A burn disease is commonly referred to as a series of clinical symptoms that appear due to a burn. Pathology develops only with extensive injuries, and if they are insignificant, then the manifestations of the disease will pass less noticeably.
With burn disease, not only local disturbances appear, but also numerous violations in internal organs. The disease is very dangerous and in a fairly large proportion of cases it causes a fatal outcome after a thermal injury. In this issue, we'll talk about the causes, periods, early signs and stages of the burn disease, first aid, flow and treatment of the disease.
Features of the disease
- The severe form of burn disease occurs with burns up to 30% of the body area if the lesions are superficial.
- With deep burns, 10% of lesions are sufficient to develop a burn disease.
- Hardly it penetrates in the elderly and children, and if their reception is also associated with a mechanical trauma, then such damage is transferred even more difficult. Deep
damage of only 5% of the body can lead to a fatal outcome in both cases.
In a long-term prognosis, in most cases, a burn disease provokes disability.
There are 4 stages of the disease:
- Burn shock ( duration up to 72 hours).Characterized by the general excitation of the central nervous system, so the victim is often unable to assess the surrounding reality, his own condition. After a while, mobility and excitement is replaced by retardation, confusion of consciousness. Development of hypovolemia, hypodynamic disorders begins. The stage of burn shock is divided into 4 forms according to severity, based on all described indicators and manifested symptoms. The blood reveals a high level of hemoglobin, develops hyperkalemia, hypoproteinemia.
- Burn toxemia( acute) - 2 phase of burn disease. The duration of the phase can go up to 15 days, sometimes it takes only 3 days. In the vascular bed, along with toxins, liquid is returned, which causes toxemia. Some indicators improve, but the patient's condition is usually not affected, because intoxication is very pronounced, sometimes accompanied by the development of infection. Reduces the number of red blood cells in the blood, reduced and hemoglobin level, leukocytosis develops, pulmonary edema is likely.
- Septicotoxemia is a stage characterized by the development of a number of complications that appear after the death of a burnt scab. It lasts about 5 weeks, accompanied by intermittent fever. Infection is caused by intestinal and pseudomonas aeruginosa, staphylococcus. Due to the weakened state of patients at this stage of the burn disease, complications that threaten the patient's life( sepsis, pneumonia) may occur. Thanks to polyuria, the density of urine decreases. With a favorable prognosis, the wound is restored gradually, and the burn disease passes to the next stage.
- Recovery after a burn disease takes about 4 months. At this stage, the well-being improves, the temperature and weight are normalized, metabolic processes are restored.
The causes of
Scientists in the medical field do not have a common opinion as to what exactly provokes a number of clinical signs characteristic of the burn disease. There are many different theories, the founders of which believe that pathological reactions to a burn occur under the influence of morphological and pathological changes. Isolate neurogenic, toxemic, allergic, endocrine, dermatogenic, anaphylactic theories.
For example, in the theory of toxicity, it is believed that a burn disease is triggered by the breakdown of a large number of proteins and secreted by exposure to fire toxins. Neurogenic theory explains the disease by redefinition of nerve endings and subsequent inhibition of the CNS.
All the theories of the origin of pathology are explained differently, but so far no one has been able to explain the exact mechanism of the appearance of a burn disease. Many doctors tend to believe that all of these factors affect the body, causing such a significant deterioration in health and condition.
Symptoms of burn disease in different periods of time depend on the phase of the disease:
- Symptoms of septicotoxemia are very pronounced: weakness, exhaustion, muscles are atrophied, the victim has a low appetite. Surface of wounds slowly heals, they themselves are covered with pus, sometimes bleed. To the described symptoms signs of diseases complicating the disease, if they developed, are added.
- Acute burn toxemia is accompanied by such phenomena: insomnia, delirium, hallucinations, convulsions, confused consciousness, high fever. Various complications can develop, and especially the patient experiences symptoms of pleurisy, pneumonia, toxic hepatitis, intestinal obstruction. There are a number of violations from the cardiac( deaf tones, tachycardia, irregular heartbeat rhythm) and digestive systems( flatulence, abdominal pain, stomach ulcers).One of the important symptoms of the stage is the rapid formation of pressure sores.
- Burn shock. The victim is mobile, agitated, after a while becomes sluggish. Often at this stage there is indomitable vomiting, thirst. Blood pressure is often normal, the pulse is fast, the skin is pale. Urine acquires a darker shade, often cherry, but most patients do not have urination. Body temperature is low or subfebrile, a person feels chills, trembling.
- During the recovery period, feels well, although it is improving, but the patient's condition is still being monitored, since even in this case, various complications may occur.
Next, the formulation of the diagnosis of a burn disease is considered.
The diagnosis is based on the received data, indicating the extent and depth of the burn. The functioning of the internal organs is evaluated, taking into account a number of laboratory tests. Sometimes it is necessary to consult specialists from other fields, but most often a gastroenterologist, cardiologist, pulmonologist.
Diagnosis helps a lot in detecting any pathological changes, as well as in predicting the further condition of the victim. Diagnostic methods are as follows:
- radiography( including contrast),
For treatment of burn disease by stages and intensive care, read below.
The first therapeutic methods of treatment are taken at the time of first aid. Up to the beginning of a full-fledged medical correction, a series of procedures are performed:
- Injection of tranquilizers together with anesthetic.
- In the presence of an airway burn, fight with respiratory failure by inhalation with Naphthyzine, Prednisolone, Euphyllinum or humidified oxygen. Sometimes this stage is replaced by intubation of the lungs.
- A special spray is sprayed on the burn or the bandage is applied with an anesthetic and an antiseptic.
- The next step is to restore the lost liquid, but drink not pure water, but water with soda and salt( 1 tsp per 1 liter).
- If necessary, a catheter is inserted into the central vein and infusion therapy is initiated to eliminate the risk of shock.
If there are indications, the transfusion of blood, plasma, colloidal and crystalline solutions is done to the victim.
About a burn shock for a burn illness will tell this video:
At different stages of treatment, therapy has slightly different goals. So, with the first form of the disease, it is important to minimize the manifestations and effects of shock, in the subsequent stages, detoxification therapy is widely carried out and cell regeneration is activated.
The greatest value is given to antibiotic therapy, infusion therapy. The patient's condition is adjusted by a number of other medicines, among them:
- means to reduce vascular permeability;
- anticholinesterase medications;
- cardiac glycosides;
- analgesics( including narcotic);
After the transition to stages 2 and 3 of the burn disease continue therapy aimed at detoxification of the body and fight infection, but connect regenerating drugs, anabolic steroids, protein means. Great attention is paid to vitamin therapy.
Because of insomnia, the patient should take sleeping pills. Their dosage rises gradually to slowly prolong the sleep.
Prevention of the disease
Prevention of the most burn disease is simple enough - it is compliance with fire safety techniques and minimal contact with an open fire. During the whole period of treatment, doctors are engaged in the prevention of dangerous complications, which have a considerable influence on the further prognosis.
Complications and consequences of burn disease
Approximate appearance of infectious complications - 7 days after injury. In the same period, active development of pressure ulcers, pneumonia, sepsis begins. At a late stage( after 4 months), dysfunction of the most diverse areas of the body can be detected, but most often the digestive function, cardiovascular sphere suffers. Often found in patients with pulmonary edema of toxic form, toxic myocarditis.
Burn disease can be complicated by such phenomena as:
- trophic ulcers,
- parenchymal hepatitis,
- erosive gastritis,
- bleeding in the gut,
- viral hepatitis,
- renal amyloidosis,
- myocardial infarction,
The three most common complications are:
- sepsis( occurs in 10% of cases),
- burns depletion( 37%) and
- pneumonia( 21%).
Among the local complications, of course, highlight the changes that occur with the affected skin. Perhaps the appearance of itching, contracture, scars and dermatitis, erysipelas. There is a risk of pyoderma, thrombophlebitis and skin cancer.
The prognosis depends on the severity of the burn disease. In this case, they are based on the "rule of the hundreds", Frank's index. In the latter case, take into account the age of the victim, whether the airways were affected, how many percent of the body was affected.
- In persons over 45 years of age, even with 10% of burns, a dubious prognosis.
- For those who are more young, even with 40% of body lesions, a favorable prognosis can be made.
There are a number of indicators on which it is possible to predict the further condition of the patient. There are 8 positions:
- Presence of decompensated diseases.
- The victim is over 50 years old.
- Loss of consciousness.
- The cause of the burn was an open flame.
- Pulse above 100 beats per minute.
- There is a burn of the respiratory tract.
- The burn area occupies 60%.
If the patient has at least 4 signs, the prognosis is unfavorable. Complications have a lot of impact on the prognosis, but in each case they are individual, as well as their severity. However, the statistics are such that the lower the percentage of burns( the deepest is not more than 10%, and the surface one is not higher than 30%), the less the probability of life-threatening complications. And this already contributes to recovery and improves the prognosis.