Introduction to burns

The skin has an important role to play in the fluid and temperature regulation of the body. If enough skin area is injured, the ability to maintain that control can be lost. The skin also acts as a protective barrier against the bacteria and viruses that inhabit the world outside the body. The anatomy of the skin is complex, and there are many structures within the layers of the skin. There are three layers: 1. Epidermis, the outer layer of the skin 2. Dermis, made up of collagen and elastic fibers and where nerves, blood vessels, sweat glands, and hair follicles reside. 3. Hypodermis or subcutaneous tissue, where larger blood vessels and nerves are located. This is the layer of tissue that is most important in temperature regulation. The amount of damage that a burn can cause depends upon its location, its depth, and how much body surface area that it involves.

Burns are one of the most devastating conditions encountered in medicine. The injury represents an assault on all aspects of the patient, from the physical to the psychological. It affects all ages, from babies to elderly people, and is a problem in both the developed and developing world. All of us have experienced the severe pain that even a small burn can bring. However the pain and distress caused by a large burn are not limited to the immediate event. The visible physical and the invisible psychological scars are long lasting and often lead to chronic disability. Burn injuries represent a diverse and varied challenge to medical and paramedical staff. Correct management requires a skilled multidisciplinary approach that addresses all the problems facing a burn patient. How are burns classified? Burns are classified based upon their depth. First degree burn is superficial and causes local inflammation of the skin. Sunburns often are categorized as first degree burns. The inflammation is characterized by pain, redness, and a mild amount of swelling. The skin may be very tender to touch. Second degree burns are deeper and in addition to the pain, redness and inflammation, there is also blistering of the skin. Third degree burns are deeper still, involving all layers of the skin, in effect killing that area of skin. Because the nerves and blood vessels are damaged, third degree burns appear white and leathery and tend to be relatively painless.

Burns are not static and may mature. Over a few hours a first degree burn may involve deeper structures and become second degree. Think of a sunburn that blisters the next day. Similarly, second degree burns may evolve into third degree burns. Regardless of the type of burn, inflammation and fluid accumulation in and around the wound occur. Moreover, it should be noted that the skin is the body's first defense against infection by microorganisms. A burn is also a break in the skin, and the risk of infection exists both at the site of the injury and potentially throughout the body.

Only the epidermis has the ability to regenerate itself. Burns that extend deeper may cause permanent injury and scarring and not allow the skin in that area to return to normal function.

Name of Drug Cefuroxime IV 50mg q6

Classification ANTIINFECTIVE; ANTIBIOTIC SECONDGENERATION CEPHALOSPORIN

Adverse Effect Body as a Whole: Thrombopheletis (IV site); pain, burning, cellulitis(IM site); super infections, positive Coombs 'test. GI: Diarrhea nausea, antibioticassociated colitis. Skin: Rash ,pruritus, Urticaria Urogenitall:

Indication It is effective for the treatment of penicillinase producing neisseria gonorrhea(PPNG) Effectively treats bone and joint infections, bronchitis, meningitis ,gonorrhea, otitis Media pharyngitis/tonsillitis, sinusitis, lower respiratory tract infections, skin and soft tissue infections, urinary tract infections, and is used

Contraindication Hypersensitivity to cephalosporins and related antibiotics; Pregnancy (Category B), Lactation

Nsg. Consideration Determine history of hypersensiti vity reactions to Cephalosporins , penicillins, and history of allergies, particularly to drugs, before therapy is initiated Inspect IM and IV injection sites frequently for signs

Increased serum Creatine and BUN, decreased creatinine Clearance

for surgical prophylaxis, reducing or eliminating infection

of phlebitis

Name of Drug Ascorbic acid 0.5 BID

Classification Vitamins

Adverse Effect GI: Nausea, vomiting, Heartburn, Diarrhea, Hematologic: Acute Hemolytic anemia(Patience is deficiency of G6PD); sickle cell crisis. CNS; headache(high doses) Other; Mild soreness at injection site; dizziness and temporary faintness with rapid IV Administration.

Indication Prophylaxis and treatment of scurvy and as a dietary supplement. Increased protection mechanism of the immune system, thus supporting wound healing. Necessary for wound healing and resistance to infection

Contraindication Use of sodium ascorbate in patient on sodium restriction; use of calcium ascorbate in patient receiving digitalis, safety during pregnancy (category C) or lactation is not establish

Nsg. Consideration Assessment & drug effects