burns & problems

• HEALTH PROBLEMS COMMON IN TODDLERS

  1. Burns
  2. Poisoning
  3. Child Abuse
  4. Cerebral Palsy
  5. Common injuries (Drowning & Aspiration)
• BURNS ASSESSMENT

  • Airway
  • Breathing: beware of inhalation and rapid airway compromise
  • Circulation: fluid replacement
  • Disability: compartment syndrome
  • Exposure: percentage area of burn
• GRAFTING

  1. Allografting – the placement of sterilized and frozen skin (from donor or cadaver) on the cleaned burn site.
  2. Xenograft – Skin from other sources like pigs, done in small children
  3. Autografting- Layer of OWN unburned skin placed over the burned site
• POISONING


  Usual agents ingested are soap, cosmetics, detergents or cleaners, plants, OTC drugs, vitamins, aspirin, acetaminophen and prescription drugs
• CAUSTIC POISONING

  • Ingestion of strong alkali, such as lye, which is contained in certain toilet bowl cleaners and hair products.
  • Causes burns and tissue necrosis in the mouth, esophagus, and stomach
  • Don't let child vomit
• SECOND DEGREE/PARTIAL THICKNESS

  • involves the epidermis and part of the dermis layer of skin
  • red, blistered, swollen
  • very painful
  • heals 2-6 weeks
• THIRD DEGREE/FULL THICKNESS

  • epidermis and full extent of dermis and may go into the subcutaneous tissue
  • white or charred, nerve endings are destroyed
  • healing takes months
• SHAKEN BABY SYNDROME


  Repetitive violent shaking of a small infant by the arms or shoulders, causing a whiplash injury to the neck, edema of brainstem or possibly subdural or retinal hemorrhage
• PSYCHOLOGICAL MALTREATMENT


  Constant belittling, threatening, rejecting, isolating or exploiting a child
• MUNCHAUSEN SYNDROME BY PROXY


  repeatedly brings a child to a health care facility and reports symptoms and illness when the child is well.
• SOCIAL/EMOTIONAL

  • playing with others, taking turns, doing fantasy play
• THERMAL BURNS


  due to external heat sources

  eg: Hot metals, scalding liquids, steam, & flames
• RADIATION BURNS


  caused by prolonged exposure to ultraviolet rays of the sun, therapeutic cancer treatments, or nuclear power plant leaks.
• CHEMICAL BURNS


  caused by strong acids, alkalis, detergents, or solvents
• ELECTRICAL BURNS


  from electrical current
• FRICTION BURNS


  from direct damage to the cells and from the heat generated by friction
• Wallace the rule of nines

  is the way medical professionals calculate the TSBA (total body surface area)
• MINOR BURNS

  • Immediately apply cool water
  • Analgesic-antibiotic ointment and a gauze bandage to prevent infection
• MODERATE BURNS


  Silver sulfadiazine-silvadene
• SEVERE BURNS

  • Fluid therapy
  • Morphine sulfate IV
• ELECTICAL BURNS


  Clean with antiseptic solution