableunderthetermsoftheCreativeCommonsAttribution3.0License:http://creativecommons.org/licenses/by/3.0/

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Page 2: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

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Page 3: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Advanced Emergency Trauma Course

GhanaEmergencyMedicineCollaborativePatrickCarter,MD∙DanielWachter,MD∙RockefellerOteng,MD∙CarlSeger,MD

Burns

Presenter:CarlSeger,MD

Page 4: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Epidemiology of Burns

  1-1.5%ofpopulationseesMDforburns/yearinUS

  1.25-2.5millionburnseachyear  500,000EDvisits,50,000admits,5,000deaths

  Mostburnscoverlessthan5-10%ofbodysurfacearea

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 5: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Types of Burns

 Thermal Chemical Electrical

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 6: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Thermal Burns

  Contact  Flame  Heat  Scalding

Medscape

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 7: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Chemical Burns

  Bothacidsandbasescanbedefinedascaustics,whichcausesignificanttissuedamageoncontact.

  ACIDSproduceacoagulationnecrosisbydenaturingproteins,formingacoagulum(eg.eschar)thatlimitsthepenetrationoftheacid.

  BASEStypicallyproduceamoresevereinjuryknownasliquefactionnecrosis

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 8: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Chemical Burns

  Acids•  Toiletbowlcleaners,draincleaners,metalcleaners,automobilebatteryfluid,fertilizermanufacturing,rustremovers,tirecleaners,tilecleaners,glassetching,dentalwork,refrigerant,andhairwaveneutralizers

  Bases•  Draincleaners,bleach,ovencleaners,mortar,plaster,andcement

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 9: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Electrical Burns   LOW-VOLTAGE•  Electricburnsalmostexclusivelyinvolveeitherthehandsororalcavity.

  HIGH-VOLTAGE•  Inburnsfromanelectricarc,thecurrentcoursesexternaltothebodyfromthecontactpointtotheground•  Electriccurrentthatpassesbetweenthepowersourceandtheanatomicpointofcontact(entrancewound),andbetweenthepatient(exitwound)andthegroundingmechanism,causinghiddendestructionofdeepertissues

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 10: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

General Skin Anatomy and Physiology

  SkinLayers•  Epidermis•  Dermis

  SkinFunction•  Protection

  Pathogens  Waterloss

•  Tempregulation•  Sensation•  VitaminDSynthesis

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

NationalCancerInstitute,SEER

Page 11: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Classification

  TraditionalClassification•  1stdegree•  2nddegree•  3rddegree

  CurrentClassification•  Superficialpartialthickness•  Deeppartialthickness•  FullThickness

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 12: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Burn Classification

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

K.Aainsqatsi,Wikipedia

Page 13: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

1st Degree

  Redness  Dryskin  Painfultotouch  Painlasts48to72hrs  Peelingskin

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

SourceUndetermined

Page 14: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

2nd Degree; Partial Thickness

  Involvesthetoplayersofskin.

  Theskinisredandblistered.

  Usuallypainful.  Takesupto3-4weekstoheal.

  Mayscar.

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

SourceUndetermined

Page 15: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

3rd degree; Full thickness burns

  Destroysalllaysofskinandunderlyingstructures.

  Maylookbrownorblackandtissueunderneathmaybewhite.

  Usuallynotpainful.

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

SourceUndetermined

Page 16: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Pathophysiology of Burns   Cellulardamageat>45°C  Dependentontemperatureandduration

•  Singeretal.AcadEmergMed2000;7:1

  Threezonesofinjury–  Centralzoneofnecrosis  Zoneofstasis(atriskofnecrosis)  Zoneofhyperemia•  JacksonBrJSurg1953;40:588BurnPathophysiology

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 17: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Pathophysiology of Burns   Thermalinjurytriggersintenseinflammatoryresponse•  Initialreleaseofhistamine,bradykinin•  Increasedcapillarypermeabilitywiththirdspacing•  ProgressivevascularocclusionbyPMN,RBCs•  Releaseoffreeradicals,proteases

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 18: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Clinical Evaluation

  History•  Historyofevents–closedspace,toxicfumes•  Evaluateforinconsistenciesorpatternssuggestingchildabuse(immersioninjuries)•  PMH:AMPLE,Tetanusimmunizationstatus

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 19: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Clinical Evaluation •  PhysicalExam

  Assessforinhalationinjury•  Signsnotalwayspresent•  Singednasalhair•  Carbonaceoussputum•  Cough•  Hoarseness•  Dyspnea•  AMS

•  AssessSeverityofInjuryGhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 20: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Clinical Evaluation

  DetermineSeverityofInjury•  Size• Depth/Degree•  Location-

 Hands,face,genitals,feet,circumfrential• Ruleof9’s

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 21: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Rule of 9’s

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Burnsurgery.org

Page 22: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Initial Burn Management

  ABCs  Identifyandtreatassociatedinjuries  Removesource,protectrescue  Initialcoolingwithcoolwater(notcold)  Coverwithdressing,leaveblistersintact  Brushoffanymetalothermaterial  Irrigationforchemicalburns

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 23: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

  AirwayManagement•  Secureairwayearly•  Signsofimpendingairwayobstruction

  Hoarseness,Stridor,Facialedema•  EndotrachealintubationorsurgicalairwayifETnotpossible•  Give100%O2forsuspectedsmokeinhalation

Acute Management

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 24: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Chemical Burns

  Brushoffdrymaterialfirst

  Takeoffanyclothingthatcaneasilyberemoved

  Flushwithwaterforatleast20-30minutes

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 25: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

 FluidResuscitation• ParklandFormula• UrineOutput• PediatricConsiderations

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Acute Management

Page 26: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Parkland Formula

  4x(%bodysurfaceburned)xwtinKg  Thisequalstheamountoffluid(inml)toreplaceina24hrperiod

  Thefirsthalfinthefirst8hrs  Therestinthenext16hrs

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 27: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Acute management

 GeneralWoundCarePrinciples• BiologicalDressing• WoundDebridement

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 28: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Acute management

  TopicalAgents•  Silvadinecream• Coveringthewoundwithcleanlinens

 Analgesia• Oftenverypainfulandrequirelargeamountofpainmedication

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 29: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Do’s and Don’ts of Burn Care

  Do’s•  Brushoffdrychemicalwhileinaprotectivesuit•  Flushwithcoolwater•  Coverwoundwithdrydressing•  Keepvictimcomfortable

  Don’ts•  Applyice•  Touchtheburn•  Removepiecesofclothfromburnedarea•  Cleansevereburns•  Breakblisters•  Useointmentonsevereburns

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 30: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Acute management

  Escharotomy•  Deepcircumferentialburnsoverneck,chestlimbs•  CompromisedABC’s•  Maybelifeorlimbthreatening•  IncisionofeschartosubQfat•  Avoidmajorvesselsandnerves•  Anestheticsusuallynotrequired

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 31: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Escharotomy

MedscapeGhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 32: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Acute management

  InhalationalInjuries• GeneralEvaluationandManagement• CarbonMonoxide

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 33: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Inhalational Injuries

  Responsibleformostdeaths  Evolutionmayrequireseveraldays  Exposureofairwaysandlungstotoxicchemicals

  Tracheobronchitis  Airwayobstruction  Pulmonaryedemawithin2-3days

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 34: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Inhalation Injury

  CarbonMonoxide•  HashigheraffinityforhemoglobinthanO2.•  COpoisoningcanleadtoAMS,myocardialischemia,andseverelongtermneurologicsequelae•  O2inhigherconcentrationsacceleratesCOelimination•  Canalsotreatwithamylnitrate,sodiumnitrite,sodiumthiosulfate

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 35: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Complications of Burn Care

 Infection AirwayConsiderations CircumferentialBurns

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 36: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Indications for Admission

  Adults>15%2°DegreeBurns  Children>10%2°DegreeBurns  3°burns>2%  Face,hands,feet,perineum  Seriousunderlyingdiseases  Socialconsiderations

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 37: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

When does Cold Injury Occur?   TheFactorsthatcontributetoColdInjury•  Temperature• Durationofexposure•  Immobilization• Moisture•  Vasculardisease• Openwounds

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 38: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Recognize local cold injuries

  Frostnip-Mildform,doesnotresultintissuedestruction,verypainful

  Frostbite-intracellularicecrystals,cangetreperfusioninjury,Classifiedbasedoffofdepth

Medscape

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 39: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Frostbite

Medscape

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Medscape

Page 40: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Treating cold injuries

  Donotdelay  Removeclothing  Warmedblankets  Rewarmfrozenpart  Preservedamagedtissue  Preventinfection  Elevatedexposedpart  Analgesics,tetanus,andantibiotics

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 41: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Recognize hypothermia

  Rapidorslowdropincoretemperatureto<35degreesC

  Elderlyandchildrenatgreaterrisk  Low-rangethermometerrequired

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 42: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Hypothermia clinical signs

  Temperature<35degreesC  DepressedLevelofconsciousness  Gray,cyanotic  Variablevitalsigns  Absenceofcardiorespiratoryactivity

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 43: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Treating Hypothermia

  ABCDE’s  Rewarm  Assessforassociateddisorders  Bloodanalyses,includingK+andC++

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 44: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Treating hypothermia

  Passiveexternalrewarming:Warmenviroment,blankets,IVfluids

  Activecorerewarming:surgicalrewarmingtechniques

  Notdeaduntilwarmanddead

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse

Page 45: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

Questions?

Dkscully(flickr)

Page 46: Author(s): Patrick Carter, Daniel Wachter, Rockefeller ......Epidemiology of Burns 1-1.5% of population sees MD for burns/ year in US 1.25-2.5 million burns each year 500,000 ED visits,

References   Schwartz,L.,Balakrishnan,C.ThermalBurns.inEmergencyMedicine:AComprehensiveGuide.Tintinalli,Editor.2004,McGraw-Hill.p.1220-1226.

  Harchelroad,F.,Rottinghaus,D.ChemicalBurns,inEmergencyMedicine:AComprehensiveGuide.Tintinalli,Editor.2004,McGraw-Hill.p.1226-1231

  Fish,R.ElectricalInjuriesandLightningInjuries,inEmergencyMedicine:AComprehensiveGuide.Tintinalli,Editor.2004,McGraw-Hill.p.1231-1238

  AmericanCollegeofSurgeons.Injuriesduetoburnsandcold,inAdvancedTraumaLifeSupportforDoctors7thedition.2004.p.231-241.

GhanaEmergencyMedicineCollaborativeAdvancedEmergencyTraumaCourse


Port of zeebrugge by Sven De Wachter

Burns lecture for 4th year MBBS

Author(s): Patrick Carter, Daniel Wachter, Rockefeller

Carol Ann Wachter

Safety Wachter Accident

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LV: Medienforschungspraxis MMag. Bernd Wachter SS 2006media.brainity.com/uibk/lvs/regionalss06/ORF_LV_Arbeit.pdf · LV: Medienforschungspraxis MMag. Bernd Wachter SS 2006 ORF –

Ami report-19 wachter-integrated_microelectronics_for_smart_textiles_-_paper

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Burns. Types of Burns Thermal (heat) burns Chemical burns Electrical burns © Scott Camazine/Photo Researchers, Inc

Serge Wachter To cite this version

Wachter CV July 2017 - real.wharton.upenn.edureal.wharton.upenn.edu/~wachter/documents/Wachter_CV_July 2017.pdf · and Eva Steiner, Real Estate Economics, forthcoming (Recipient of

Digitale GIP Maarten De Wachter

Burns Scald Burns Chemical Burns - Amazon S3 · Burns Types of Burn Injury ... or industrial agents ...