Medical Surgical Nursing

(Tina Sui) #1

  • Burn patients become hyperthermic for much of the postburn period, even in the


absence of infection


GI responses



  • Paralytic ileus (absence of intestinal peristalsis):

  • decreased peristalsis and bowel sounds are manifestations of paralytic ileus resulting


from burn trauma and



  • Gastric distention and nausea may lead to vomiting unless gastric decompression is


initiated



  • Curling ́s ulcer (gastric or deuodenal erosion)

  • Gastric bleeding secondary to massive physiologic stress may be signaled by occult


blood in the stool, regurgitation of coffee ground material from the stomach or bloody


vomitus


Phases of Burn Injuries



  • Emergent Phase: From onset of injury to completion of fluid resuscitation

  • Acute Phase: From beginning of diuresis to near completion of wound closure

  • Rehabilitative Phase: From major wound closure to return to individual's optimal


level of physical and psychosocial adjustment


Emergent Phase



  • Immediate problem is fluid loss, edema, reduced blood flow (fluid and electrolyte


shifts)



  • Goals:



  1. First aid (A, B, C)

  2. Intubation if needed

  3. Prevention of shock

  4. Prevention of respiratory distress

  5. Detection and treatment of concomitant injuries

  6. Wound assessment and initial care


Emergent phase/ at fire sceine



  • Extinguish the flames , switch off power source, remove chemical soaked clothes,


etc...

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