Nadia burns her hand

Nadia burns her hand

1. Nadia runs a fast food shop. One friday she spilled hot oil on her hand. she did not take a day off and only used painkiller and dressing.

   • the next day she went to health care, the doctor found she have a burn and pain persistent, unable to use hands and swollen, tender and red, blisters, bullae, necrotic cells.
     • doctor informed her she have 2nd degree burn
       • degree of burn injury
         • 1st degree
           • erythema , pain , absence of blisters , not life threatening , do not require IV fluid replacement , totally heal in few days
         • 2nd degree
           • red or mottled appearance , swelling , blister formation , the surface may have weeping , wet appearance , painfully hypersensitive even to air current .
         • 3rd degree
           • appear dark & leathery , the skin may appear translucent , mottled , or waxy white , the surface may be red & does not blanch with pressure , the surface is painful & generally dry , healing may be from edge but mostly needs skin graft .
         • 4th degree
           • involves the subcutaneous tissues , fat , tendon , muscles , fascia ,nerves , vessels & bones
       • after few days, the pain increased all the way to her armpits. she had fever. she went to doctor and he found her temp was 38 C
         • doctor told her: the burn appears infected that is caused by pathogenic bacteria
           • Burn wounds are dynamic and need reassessment in the first 24-72 Hours, otherwise bacteria invasion will occur.
             • Impaired cellular immunity also humoral immunity defect , leading to local infection if severe can leads to sepsis & septic shock .
           • doctor took a wound swab from infected site to determine the cause of infection.
             • why we do wound swab?
               • To identify organisms in wounds known or suspected to be infected.
               • As part of screening programmes to identify patients who may be carrying infections without displaying any signs or symptoms.
             • he recommended antibiotics to her. And gave her penicillin injection based on Nadia's request.
               • what are antibiotics
                 • of antimicrobial drug used in the treatment and prevention of bacterial infections. They may either kill or inhibit the growth of bacteria.
                 • they don't treat infections caused by viuses.
                 • antibacterial resistance?
               • one week later nadia got better
                 • 6 months later, the doctor noticed the site of burn is elevated, thick, and itchy, and the doctor told her thats the normal body response to a burn and gave her an ointment
                   • management and assessment
                     • to assess amount of fluid loss
                     • first Aid for burns
     • what is burn?
       • cell death caused by intense by many factors
         • its effect:
           • social
             • body image disorder
             • avoiding coping or -ve coping
             • sexual issues
           • physical
             • scar formation
             • disability
       • types?
         • Thermal
           • fire, boiling water or oil
         • Chemical
           • acids and alkaline
         • Electrical
           • by high voltage or Low voltage
         • mechanical
           • friction
         • radiation
           • depends on dose and type of radiation.
       • necrosis vs apoptosis
     • what is blister?
       • a small sac containing liquid or gas with diameter 0.5 cm or less
         • if it was large its called
           • bulla which is larger than 0.5 cm

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