Final

• Begin CPR.
• Open airways and look into mouth, remove object, never use blind finger sweep.
• Burns: Classification of burns, Clinical evaluation of burns, Management of burns: first aid, Late Complications of burns, Heat illness: Clinical picture, Investigations, Management, Classification of Burns, First Degree (Superficial) involves only epidermis, Red, Painful, Tender, Heal in 3~7 days, Second Degree (Partial Thickness) extends through epidermis into dermis, Salmon pink, Moist, Shiny, Painful, Blisters may be present, Heal in ~7 to 21days, Third Degree (Full Thickness) through epidermis, dermis into underlying structures, Thick, dry, Dead white or charred, May bleed from vessel da
• Management of minor burns (10% in adults) can be treated in outpatient, Moderate and severe burns should be hospitalized, Adults with burn >20% require IV therapy.
• Home remedies should not be used, Transport severe cases to hospital.
• Management of severe burns: ABC, I.V, line, Expose for evaluation, History taking, Catheter, Clean wound, Estimate depth and area, Analgesics, Calculate fluids.
• Late complications of burns include Dyspigmentation, Hypertrophic scars, Contractures, ulcer.
• Electrical burns are thermal injuries resulting from high intensity heat, the skin injury area may appear small, but the underlying tissue damage may be extensive, There may be brain or heart damage or musculoskeletal injuries associated with the electrical injuries.
• Chemical burns are caused by strong acids or alkalis, can cause progressive injury until the agent is inactivated, Flush the injured area with a copious amount of water while at the scene of the incident, Don’t delay or waste time looking for or using a neutralizing agent.
• Thermoregulation involves metabolic heat and environmental heat, body temperature.
• Heat illnesses are acute emergency conditions usually seen during summer in tropical and subtropical areas among workers in iron furnaces, marathon runners, new army recruits, pilgrims.
• Heat illnesses include Major, Minor Heat cramp, Heat syncope, Heat exhaustion, Heat stroke, Sunburn, Heat fatigue, Heat edema.
• Heat exhaustion signs/symptoms include CVS: tachycardia, hypotension, Skin: Sweaty, pale, Headache, weakness, fainting, may have muscle cramps.
• Clinical manifestations of anaphylaxis include skin rash, itching, hives, difficulty breathing, and shock.
• Heat exhaustion treatment includes Monitor CVS, Cooling and rest for few hours, Supine, legs up, most improve with rest, oral hydration, IV fluids (Normal saline, Dextrose5%) if slow response.
• Anaphylaxis can occur in severe infections, such as exotoxins of gram+ve bacteria (staph aureus) and endotoxins of gram-ve bacteria (E coli).
• In profound shock or immediately life-threatening situations, CPR is given.
• Treatment of Anaphylaxis includes discontinuing further administration of the suspected factor, removing stings by scraping them carefully away from skin, giving oxygen therapy, opening and maintaining airway, and getting specialist senior help immediately if upper airway oedema is present.
• Blood or plasma loss can cause shock due to burns, bleeding peptic ulcer, extensive fractures, crushing accidents, or external or internal injuries.
• In patients with shock, airway swelling, or respiratory difficulty, adrenaline IM is given.
• Treatment of Anaphylaxis also includes giving a bronchodilator (e.g. salbutamol 5mg) nebulized with O2 for bronchospasm, IV fluids if hypotension does not rapidly respond to adrenaline.
• Acute renal failure is a medical condition that necessitates close monitoring of vital signs, including pulse, blood pressure, respiratory rate, pattern, volume, and fluid input/output.
• Normal tissue perfusion requires three intact mechanisms: a functioning pump (heart), adequate volume (blood and plasma), and an intact vascular system.
• Causes of inability of heart to pump needed blood include myocardial infarction, cardiac arrhythmia, pulmonary embolism, myocardial contusion.
• Signs and symptoms of shock include confusion and delirium, scared appearance, rapid and shallow respiration, rapid and weak pulse, cold and pale skin, nausea and vomiting, and reduced blood pressure.
• Shock is a disturbance of circulation leading to inadequate perfusion of vital tissues and with a wide variation of systemic effects.
• Bleeding can be internal or external, such as epistaxis or hematuria.
• Vertigo (sense of spinning)
• The rescuer should initially ensure that the scene is safe when the rescuer first sees a victim
• Transport for care re.Basic life support (BLS) Cardiopulmonary Resuscitation ( CPR)
• The depth of chest compressions for an adult victim should be at least 2 inches (5cm)
• A victim who is unresponsive with no normal breathing (i.e., only gasping), and no pulse needs CPR
• Arm drift: when patient close eyes and holds hands in front
• Time: call EMS
• Changes in basic life support (BLS) include: Early recognition of sudden cardiac arrest (SCA), beginning excellent CPR immediately, encouraging rescuers to perform excellent chest compression, use automated external defibrillator (AED), activate the emergency medical services (EMS) 911 as soon as possible once SCA is identified
• Headache: sudden severe unusual
• The heart compression site is the costal margin → sternal notch → lower end of sternum
• Unconscious patient in recovery position
• After 10 minutes of clinical death, irreversible brain damage is certain
• Within 6-10 minutes of clinical death, brain damage is likely