الفهرس | Only 14 pages are availabe for public view |
Abstract The most immediate concern of the burn team, after ~1tial assessment, is the adequacy of resuscitation. umerous formulas exist, and although quite different, all ”I have proved effective in a wide range of clinical ~ituatiDns. The assessment of resuscitation, however is more mportant than specific formula choosen. Assessment of the burn patient’s response to therapy necessiates accurate understanding, management, and doucmentation of parameters normally associated with effective perfusion. These include level of consciousness, blood ”pressure, pulses, capillary refill haematocrite value and urine output. All of these should be considered individually and together as a clinical entity. The most helpful in assessing and optimizing cardiac function are wedge pressure, arteriovenous o xyqe n content difference, mixed venous P02 (Saturation), thermodilution cardiac output, and calculated peripheral resistance. Smoke inhalation occurs in approximately 30 percent of all burn patients as carbon monoxide poisning, upper airway obstruction, or chemical pneumonitis. Upper airway obstruction results from inhalationoT noxious agents or superheated air and causes irritation of the airway, laryngeal oedema, and potential obstruction. Besides noting the physical findings, such as singed nasal hairs and facial burns, the patient must be observed hourly for slight changes in quality or rate of respiration. Stridor, |