Hyper metabolic state depletion of protein stores

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Hyper metabolic state & depletion of protein stores- weight loss, hyperglycemia (because of stress respirations) Gastric ileus- nausea, vomiting, food aversion, peristalsis Signs of infection: Purulent drainage, swelling, erythema, discoloration of wound margins, pain in uninjured skin around the wound Treatment First step is always to make sure child has an airway, is breathing, and has a pulse. Stop burning process by removing any jewelry & clothing. Moist soaks or ice are used to stop burning process and relieve pain. Major burn treatment focuses on decreasing burn fluid losses, preventing infection, controlling pain, promoting nutrition, and salvaging all viable burned tissue. Treatment in hospital: IV fluids 24-48 hour- lactated ringer’s or normal saline is preferred fluid (20mL/kg), aggressive to maintain urinary output Supplemental oxygen or possible intubation Transfusion of packed RBCs High protein diet to build up tissues, and insulin therapy to remove sugars if needed Other treatments: Debridement- removal of dead tissue to speed the healing process, may use Whirlpools Antimicrobial creams- Silvadene, Sulfamylon, aqueous silver nitrate, bacitracin, Aquacel Pain management- IV opioids around the clock for severe burns Skin grafts- allograft (cadaver) or auto-grafting (healthy skin of patient)
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Pressure garments- Jobst is example, used to reduce hypertrohic scarring and contractures, worn 23 hours a day for 6-8 months to shorten scar maturation & reduce thickness of scar Goals of treatment: Careful monitoring of child’s condition (vital signs, urinary output, pulses, capillary refill) Careful assessment of brain injury Pain management keep sedated Psychosocial support of child and family Q: If a burn is circumferential, what should you assess? A: Circumferential- completely around chest or extremity, blood flow can become restricted due to edema and the scab, leading to impaired circulation and tissue hypoxia. Assess for an increase in cyanosis, deep tissue pain, capillary refill time, and a decreased pulse distal to the circumferential burn. If ANY of these signs are present, immediately notify the doctor! COMMON COMMUNICABLE DISEASES Recognition and First Aid Communicable diseases cause acute illnesses, and can be caused by bacterial, viral, protozoan, or fungal organisms. Active immunity to microorganisms does not occur until there is a natural exposure or immunization that leads to antibodies, therefore infants & children are more susceptible. Communicable Disease Clinical Manifestations: Fever (most common), fatigue, malaise, weakness, body aches, poor appetite, nausea, vomiting, diarrhea, headache, reduced responsiveness and ability to concentrate First Aid: ABC’s, determine if 911 needs to be called, transition treatment until help arrives, notify parents, document, recognize communicable disease and contain and prevent spread.
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  • Winter '19
  • Melissa DuVall

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