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烧伤的紧急治疗。

Emergency treatment of burn injury.

作者信息

Baxter C R, Waeckerle J F

机构信息

Department of Surgery, University of Texas Southwestern Medical School, Parkland Hospital, Dallas.

出版信息

Ann Emerg Med. 1988 Dec;17(12):1305-15. doi: 10.1016/s0196-0644(88)80356-1.

Abstract

Emergency physicians often encounter patients who have suffered burn injuries. Most are minor in nature but approximately 100,000 a year are true emergencies. Regardless of severity, the emergency physician and staff must possess the evaluative skills and knowledge of current treatment regimens to appropriately treat these patients. Burn injuries are classified according to extent of body surface involved and depth of skin injury. This classification, together with an understanding of the pathophysiology based on the source of injury, will allow categorization and thereby determine initial therapy and definitive management. The treatment of minor burns focuses on three primary objectives: relief of pain, prevention of infection and additional trauma, and minimizing of scarring and contracture. With major burns the first hours after injury are characterized by life-threatening problems. Airway injuries, trauma other than the burn injury, treatment of shock, and pain relief are of the highest priority, overriding the management of the burn wound itself. The care that the minor burn victim receives is critical to ultimate outcome; the care that the major burn victim receives is critical to both immediate survival and ultimate outcome. The emergency physician must provide optimal care to ensure optimal results.

摘要

急诊医生经常会遇到烧伤患者。大多数烧伤情况较轻,但每年约有10万例属于真正的紧急情况。无论烧伤严重程度如何,急诊医生及其工作人员都必须具备评估技能和对当前治疗方案的了解,以便妥善治疗这些患者。烧伤根据体表受累范围和皮肤损伤深度进行分类。这种分类,再加上基于损伤来源对病理生理学的理解,将有助于进行分类,从而确定初始治疗和最终管理方案。轻度烧伤的治疗主要集中在三个主要目标:缓解疼痛、预防感染和额外创伤,以及尽量减少瘢痕形成和挛缩。对于重度烧伤患者,受伤后的最初几个小时存在危及生命的问题。气道损伤、烧伤以外的创伤、休克治疗和疼痛缓解是最优先考虑的事项,优先于烧伤创面本身的处理。轻度烧伤患者接受的护理对最终结果至关重要;重度烧伤患者接受的护理对即时生存和最终结果都至关重要。急诊医生必须提供最佳护理以确保取得最佳效果。

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