1. Burn and Scald

5. Chemical burns

7. Electrical hand burn.

14. 1° burn 2° burn

15. Superficial burn (1° burn)

16. Partial thickness (2°burn)

18. Blister may ↑size because continuous exudation and collection of tissue fluid

20. 3° burn

21. Eschar:composed of denatured protein

22. Full thickness (3°burn)

27. Zon of injury

28. Thermal injury Inflammation Vasodilatation & ↑blood flow Leukocyctes & nutrient promote healing Vasoactive substance

29. Normal Vasodilatation

33. Intravascular Normal

34. Burn Shock First 24 hours Burn Shock after 24 hours

35. Thermal injury Inflammation Histamine release Vasoconstriction ↑ blood pressure ↑ blood flow to injury ↑ capillary permeability Fluids leakage and Loss from injury Site (edema) ↓ intravascular fluid Hypovolemic shock ↑ Protein leakage Hypoproteinemia ↓ Plasma osmotic pressure

48. Myoglobinuria

53. Rule of nines

56. Lund and Browder chart 3½ 3¼ 3 2¾ 2½ 2½ C-1 leg (back or front) 4¾ 4½ 4¼ 4 3¼ 2¾ B-1 thigh (back or front) 3½ 4½ 5½ 6½ 8½ 9½ A-head (back or front) Adult 15 10 5 1 0 Age in years

66. ER Assessment History Physical examination Intravenous line Nasogastric tube Indwelling catheter Neurological assessment Vital signs

72. Pulse oximeter

75. Arterial blood gases *To assess acid-base balance due to a respiratory disorder, respiratory acidosis . 75-100mmHg PO 35-45 mmHg PCO2 ↑ 7.35-7.45 PH ↓

78. Summary; Emergent phase

81. Diagnostic test Swabs for culture &sensitivity Daily urea , electrolytes Daily FBC ABGs PCV until stable Later Urinalysis ABGs Grouping & typing Carboxyhemoglobin Blood sugar ECG Urea & electrolytes CXR Full Blood Count Optional Essential Initial

93. Crystalloid Solutions 273 308 289 Osmolality (mosm/kg) 6.7 5.7 7.4 pH mEq/L Lactate (28) -- Bicarb. (26) Buffer mEq/L 3/0 -- 5/2 Ca/Mg mEq/L 4 -- 4-5 K mEq/L 109 154 103 Cl mEq/L 130 154 141 Na Ringer’s lactate 0.9% Saline Plasma

104. Burn victim

105. Endotracheal tube

106. Tracheostomy