Following a burn injury, some patients will be admitted to the hospital for a period of time and then discharged home. When the patient returns home, he/she will require an adjustment period not only for him/her but also for the whole family.
Consideration after discharge:
Medications are often used when the patient is intubated in the form of sedative and analgesic drugs to reduce the anxiety and stress associated with the intubation as well as helping the patient with tolerating the constant irritation of the endotracheal tube. The patient is also given prophylaxis against Deep Vein Thrombosis Part I, II. When the patient is intubated this will affect the ability of the patient to talk or speak.
There is another form of mechanical ventilator which is the oldest form in which a negative pressure is used instead of a positive pressure to create a vacuum which forces air into the lung.
Ventilators are used to support and help people who can’t breathe adequately.
Burns can affect different parts of the body in different ways. Some patients will not be able to breathe on their own and may need the help of a breathing machine (mechanical ventilator).
Mechanical ventilator: can be defined as a device that is designed to help the patient to breathe simply by moving air into and out of the lungs.
Mechanical ventilators may be used in diseases, conditions, or factors that interfere with or impair breathing such as:
Management:
First aid should be administered as soon as a chemical burn has occurred.
Chemical burns of the skin are burns that happen when strong acids or strong bases (alkalies) come in contact with the skin. Chemical burns follow the standard burn classification (first part I, II, second and third degree part I, II), most chemical burns occur on the face, eyes, arms and legs.
Clinical features:
The exact clinical features of a chemical burn depends on the type of chemical substance involved, it’s concentration, it’s physical form, duration of contact, site of contact, whether or not the skin is intact and if the substance is swallowed or inhaled. Symptoms may include:
Treatment:
Electrical burns are burns that happen when a person is directly exposed to an electrical current, they can cause extensive damage to internal organs.
Potential causes:
A contracture scar can be defined as tightening of the skin overlying the affected area. This type of scar may affect the adjacent muscles, tendons and nerves leading to limitation in the ability to move.
A contracture is a serious complication; it happens when the normal elastic connective tissue is replaced with inelastic fibrous tissue. The fibrous tissue is resistant to stretching. Depending on where the contracture scar is located, the patient may have difficulty performing normal daily activities. This may occur because the contracture can inhibit movement. For example, if the contractures restrict range of motion of a joint.
Treatment of contractures:
The skin plays an important role in the regulation of body temperature and protecting it from sudden temperature changes. Our body needs to be kept at an optimum operating temperature in order for our cells to perform properly. Temperature affects the rate of chemical reactions inside the body. The average body temperature is 98.6F or 37 degree centigrade. The body temperature is kept constant by physiological adjustments controlled by the hypothalamus which acts as a thermostat. The hypothalamus receives nerve impulses from the heat and cold thermoreceptors in the skin called the peripheral thermoreceptors as well as from central thermoreceptors located in the hypothalamus itself.
Our body uses energy to generate heat through the vital actions of the body. This heat production rises with muscle activity like exercise and shivering. Heat is lost and gained through radiation, conduction and conviction while evaporation contributes only to heat loss which occurs through sweating.
When someone has a fever the body thermostat will be set at a higher level, therefore the person first shivers leading to heat release which will lead to the rise of temperature to the new setting, and when the fever subsides the setting of the thermostat will drop back to normal and the person sweats to dispose the excess heat.
Vitamin D is one of the fat soluble vitamins; it plays an important role in maintaining the normal blood levels of calcium and phosphate which are needed for normal mineralization of bone, muscle contraction, nerve conduction and proper cellular function of the body, it also plays a role in the immune modulation and evidence suggest that it has an anti-cancer properties.
The skin plays an important role in the formation of vitamin D; vitamin D can also be obtained from certain food, and supplements. When we are exposed to sun, Ultraviolet B radiation (UVB) found in the sunlight will convert cholesterol (7-dehydrocholesterol) found in the skin to Vitamin D3 (Cholecalciferol), Vitamin D3 will be transported to the liver where it will be converted to Calcidiol (25 D3) and this is what is tested when we measure Vitamin D level in the blood, normal level is between 80 – 175 nmol/L. Calcidiol will be carried to the kidney and will be converted there to Calcitiol (1, 25 D3) which is the active form of vitamin D; it will be released to the circulation and will be carried in the plasma to the target organs. Vitamin D toxicity doesn’t usually occur if we are exposed for a long period of time to sunlight and this is because once Vitamin D3 concentration produced in the skin reaches equilibrium, further Vitamin D3 produced will be degraded by the same Ultraviolet light that created it.
Sources of Vitamin D: 1- The main source of Vitamin D comes from the exposure of our body to sunlight (see above). 2- Food sources: like oily fish such as salmon and sardines butter, egg yolks, some food can be fortified with Vitamin D like milk and cereals. 3- Vitamin D supplements.
