Emergency Burns
Emergency Burns
Emergency Burns
EMERGENCY: BURN
Pengertian Luka bakar (burn injury) adalah kerusakan kulit yang disebabkan
kontak dengan sumber panas seperti api, air panas, bahan kimia, listrik
dan radiasi.
Definition Burn injury is skin damage caused by contact with heat sources such as
fire, hot water, chemicals, electricity, and radiation.
Anamnesis Results
Diagnostic Sign and symptoms
Criteria In first degree burns are most often caused by sunlight. The patient only
complains of sore skin and redness. In second-degree burns there is
pain and blisters. In third degree burns, dark brown areas appear on
the skin, and peel off.
Pemerisaan Penunjang :
Darah Lengkap, Elektrolit
Supporting Examination:
Whole Blood
Electrolytes
Kriteria Rujukan
1. Rujukan dilakukan pada luka bakar sedang dan berat
2. total permukaan tubuh untuk anak dibawah 10 tahun atau
dewasa diatas 50 tahun.
3. Luka bakar tingkat tiga yg mencakup total permukaan tubuh
lebih dari 5%
4. Luka bakar tingkat dua atau tingkat tiga yg melibatkan daerah
kritis (seperti: tangan, kaki, wajah, perineum, alat kelamin, atau
sendi utama ekstremitas.
5. Luka bakar yang berhubungan dengan trauma inhalasi
6. Luka bakar akibat sengatan listrik atau petir
7. Luka bakar berat yang komplikasi dengan trauma lain. Bila
cedera traumanya lebih berbahaya dari luka bakarnya, maka
sebaiknya pasien dikirimkan ke trauma center terlebih dahulu
8. Penyakit pasien yang mempersulit penanganan luka bakar
9. Luka bakar akibat bahan kimia dari kosmetika yg
membahayakan fungsi organ
10. Luka bakar melingkar pada kaki dan tangan.
Procedure
Comprehensive Management (Plan)
Management
a. First degree burns heal spontaneously without special treatment.
b. The management of second and third degree burns depends on the
extent of the burn.
c. If there is a second or third degree burn, pay attention to the affected
area, with the emergency principle in trauma, namely ABCDE
• Airway: clear the airway, intubate if necessary
• Breathing: note respiratory distress
• Circulation: watch for signs of hypovolemia; install a 2 line IV line
if needed
• Disability: note if the patient is in an unconscious condition
• Environment: remove the victim's clothing, replace it with a
hypothermia warning blanket, and remove any metal objects found
on the body
In the treatment of improving circulation in burns, several formulas are
known, one of which is the Baxter Formula as follows:
a. First day:
Adult: Lactated Ringer's 4 cc x body weight x % burned area
per 24 hours
Children : Ringer Lactate : Dextran = 17 : 3
2 cc x body weight x % wound area plus physiological needs.
Physiological needs:
< 1 year: body weight x 100 cc
1-3 years: body weight x 75 cc
3-5 years: body weight x 50 cc
½ the amount of fluid given in the first 8 hours. ½ given the next
16 hours.
b. The second day
Adults: ½ day I;
Children: given according to physiological needs
This resuscitation fluid formula is only an estimate of fluid
requirements, based on calculations at the time the burn occurred, not
at the start of resuscitation. In fact, the fluid count must still be adjusted
according to the patient's response. For this reason, it is always
necessary to monitor the patient's condition, such as general condition,
vital signs, and urine production. Furthermore, an ECG monitor can be
installed to monitor heart rhythm as an early sign of hypoxia, electrolyte
disturbances and acid-base balance.
Administration of broad spectrum antibiotics for moderate and severe
burns.
Referral Criteria
1. Referrals are made to moderate and severe burns
2. Total body surface area for children under 10 years or adults over
50.
3. Third-degree burns covering more than 5% of the total body surface
area
4. Second degree or third degree burns involving critical areas (such as
hands, feet, face, perineum, genitals, or major joints of the
extremities.
5. Burns associated with inhalation trauma
6. Burns due to electric shock or lightning
7. Severe burns complicated by other trauma. If the traumatic injury is
more dangerous than the burn, then the patient should be sent to the
trauma centre first
8. Diseases of the patient complicating the management of burns
9. Burns caused by chemicals from cosmetics that endanger organ
function
10. Circumferential burns to the feet and hands.
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