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Burn - Dual Band Mobile Phones Manufacturer - Large Button Mobile Phones Manufacturer by wqegtf rebr
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Burn - Dual Band Mobile Phones Manufacturer - Large Button Mobile Phones Manufacturer by WQEGTF REBR
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| Article Posted: 01/23/2011 |
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Burn - Dual Band Mobile Phones Manufacturer - Large Button Mobile Phones Manufacturer |
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Burn Depth Classification A number of different classification systems exist. The traditional system divided burns in first-, second-, or third-degree. This system is however being replaced by one reflecting the need for surgical intervention. The burn depths are described as either superficial, superficial partial-thickness, deep partial-thickness, or full-thickness. The following are brief descriptions of these classes: By degree First-degree burns are usually limited to redness (erythema), a white plaque and minor pain at the site of injury. These burns involve only the epidermis. Most sunburns can be included as first-degree burns. Second-degree burns manifest as erythema with superficial blistering of the skin, and can involve more or less pain depending on the level of nerve involvement. Second-degree burns involve the superficial (papillary) dermis and may also involve the deep (reticular) dermis layer. Third-degree burns occur when the epidermis is lost with damage to the subcutaneous tissue. Burn victims will exhibit charring and extreme damage of the epidermis, and sometimes hard eschar will be present. Third-degree burns result in scarring and victims will also exhibit the loss of hair shafts and keratin. These burns may require grafting. Fourth-degree burns damage muscle, tendon, and ligament tissue, thus result in charring and catastrophic damage of the hypodermis. In some instances the hypodermis tissue may be partially or completely burned away as well as this may result in a condition called compartment syndrome, which threatens both the life and the limb of the patient. Grafting is required if the burn does not prove to be fatal. Other classifications A newer classification of "Superficial Thickness", "Partial Thickness" (which is divided into superficial and deep categories) and "Full Thickness" relates more precisely to the epidermis, dermis and subcutaneous layers of skin and is used to guide treatment and predict outcome. Table 1. A description of the traditional and current classifications of burns. Nomenclature Traditional nomenclature Depth Clinical findings Example Superficial thickness first degree Epidermis involvement Erythema, significant pain, lack of blisters Partial thickness superficial second degree Superficial (papillary) dermis Blisters, clear fluid, and pain Partial thickness deep third degree Deep (reticular) dermis Whiter appearance or fixed red staining (no blanching), reduced sensation Full thickness fourth degree* Epidermis, Dermis, and complete destruction to subcutaneous fat, eschar formation and minimal pain, requires skin grafts Charred or leathery, thrombosed blood vessels, insensate * It should however be noted that although fourth-degree is not a technical term, it is often used to describe burns that reach muscle and bone. Third-degree sufficiently describes all burns of this nature. An even simpler, more accurate and more descriptive classification is epidermal, dermal and full thickness. Dermal injuries are subdivided into superficial, mid and deep. Burn Surface Area Main article: Total body surface area Burns can also be assessed in terms of total body surface area (TBSA), which is the percentage affected by partial thickness or full thickness burns (erythema/superficial thickness burns are not counted). The rule of nines is used as a quick and useful way to estimate the affected TBSA. More accurate estimation can be made using Lund & Browder charts which take into account the different proportions of body parts in adults and children. The size of the patient's hand print (palm and fingers) is approximately 1% of their TBSA. The actual mean surface area is 0.8% so using 1% will slightly over estimate the size. Burns of 10% in children or 15% in adults (or greater) are potentially life threatening injuries (because of the risk of hypovolaemic shock) and should have formal fluid resuscitation and monitoring in a burns unit. Causes Burns are caused by a wide variety of substances and external sources such as exposure to chemicals, friction, electricity, radiation, and heat. Chemical burn Main article: chemical burn Most chemicals that cause severe chemical burns are strong acids or bases. Chemical burns are usually caused by caustic chemical compounds, such as sodium hydroxide, silver nitrate, and more serious compounds (such as sulphuric acid and Nitric acid). Hydrofluoric acid can cause damage down to the bone and its burns are sometimes not immediately evident. Electrical burn Electrical burns are caused by an exogenous electric shock. Common causes of electrical burns include workplace injuries or being defibrillated or cardioverted without a conductive gel. Lightning is a rare cause of electrical burns. The internal injuries sustained may be disproportionate to the size of the burns seen, and the extent of the damage is not always obvious. Such injuries may lead to cardiac arrhythmias, cardiac arrest, and unexpected falls with resultant fractures. Radiation burn Main article: radiation burn Radiation burns are caused by protracted exposure to UV light (as from the sun), tanning booths, radiation therapy (as patients who are undergoing cancer therapy), sunlamps, and X-rays. By far the most common burn associated with radiation is sun exposure, specifically two wavelengths of light UVA, and UVB, the latter being more dangerous. Tanning booths also emit these wavelengths and may cause similar damage to the skin such as irritation, redness, swelling, and inflammation. More severe cases of sun burn result in what is known as sun poisoning. Scalding Two-day-old scald caused by boiling radiator fluid. Scalding is caused by hot liquids (water or oil) or gases (steam), most commonly occurring from exposure to high temperature tap water in baths or showers or spilled hot drinks. A blister is a "bubble" in the skin filled with serous fluid as part of the body's reaction to the heat and nerve damage. The blister "roof" is dead. Steam is a common gas that causes scalds. The injury is usually regional and usually does not cause death. More damage can be caused if hot liquids enter an orifice. However, deaths have occurred in more unusual circumstances, such as when people have accidentally broken a steam pipe. The demographics that are of the highest risk to suffering from scalding are young children, with their delicate skin, and the elderly over 65 years of age. Management Burns over 10% in children and 15% in adults need hospital admission and fluid resuscitation due to the risk of hypovolaemic shock. Most countries have explicit criteria for the transfer and management of burns patients.[citation needed] Major burns should be managed using the principles of Advanced Trauma Life Support (ATLS). This consists of a primary survey to identify and treat immediately life threatening conditions and then a secondary survey. The primary survey in burns patients should follow the ABCDE guidlelines (Airway & axial spine control, Breathing & ventilation, Circulation and arrest of haemorrhage, neurological Disability, Exposure to allow accurate assessment and Estimation of burn surface area and Fluid resuscitation).[citation needed] If the patient was involved in a fire accident in an enclosed space, then it must be assumed that he or she has sustained an inhalation injury until proven otherwise, and treatment should be managed accordingly. At this stage of management, it is also critical to assess the airway status. Any suspicion of burn injury to the lungs (e.g. through smoke inhalation) is considered a potential medical emergency and the patient should be reviewed by an anaesthetist. First Aid Regardless of the cause, the first step in managing a person with a burn is to stop the burning process at the source, and cool the burn wound (but not the patient. It is essential to avoid the "lethal triad" of hypothermia, acidosis and coagulopathy). For instance, with dry powder burns, the powder should be brushed off first. With other burns the affected area should be rinsed thoroughly with a large amount of clean water. Cold water should not be applied to a person with extensive burns for a prolonged period (greater than 20 minutes), however, as it may result in hypothermia. Do not directly apply ice to a burn wound as it may compound the injury. To help ease pain people may be placed in a special burn recovery bed which evenly distributes body weight and helps to prevent painful pressure points and bed sores. Survival and outcome of severe burn injuries is remarkably improved if the patient is treated in a specialized burn center/unit rather than a hospital. Intravenous fluids Children with TBSA >10% and adults with TBSA > 15% need formal fluid resuscitation and monitoring (blood pressure, pulse rate, temperature and urine output). Once the burning process has been stopped, the patient should be volume resuscitated according to the Parkland formula . This formula is 4 ml lactated ringers x TBSA (total body surface area) % burned x patient weight in kg for first 24 hours, with half this volume given in the first 8 hours. Children also require the addition of maintenance fluid volume. Such injuries can disturb a person's osmotic balance. This formula dictates the amount of Lactated Ringer's solution or Hartmann's Solution to deliver in the first twenty four hours after time of injury. This formula excludes first degree burns, so erythema alone is discounted. Half of the fluid should be given in the first eight hours post injury and the rest in the subsequent sixteen hours. Inhalation injuries in conjunction with thermal burns initially require up to 4050% more fluid. The formula is a guide only and infusions must be tailored to the urine output and central venous pressure. Inadequate fluid resuscitation causes renal failure and death but over-resuscitation also causes morbidity and mortality. All resuscitation formulae should be delivered as a goal directed therapy to prevent the complications of hypovolaemic shock or over-hydration. Wound management The key to the management of all burn injuries is the management of the burn wound itself. The wound is the cause of the morbidity and mortality of burn injuries and until the wound is healed the patient remains at risk of complications. The essential aspects of wound management are an initial assessment, to determine burn area and depth, and then debridement (removing devitalised tissue and contamination), cleaning and then dressings. Burn wounds are painful so analgesia (pain relief) should be given. The management of burns over 10% in children and 15% in adults, and of important areas (hands, face and perineum) is more complex and requires specialist help. Circumferential burns of digits, limbs or the chest may need urgent surgical release of the burnt skin (escharotomy) to prevent problems with distal circulation or ventilation. The wound should then be regularly re-evaluated until it is healed. Wounds requiring surgical closure with skin grafts or flaps should be dealt with as early as possible. One of the major advances in burn care has been the early excision and skin grafting of full thickness and deep-dermal burn wounds. Dressings In the management of first and second degree burns little quality evidence exist to determine which type of dressing should be used. However, silver sulfadiazine is not recommended as it potentially prolongs healing time and biosynthetic dressings may speed healing. Pain management A number of different options are used for pain management. These include simple analgesics ( such as ibuprofen and acetaminophen ) and narcotics. A local anesthetic may help in managing pain of minor first-degree and second-degree burns. Alternative treatments Hyperbaric oxygenation has not been shown to be a useful adjunct to traditional treatments. Honey has been used since ancient times to aid wound healing and may be beneficial in first and second degree burns. Prognosis The outcome of any injury or disease depends on three things: the nature of the injury, the nature of the patient and the treatment available. In terms of injury factors in burns the prognosis depends primarily on the burn surface area (% TBSA) and the age of the patient. The presence of smoke inhalation injury, other significant injuries such as log bone fractures and serious co-morbidities (heart disease, diabetes, psychiatric illness, suicidal intent etc) will also adversely influence prognosis. Advances in resuscitation, surgical management, control of infection, control of the hyper-metabolic response and rehabilitation have resulted in dramatic improvements in burn mortality and morbidity in the last 60 years. Following a major burn injury, heart rate and peripheral vascular resistance increase. This is due to the release of catecholamines from injured tissues, and the relative hypovolemia that occurs from fluid volume shifts. Initially cardiac output decreases. At approximately 24 hours after burn injuries (for patients receiving fluid resuscitation) cardiac output returns to normal, then increases to meet the hypermetabolic needs of the body. Infection is a major complication of burns. Infection is linked to impaired resistance from disruption of the skin's mechanical integrity and generalized immune suppression. The skin barrier is replaced by eschar. This moist, protein rich avascular environment encourages microbial growth. Migration of immune cells is hampered, and there is a release of intermediaries that impede the immune response. Eschar also restricts distribution of systemically administered antibiotics because of its avascularity. Risk factors of burn wound infection include: Burn > 30% TBS Full-thickness burn Extremes in age (very young, very old) Preexisting disease e.g. diabetes Virulence and antibiotic resistance of colonizing organism Failed skin graft Improper initial burn wound care Prolonged open burn wound Burn wounds are prone to tetanus. A tetanus booster shot is required if individual has not been immunized within the last 5 years. Circumferential burns of extremities may compromise circulation. Elevation of limb may help to prevent dependent edema. An Escharotomy may be required. Acute Tubular Necrosis of the kidneys can be caused by myoglobin and hemoglobin released from damaged muscles and red blood cells. This is common in electrical burns or crush injuries where adequate fluid resuscitation has not been achieved. Epidemiology Disability-adjusted life year for fires per 100,000 inhabitants in 2004. no data less than 50 50-100 100-150 150-200 200-250 250-300 300-350 350-400 400-450 450-500 500-600 more than 600 In 1991, burns led to 5,500 deaths in the United States. In India about 700,000 patients a year are admitted to hospital, though very few are looked after in specialist burn units.. About 90% of burns occur in the developing world and 70% of these are in children. Survival of injuries greater than 40% TBSA is rare in the developing world. Gallery Second-degree burn caused by contact with glue at 145 C See also List of burn centers in the United States Further reading Herndon, David (2007). Total Burn Care. Saunders. ISBN 978-1-4160-3274-8. References ^ Burns MedlinePlus Accessed February 25, 2008 ^ Burns Topic Overview WebMD Accessed February 27, 2008 ^ a b Total Burn Care, 3rd Edition, Edited by David Herndon, Saunders, 2007. ^ Total Burn Care 3rd Edition. Editied David Herndon. Chapter1 Accessed January 8 2010 ^ A review of the complications of burns, their origin and importance for illness and death - Abstract J Trauma. 1979 May;19(5):358-69. Accessed February 27, 2008 ^ Burn Degrees Lifespan.org Accessed February 24, 2008 ^ Mertens DM, Jenkins ME, Warden GD (June 1997). "Outpatient burn management". Nurs. Clin. North Am. 32 (2): 34364. PMID 9115481. ^ Burn Practical Management, Nuffield Department of Anaesthesia, Oxford, UK Accessed January 1st, 2010 ^ Determining the approximate area of a burn: an inconsistency investigated and re-evaluated R J Perry, C A Moore, B D G Morgan, D L Plummer BMJ 1996;312:1338 http://www.bmj.com/cgi/content/extract/312/7042/1338?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=1&title=burn+area&andorexacttitle=and&andorexacttitleabs=and&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=date&fdate=//&resourcetype=HWCIT ^ Chemical Burn Causes emedicine Health Accessed February 24, 2008 ^ Chemical Burn Causes eMedicine Accessed February 24, 2008 ^ Hydrofluoric Acid Burns emedicine Accessed February 24, 2008 ^ Electrical Burns: First Aid Mayo Clinic Accessed February 24, 2008 ^ Scald and Burn Care, Public Education City of Rochester Hills Accessed February 24, 2008 ^ Initial management of a major burn: IIssessment and resuscitation S Hettiaratchy, R Papini BMJ 2004;329:101-103 (10 July), doi:10.1136/bmj.329.7457.101 ^ Damage control resuscitation for patients with major trauma J O Jansen BMJ 2009;338:b1778 ^ Chapter 9 TOTAL BURN CARE Ed David Herndon Paperback, 880 pages, publication date: MAY-2007 ISBN 978-1-4160-3274-8 ISBN 1-4160-3274-6 Imprint: SAUNDERS ^ www.dr-green.co.uk/PDFs/Ringer%20and%20Hartmann.pdf ^ Wasiak J, Cleland H, Campbell F (2008). "Dressings for superficial and partial thickness burns". Cochrane Database Syst Rev (4): CD002106. doi:10.1002/14651858.CD002106.pub3. PMID 18843629. ^ Wasiak J, Cleland H, Campbell F (2008). "Dressings for superficial and partial thickness burns". Cochrane Database Syst Rev (4): CD002106. doi:10.1002/14651858.CD002106.pub3. PMID 18843629. ^ Hubley P (July 2009). "Review: evidence on dressings for superficial burns is of poor quality". Evid Based Nurs 12 (3): 78. doi:10.1136/ebn.12.3.78. PMID 19553415. ^ Minor Burns quickcare.org Accessed February 25, 2008 ^ Villanueva E, Bennett MH, Wasiak J, Lehm JP (2004). "Hyperbaric oxygen therapy for thermal burns". Cochrane Database Syst Rev (3): CD004727. doi:10.1002/14651858.CD004727.pub2. PMID 15266540. ^ Jull AB, Rodgers A, Walker N (2008). "Honey as a topical treatment for wounds". Cochrane Database Syst Rev (4): CD005083. doi:10.1002/14651858.CD005083.pub2. PMID 18843679. ^ "WHO Disease and injury country estimates". World Health Organization. 2009. http://www.who.int/healthinfo/global_burden_disease/estimates_country/en/index.html. Retrieved Nov. 11, 2009. ^ Brigham PA, McLoughlin E (1996). "Burn incidence and medical care use in the United States: estimates, trends, and data sources". J Burn Care Rehabil 17 (2): 95107. PMID 8675512. ^ Bhattacharya S. Principles and Practice of Burn Care. Indian J Plast Surg 2009;42:282-3 ^ Potokar T, Chamania S, Ali S. International network for training, education and research in burns. Indian J Plast Surg 2007;40:107 External links Alisa Ann Ruch Burn Foundation Self help guide (NHS Direct) After the Injury- Children's Hospital Of Philadelphia British Burn Association American Burn Association European Burn Association eMedicine Thermal burns article The UK National Burn Care Government Review Changing Faces - UK charity for people with disfigurement Total Burn Care:Website of the world's most famous Children's Burn Unit Burn Survivors Online USA Cool The Burn USA Burnsurgery USA Burn articles in the Indian Journal of Plastic Surgery v d e Foreign bodies, burns, corrosion, and frostbite (T15-T35, 930-959, 991.3) Foreign body In alimentary tract (Bezoar) Other Burn Corrosion Frostbite Categories: Skin conditions resulting from physical factors Medical emergencies InjuriesHidden categories: All articles with unsourced statements Articles with unsourced statements from January 2010 I am an expert from cemobilephone.com , while we provides the quality product, such as Dual Band Mobile Phones Manufacturer , Large Button Mobile Phones Manufacturer, Wrist Watch Mobile Phone,and more.
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