management of a burned child. burn – aseptic necrosis of tissues
TRANSCRIPT
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MANAGEMENT OF A BURNED CHILD
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BURN – ASEPTIC NECROSIS OF TISSUES
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A burn that has the potential for significant physiologic derangement, functional impairment, or cosmetic impairment is defined as a MAJOR BURN.
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2 Million burn cases per year in USA.
Among 92000 burn cases from 133 burn centres 30000 were children 1-8 years.
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• IN BANGLADESH : No national data on burn
• IN DSH : Separate 12 bed burn unit started in 1999
- More than 500 patients admitted per year
- Burned area 5 – 70%
- Hospital stay 4 – 154 days
- Average 19.3 days
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Classification of Burn
First degree - Superficial burn
Partial thickness burn
Second degree - Deep dermal
Third degree - Full thickness burn
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The Rule of Nines
9%
9X2%
9%9%
1%
9X2% 9X2%
9X2%
18%
9X2%
9%9%
1%
13.5%
9X2%
13.5%
ADULT CHILD
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Several factors directly affect the prognosis following burn injury and determine whether there is a need for hospitalization. The most important factors include:
1. The location of the burn
2. The depth of the burn
3. The extent of the burn
4. The age of the patient
5. General physical condition
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Whom to admit
1. Total body surface more than 10%
2. Full thickness burn more than 5%
3. Circumferential burns
4. Immersion burns
5. Electrical burns
6. Special areasA. Face B. Feet C. Hands D. Perineum
7. Suspicion of child abuse
8. Parents unable to cope.
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Age Incidence
60%
25%
15%
Upto 2 years2 - 5 yearsMore than 5 years
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Sex Incidence
56%44%
Male PatientsFemale Patients
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Causes of Burn
17%
15%
49%
19%
Hot WaterHot SoapBurning ClothesOthers
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Economic Status
Higher Income Group- 10%
Middle Income Group- 49%
Lower Income Group - 41%
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Management of Burn
1. Management of shock
2. Management of infection
3. Nutritional support
4. Psychological support
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Burn Wound Management1. Open method
2. Dressing:a) Vaseline gauze
b) Sofra Tulle
c) Deo Derm
d) Amniotic membranes
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Tissue Banking
Procurement, processing, storage and distribution of amnions, bones, skin, fascia lata etc. for clinical use.
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Amniotic Membranes
• Decrease bacterial count of the wound
• Reduction of fluid loss
• Promotion of healing
• Tight adherence to the wound surface, increase in mobility and diminished pain
• Patient comfort
• Help in prediction of readiness for grafting
Advantages
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AMNION MEMBRANE SEPARATED FROM PLACENTAL SAC.
ACTIVITIES – QC, QS/QMS (PROCESSING STEPS etc.)
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CLEAN WITH STERILE SALINE SOLUTION
SHAKEN IN PLATFORM SHAKER WITH STERILE SALINE
SOLN.FOR 4/5 TIMES UNTIL REMOVE ALL KIND OF CELLS
& MUSCELINIOUS SUBSTANCES.
ACTIVITIES – QC, QS/QMS (PROCESSING STEPS etc.)
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CLEANED AMNION MEMBRANE SPREAD ON STERILE
SURGICAL GAUZE AND MOUNTED IN PLASTIC FRAME OR
FREEZE DRYING RACK.
ACTIVITIES – QC, QS/QMS (PROCESSING STEPS etc.)
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AMNION MEMBRANE DRIED AT 400C IN CONTROLLED
TEMPERATURE DRIER/OVEN FOR 14-15 HOURS OR FREEZE
DRY (6-8 HRS.)
ACTIVITIES – QC, QS/QMS (PROCESSING STEPS etc.)
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DRIED AMNION MEMBRANE CUT INTO SIZES (10X15 cm), TRIPLE PACKED WITH POLYTHENE POUCH & VACCUM SEALED UNDER LAMINAR FLOW CABINET.
ACTIVITIES – QC, QS/QMS (PROCESSING STEPS etc.)
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