Syllabus
1.Essential difference between extensive and not extensive burn injury Estimation of factors determining, early outcome, late outcome . 2.Prehospital management, transportation, emergency care : - airway issues, - carbon monoxide intoxication, - release incisions (in deep circumferencial burn on neck), - fluid replacement, - relieve of pain + anxiety (analgesia + sedation), - cooling in not extensive burns, cooling in extensive burns 3.Pathophysiology of burn shock : stress reaction, burn edema, hypovolemia, SIRS, MOFS 4.Burn wound care: - release incisions (extremity perfusion, chest expansion), change of dressings , hydrotherapy, topical antibacterial creams temporary wound coverage: skin substitutes (biologic,synthetic) , removal of necrotic tissues: necrolysis, necrectomy, permanent wound closure: autografting, isografting, artificial skin (integra,dermagraft,alloderm) 5.Inhalation Injury: - pathophysiology, diagnosis: upper airways, lower airways , treatment: endotracheal intubation, tracheostomy, complications (early, late) 6.Electrical injury: - pathophysiology (electrical field - electroporation + Joule effect), diagnosis: voltage, cardiac arrest + EKG,loss of conciousness,pigmenturia,X-ray (scull,chest,spine,long bones, pelvis) 7.Cold-induced injury: frostbite: - pathophysiology,classification, treatment 8.Chemical injury: - mechanisms of action , chemical classes (acids,bases,organic compounds inorganic agents) 9.Hypertrophic scars + keloids: - characteristics + evaluation, compression therapy: elastic pressure , rigid pressure, silicone gel sheets , steroids (Triamcinolone acetonide) 10.Reconstruction: - early (urgent) - periorbital region, perioral region + neck , late (after scar maturation) - hand ,foot ,trunc + genitalia 11.Child neglect,child abuse,Münchhausen syndrome by proxy 12.Pain response,psychiatric disorders
Annotation
Students learn the basic difference between the extensive (major) and not extensive (minor) burns and all the factors important for estimating severity of burn injury (early and late prognosis). There is printed out significance of the prehospital care (transport, securing ventilation and oxygenation, analgesia and sedation, fluid replacement, urgent procedures).
There are explained principles of burn wound care (indications and methods of conservative treatment, indications and methods of surgical procedures). There are indicated peculiarities of electricalinjuries(prognosis often dubious) - high voltage: resuscitation,cardiac complications,renal complications,neurologic complications,contacts and pathway of current - low voltage: risks related to contact - electrical arc: depth of burn wound,surgical treatment,late results.
Specific features of chemical (caustic) injuries and intoxication. Cold injuries:local (post bite),risks of general hypothermia.
Paediatric burns require different approach:in extimation prognosis(survival)in longtherm outcome(quality of life). Particularities of reconstructive surgery in burn scar deformities: - urgent procedures - surgery following physiotherapy (maturation of scars).
Students learn to comprehend psychic derangement starting with the mechanism of injury and changing according to psychological care of burn team and of family background.