Trupkovic T, Giessler G
Abteilung für Anästhesie, Intensivmedizin und Schmerztherapie, Berufsgenossenschaftliche Unfallklinik Ludwigshafen, Ludwigshafen.
Anaesthesist. 2008 Sep;57(9):898-907. doi: 10.1007/s00101-008-1428-5.
Severe burn injuries are rare and represent less than 1% of all medical emergencies. At the scene of the accident self-protection is important. The progress of thermal injury should be stopped, while cold water therapy is usually not indicated as the resulting hypothermia severely reduces the prognosis. A thorough body check reveals the burn size, depth and presence of co-injuries. Volume depletion is the main pathophysiological reason for burn shock. Early infusion therapy is of prognostic significance. Sufficient analgesia has to be established. Intubation is not generally indicated even with extensive burns, whereas early intubation can be life-saving in the case of circular thoracic burns, face burns and inhalation trauma. Local or systemic administration of corticosteroids is not indicated. Transfer to a specialized burn unit depends on burn size and depth. Emergency room management includes stabilization of vital functions, evaluation of co-injuries and initiation of the specific surgical and intensive care therapy.
严重烧伤很少见，占所有医疗急症的比例不到1%。在事故现场，自我保护很重要。应阻止热损伤的进展，而通常不建议进行冷水疗法，因为由此导致的体温过低会严重降低预后。全面的身体检查可确定烧伤面积、深度以及是否存在合并伤。血容量减少是烧伤休克的主要病理生理原因。早期输液治疗具有预后意义。必须建立充分的镇痛措施。即使烧伤面积广泛，一般也不建议进行插管，而对于环形胸部烧伤、面部烧伤和吸入性创伤，早期插管可能挽救生命。不建议局部或全身使用皮质类固醇。是否转至专业烧伤病房取决于烧伤面积和深度。急诊室管理包括维持生命功能稳定、评估合并伤以及启动特定的手术和重症监护治疗。
