外科急诊创伤(英文)烧伤.docx

外科急诊创伤(英文)烧伤

Burnsareacommonpresentationinsurgicalemergencydepartments,oftenresultingfromthermal,electrical,chemical,orradiantenergyexposure.Hereisadetailedaccountofthemanagementofburninjuries:

Burnscanvaryinseverity,withdepthandextentbeingtheprimaryfactorsdeterminingtheoverallimpactonthepatient.Thefollowingdetailstheassessment,initialmanagement,andsubsequentcareofburninjuries:

1.InitialAssessmentandStabilization:

Ensuretheairwayisclearandestablishadequatebreathingwithsupplementaloxygenifnecessary.

Controlanyexternalbleedingwithdirectpressure,elevation,orapplicationofapressurebandage.

Assessthepatientscirculationbycheckingforpulse,bloodpressure,andcapillaryrefill.

Administerintravenousfluidstomaintainhemodynamicstability,usingParklandformulaormodifiedRingerslactateasappropriate.

Provideanalgesiawithopioidsornonsteroidalantiinflammatorydrugs(NSAIDs),takingintoaccountthepatientspaintoleranceandanycontraindications.

2.BurnDepthandSizeEvaluation:

UsetheRuleofNinestoestimatethetotalbodysurfacearea(TBSA)affected.

Classifyburndepthintosuperficial(firstdegree),partialthickness(seconddegree),orfullthickness(thirddegree)burns.

Noteanyassociatedinjuriessuchasfractures,crushinjuries,orsmokeinhalation.

3.CleaningandDressing:

Cleantheburnwoundwithmildsoapandwaterorasalinesolutiontoremovedebrisandminimizeinfectionrisk.

Applyasteriledressingtoprotectthewound,usingnonadhesivedressingsforsuperficialburnsandthicker,absorbentdressingsfordeeperburns.

Changedressingsregularly,dependingonthewoundsconditionandthepresenceofexudate.

4.InfectionPreventionandManagement:

Administerprophylacticantibioticsforburnsinvolvingmorethan10%ofTBSAorthosewithsignificantcontamination.

Monitorthewoundforsign