Burns
Epidemiology:
US – 2M seek serious burns  70k require hospitalizations, 5k die
Usually caused by careless and ignorance, nearly half are smoking or alcohol -related.
Goal: well healed durable skin with normal function and near-normal appearance.
Pathology
Cutaneous burns – caused primarily by the application of heat to the skin resulting in coagulative necrosis of some or all of the epidermis and dermis.
Depth of burn – depends on heat of the burn source, thickness of the skin, duration of contact, and the blood flow.
Classifications:
Shallow burns
• First Degree – involve only the epidermis; no blisters; painful and erythematous due to dermal vasodilation; erythema and pain subsides in 2-3 days; desquamation occurs in day 4
• Superficial Dermal Burns (Second Degree) - include the upper layer of the dermis; form blisters at the interface of the epidermis and dermis; when blisters are removed, wound is pink and wet, and currents of air passing over it cause pain; wound is hypersensitive and blanches with pressure; if without infection, spontaneous healing in 5% TBSA in any age group
5. Electrical burns including lightning injury
6. Chemical injury
7. Inhalation injury
8. Burns of any size in patients with pre-existing medical disorders that could complicate management, prolong recovery, or affect mortality
9. Burns with concomitant mechanical trauma (e.g. fractures) where the burn injury poses the greatest risk of morbidity and mortality
10. Burns in children if there are no qualified personnel or equipment for pediatric care at the initial hospital
11. Burns in patients requiring special social, emotional, and/or long-term rehabilitative support, including cases of suspected child abuse, substance abuse, etc
Emergency Care
Airway – initial attention must be directed to this; if patient is rescued from a burning building or exposed to a smoky fire, place on 100% oxygen by tight-fitting mask; if patient unconscious, place ET tube attached to a source of 100% oxygen
Once airway is secured, assess patient for other injuries and transport to the nearest hospital. Begin fluid administration of crystalloid solution at a rate of approximately 1L/h. Wrap patient in clean sheet, remove constricting clothing and jewelries.
Cold application is used in smaller burns, particularly scalds. Ice should not be used.
Assessment of Inhalational Injury - suspect for patients with a flame burn, esp in enclosed space. Hoarseness and expiratory wheezes are signs of potentially serious airway edema or smoke poisoning; inspect mouth for swelling, blisters, soot; copious mucus production and carbonaceous sputum are signs of smoke inhalation and other products of combustion; get ABGs and carboxyhemoglobin levels (if >1, smoke inhalation)
Determining the seriousness and appropriate treatment of a burn requires its classification. Burns are classified according to three factors, the depth and number of affected tissue layers, the total percentage of the body surface that is involved, and the presence of homeostasis disruption or destruction such as respiratory distress, fluid loss, or loss of blood pressure control (Patton & Thibodeau, 2014). According to Mr. MacPherson’s appearance and symptoms, his burns are classified as second-degree or partial-thickness burns. The evidence for this diagnosis according to Patton and Thibodeau (2014), are his presenting symptoms of severe pain and the appearance of blisters, edema, and fluid loss. This type of bur...
may last one to three weeks. In many cases new clusters of blisters appear as
There are many causes of accidental death in the United States, one of the most commonly seen are burn injuries. Burn injuries can effect a victim both internally (lungs) and externally (skin), they are so serious that many major hospitals have a burn unit area solely for the treatment of burn victims. In this research paper we will discuss the important issues dealing with the injuries of a burn victim such as the etiology, epidemiology, pathophysiology, complications and treatment.
The best way to treat a severe burn is for it to be cleaned and covered in a critical amount of time. Many types of coverings can be used to get the job done. Currently, surgeons agree that the patients own skin is the best form of covering the burn wound. By taking skin from another body part, the burn wound can be covered with the transplanted skin. This process is called auto grafting. Auto grafting can't be done for those patients who have burns covering the majority of their bodies. So, there has to be another way for covering their burns. An additional possibility is called an all graft, the process when the burn is covered with cadaver skin. Cadaver skin is sometimes in short supply so animal skin might be used in place of it. The use of animal skin or Xenografting is sometimes avoided because the patient's immune system could reject the skin and have to be removed.
...am Victorian society, sexual liberalism transformed the ways in which people arranged their private lives. Shifting from a Victorian environment of production, separate sexual spheres, and the relegation of any illicit extramarital sex to an underworld of vice, the modern era found itself in a new landscape of consumerism, modernism and inverted sexual stereotypes. Sexuality was now being discussed, systemized, controlled, and made an object of scientific study and popular discourse. Late nineteenth-century views on "natural" gender and sexuality, with their attendant stereotypes about proper gender roles and proper desires, lingered long into the twentieth century and continue, somewhat fitfully, to inform the world in which we live. It is against this cultural and political horizon that an understanding of sexuality in the modern era needs to be contextualized.
The first accident occurred on a 61-year old woman who was at a follow-up appointment after a breast tumor was removed. She felt a burning sensation and told the operator “you burned me”. She developed swelling and reddening, but the AECL declared this a normal treatment reaction and not a machine malfunction. Her condition wor...
“Living with Burn Trauma,” an online article, states that “human skin is the largest organ of the body.” It provides many functions which assist humans to survive. What happens if this vital organ is destroyed? This is a question with which thousands of Americans are challenged annually. In the United States alone, 4,000 people die in burn accidents or from complications of burn injuries (“Prevention”). One common misconception is that burn victims have all come into contact with flames. Burns result from fires, electricity, hot liquids, chemicals, and even ultraviolet rays. Seeking medical attention for a proper diagnosis is critical to ensuring quality treatment and management of burns. Burn Centers have been established to help patients adapt to life after burns, which can be a great challenge. In today’s society, hospitals and medical professionals can treat burn victims, but the best remedy for burns is prevention.
“…sex attains meaning in social relations, which implies that we can only make appropriate choices around sexuality by understanding its social, cultueral and political context.” (Quote: 9293 jeffrey weeks)
Sexuality gained a connection to the truth. This results into the idea that sexuality is a part of identity and a key aspect in understating who we are individual. And all of this is only possible due to the discourse of sexuality, which is determined by social culture and time. However, the idea that sexuality objectively defines who you are is false, because the idea where this is based on, the “repressive hypothesis” also is
Sexuality is a fundamental part of our self-discovery, involving much more than just being genetically or anatomically male and female and it is not defined solely by one 's sexual acts (Ministry of Education 1989, p.79 cited in Gourlay, P 1995). The notion that sexuality is fixed and innate disregards the social aspects that impact ones’ sexualities. Gagnon and Simon (1973) further commented that sexuality is a feature of social
With the constant representation and naturalization of the discourse, heterosexuality is an identity assumed unconsciously. Heterosexuality is experienced so frequently is it no longer witnessed. It has become normalized. A simple way of explaining this process is the naturalization of sexuality. There is the continual framing of what sexual practices are natural based upon people’s biological and instinctual need to reproduce. In other words, sexuality isn’t deemed to be an exercise of agency, rather it is implemented as person’s identity from birth similarly to gender. The notion heterosexuality stems primarily from a biological sense of reproducing gives way to the mentality of it being the norm because that’s how the body was designed to work. However, this theory is socially constructed. The discourses of science explaining sexuality are produced by institutions to reinforce and maintain their power. This power conservation is demonstrated by heterosexuality’s dominance in the media, privileges deriving from heterosexuality and the correspondence between heterosexuality and gender. Heterosexuality is the identity that can’t be
Some of the most controversial issues in society have historically revolved around matters relating to gender and sexuality. As gender plays an integral part in how we function in society, we quickly learn what is expected of us through our gender roles at a young age and our sexual scripts as we get older. We are expected to conform to our respective gender roles of femininity or masculinity depending on the sex we were assigned at birth. We learn that certain characteristics and expressions are attributed to each gender but are never taught that gender is fluid but instead it is binary. We also become subjected to assumptions of our sexual desires and attraction based on our sex and our gender and are expected not to deviate from it. We become
... decades ago. This book is one that will allow the reader to view many aspects of sexuality from a social standpoint, and apply it to certain social attitudes in our society today, these attitudes can range from the acceptance of lesbian and gays, and the common sight of sex before marriage and women equality. The new era of sexuality has taken a definite "transformation" as Giddens puts it, and as a society we are living in the world of change in which we must adapt, by accepting our society as a changing society, and not be naive and think all the rules of sexuality from our parents time our still in existence now.
Sexuality has always an issue of conflict and debate. Who controls sexuality, and is male and female sexuality really distinguishable. People have always been having sex; for reproduction and for pleasure. Even though it is a women’s and a man’s rightful claim to this intercourse women tend to feel as if sexuality is against them. This would also be contingent on the type on society one lives in. In some societies the mere topic of sex is tabooed and the subject is not confronted with clarity, meanwhile in other societies it is encouraged, praised, and advocated to speak about it openly. Sexuality in The Handmaid’s Tale by Margaret Atwood was one that was tabooed and against the strict, empowering rules of the Gilead state. Sex was forbidden for men and women; but women were the ones who reproduced the babies. Therefore, they were forced into having sex with no pleasure to conceive children. In Brave New World by Aldous Huxley, sex for only sexual pleasure is what society actually strived at. The feeding of the physical as being more essential than anything else that can bring about happiness and repress the truth.