PENJAGAAN PESAKIT TERBAKAR DAN MELECUR

OBJEKTIFMenerangkan ciri-ciri klinikal keadaan pesakit yang mengalami terbakar dan melecurMenjelaskan tindakan penjagaan kejururawatan umum dari aspek pemakanan, penjagaan kawasan kecederaan, latihan, fisioterapi dan pemberian ubat-ubatanMenerangkan komplikasi-komplikasi yang boleh berlaku

DEFINISITerbakarKecederaan dan kehancuran koagalutif lapisan kulit akibat haba kepanasan keringMelecur Kecederaan dan kehancuran koagalutif lapisan kulit akibat haba kepanasan lembab

KEBAKARAN LEMBABKEBAKARAN KERING

Radiation burnairway burn

PENYEBABHaba keringThermaElektrikRadiasi KelembapanBahan kimiaWapCecair Alkaline burn injury

CIRI-CIRI KLINIKALCiri kerosakan tisu mengikut kedalaman dan jenis terbakar / melecurRenjatan neurogenikRenjatan hipovolumikBerlaku infeksi

RAWATAN DAN KEJURURAWATANRawatan kecemasanRawatan dalam wad

KOMPLIKASIRenjatanToksemia KimiaKontrakturKecacatan fizikal dan mentalSeptisaemiaParut keloid

KOMPLIKASIInfeksiAnaemiaParalisis

PARUT KELOID

KONTRAKTUR

RAWATAN UNIT KECEMASANMinor burnsPrevent from shockCool the burns (under running water @ immerse in water)Cover the burn with a sterile gauzeApplication of SSDAnalgesic (Morphine @ Pethidine)Anti-tetanus injection

RAWATAN UNIT KECEMASANCautionsDont use iceDont break blistersMajor burnsDont remove burnt cloth (but if possible try to remove it include jeweleries)Dont immerse severe large burn in cool waterShock treatmentCheck for ABCCover the area of burnFluid replacement

RAWATAN DALAM WADRefer to burns unitFor further managementMonitoring vital signs hourlyBP, pulse, respirationMonitoring ABCAppropriate fluid and oxygen therapyDiet Full high protein diet

RAWATAN DALAM WADDressingDaily @ b.d dressingChange rapidly dressing Avoid to bandage the woundBurns wound careTo avoid infectionAseptic techniqueUniversal precaution techniquePrecaution of nosocomial infection

RAWATAN DALAM WADAntibiotic and analgesicFollow the regimen and doctors orderBroad spectrum antibioticHourly @ p.r.n analgesicSurgery Skin graftingTo avoid permenant keloid and contracturePhysiotherapyTo ambulate and restore limbs function

FLUID REPLACEMENTTo all burn wounds 20% TBSACrystalloid fluid are administered thourgh 2 large-bore catheters (14G 16G)Ringers lactate used during 24 hours after burns injury2 commonly used formulasParkland formula (4ml X kg X %TBSA)Modified Brooke formula (2ml X kg X %TBSA)