Burn shock is a pathological post-traumatic condition requiring urgent medical anti-shock measures. The shock state after a burn occurs as a response of the sympathetic and nervous systems of the human body in response to the severe pain accompanying burns. Post-burn shock occurs in several stages and progresses rapidly. It is extremely important to provide the sick child or adult person with urgent help in case of burns.
Consider the degree of burn shock, its causes and treatment in children and adults.
CONTENTS
Burn shock: causes of
shock occurs upon receipt of burn skin lesions, affecting about 10% and more of the area over its entire surface. Burn shock can be difficult to recognize at an early stage.
This shock state, according to clinical manifestations, is very similar to the shock of traumatic etiology, but it has features. The main cause of burn shock is the strongest pain impulse acting on the brain - the central nervous system of the victim.
Shock condition development mechanism:
- When a foreign threat arises, the human body is reconstructed in such a way as to protect the vital organs as much as possible, such as the brain, heart, liver, lungs.
- For this, he begins to intensively supply them with oxygen, sending there the bulk of the blood circulating through the blood vessels. There is a so-called centralization of blood circulation.
- The blood supply of secondary organs is practically stopped.
- As the total volume of blood run through the vessels drops, in systems and organs the synthesis of various chemicals and, above all, norepinephrine is activated.
- During this process, the heart load increases and the normal activity of the kidneys is weakened, which leads to a delay in the tissues of the fluid and, consequently, to the appearance of edema.
Differences in burn shock from traumatic
Burn shock, unlike traumatic shock, has a number of peculiarities in the clinical course and ways of destructive effects on the body:
- The constant and over-intensive flow of nerve impulses coming from burned skin surfaces and from soft tissues in the central nervous system is the strongest source of activation of both the nervous and endocrine systems.
- Against the backdrop of painful afferentation, the patient has a strong motor, speech and emotional arousal. In this case, the metabolism in all tissues and organs becomes many times more active.
- Severe pain creates a general overvoltage in the body, so the response protective reactions of adaptation quickly go out. This explains the shortness of time in the first stage of shock.
- The condition is characterized by a significant intoxication in the body and severe hemodynamic disorders.
- The sources of intoxication are toxic microorganisms, biologically active substances, which are synthesized in the case of tissue damage, as well as a violation of the spatial structure and enzymatic decomposition of protein molecules.
- Kidney damage can be observed due to weakening of their blood supply and release of hemoglobin from red blood cells.
- Against the backdrop of extensive loss of blood plasma, dehydration of the body occurs. This increases the permeability of the vascular walls, mainly in places of burn damage.
- As a result of dehydration, the viscosity of the blood increases, a threat of thrombus formation appears.
In case of a shock condition that has arisen after getting burns, there is practically no blood loss, but the water-electrolyte and acid-base balance is severely disturbed!
Actually, the shock process is a protective reaction of the body and has the purpose to save a person's life. However, to remove the victim from the shock should be as soon as possible, since a long stay in this state can lead to his death.
Burn shock: severity
Burns distinguish three stages of shock in severity:
- Light.
- Heavy.
- Extremely heavy.
The average shock for burns lasts from 3 hours to 2 days! Sometimes it can last up to three days!
Light degree of shock state
If the burn affected less than 20% of the area of the skin, you can talk about a slight shock. A mild stage is also characterized by deep burns, even if they occupy less than ten percent of the body surface.
Patients with this thirst, often nausea, vomiting. They are shivering, muscles are trembling, undamaged parts of the body turn pale, the effect of "goosebumps" appears. However, in general, the victims are calm, their blood pressure and breathing are normal, the pulse is somewhat faster.
Severe state of shock
When more than twenty, but not more than sixty percent of the body's surface is affected, a severe shock burn occurs. Despite the severe soreness in the burn area, people tend to be conscious.
Symptoms that are characteristic of mild shock are intensified, as the general condition of the patient is severe. At this stage, the temperature of the body and the blood pressure drop somewhat, the breathing becomes faster, the pulse can reach up to 130 beats per minute.
In blood tests, there is a pronounced lack of sodium and an excess of potassium. Urine is excreted in the body in insufficient quantities, it contains blood particles and high protein content.
Patients at this stage may experience a hindered state, which is followed by a strong arousal.
Extremely severe
With a burn that has captured more than 60% of the body, the state of shock becomes extremely severe.
In order for a person to get a severe shock with deep burns, it is enough for them to spread to forty percent of the skin.
Due to dehydration of the body, the need for fluid in patients is very strong, they drink up to 5 liters of water per day.
Pale skin gets a marble shade, turning into cyanosis. There is shortness of breath, severe drop in body temperature and blood pressure. The pulse is barely palpable, its character is threadlike.
The concentration of hemoglobin in the blood can reach 240 g / l. At this phase, patients often lose consciousness, they have seriously disrupted the functioning of all body systems.
In the additional classification, the state of burn shock is divided into:
- erectile,
- torpid
- and terminal phase.
The erectile phase of is manifested by a jump in blood pressure, a rapid increase in respiration and pulse, and a general excitement. The torpid phase of develops over a period of two to six hours and is characterized by inhibition of the patient and all his reactions. The terminal state precedes a lethal outcome.
Burn shock: first aid, principles and algorithm of rendering
Emergency care for a victim with a burn shock consists in the correct provision of the first pre-medical and medical care.
Before the arrival of doctors to be able to provide first aid to a person who has received a shock as a result of a burn, it is necessary to perform a number of necessary actions:
- First of all, it is necessary to release the burnt skin of the victim from the remnants of hot clothes. To do this, clothes should be cut and removed from the body of a person. However, to remove clothes from the patient in the usual way is by no means impossible! This can aggravate the shock and provoke great damage!
- Then you need to estimate the size of the burned area. As a measurement standard, the palm is usually used, since the human palm area is about 1 percent of the total surface area of the skin. Then apply the so-called "rule of the nine", according to which the area of the head and neck, as well as each arm, hip and shin of the person is 9% of the body surface, the external genitalia occupy about one percent, and the anterior and posterior surfaces of the trunk each18% of the area. The depth of the burn should be determined visually.
- In the third stage, measures should be taken to prevent infection of the burned areas of the body. To this end, a disinfectant dressing impregnated with a solution of furacilin or novocaine is applied to the burn sites. If the area of the burn wound is large, you can use a sterile sheet or diaper for aseptic.
- To relieve pain, the patient is given painkillers and antihistamines. The latter help a person to calm down and reduce vomiting. As analgesic drugs are used, as a rule, analgin, dimedrol, droperidol, seduxen. If conventional analgesics do not help, drugs( morphine, omnepon, promedol) are used. HAVE AS WELL, all medications should be administered intravenously! Since the absorption of drugs through the tissues with burn shock is disrupted, intramuscular or subcutaneous injections are not effective enough!
- In parallel with the introduction of drugs, the victim should maximally provide fresh air.
- In the absence of vomiting, it is recommended to give a drink to a sweet hot coffee or tea, and also to drink an aqueous solution of table salt or soda or alkaline-enriched mineral water.
- The person who received a burn shock should be warmed.
The emergency medical team called to the victim will continue carrying out activities that relieve severe pain, finding out what caused the burn injury and how long it has been since it was received.
Doctors use for the anesthesia of Novocaine blockades and analgesics of a narcotic nature. Also, doctors will administer to the patient intravenous sedatives and medications to support cardiac activity. In case of burn shock, haemodes, polyglucin and reopolyglucin, and euphyllene are commonly used. Immutability of the injured limbs of the patient and inhalation of the lungs with oxygen is surely ensured.
After taking all the urgent measures, the patient is taken to the intensive care unit of the hospital or a specialized burn center. Transportation of the patient is carried out with all caution. During transportation, the injured person is in a lying position on the part of the trunk that is intact by burns.
The main task of emergency physicians is to remove the pain syndrome and maximize the recovery of the circulating blood in the body!
Burn shock: treatment and prevention
In the treatment and prevention of burn shock - the main activities consist in the necessary maintenance of vital functions.
Since the shock of a burn is characterized by pronounced pain, hypovolemia( decrease in the amount of blood moving through the vessels), and hemolysis( destruction of red blood cells), the goal of anti-shock therapy is:
- Pain relief.
- Reducing emotional stress.
- Decreased intoxication.
- Normalization of hemodynamic processes in the body.
- Return of normal metabolism.
- Restoration of the patient's breathing, his blood pressure.
- Correction of protein deficiency and water-electrolyte balance.
To prevent irreversible changes in the blood, immediately after the patient enters the resuscitation he is injected intravenously every four hours with 5,000 units! This is done with the mandatory control of blood coagulability!
For relief of pain syndrome, along with narcotic analgesics, 2-3 times a day, antihistamine drugs are treated with pifolen or dimedrol.
As a substance that removes excessive excitation, sodium oxybutyrate is used intravenously. This drug does not have a depressant effect on the respiratory center. At the same time, it slightly increases blood pressure and has a mild hypnotic effect.
The drug of neuroleptic effect of droperidol is also used as a sedative and anesthetic. In addition, it prevents vomiting. Introduce the drug together with novocaine solution up to three times a day also intravenously - drip or jet.
In addition to the above, with burn shock, intensive infusion therapy is performed, which uses solutions of glucose, sodium chloride, dextrins, albumin, protein, hemodez, plasma, and other medicinal substances.
Euphyllin is used to relieve vasospasm, which also acts as a diuretic and as a drug that enhances blood flow. Well relieves spasm and a 0.125% solution of novocaine, which is injected intravenously intravenously to 300 milliliters gradually during the day.
To restore the tone of the vascular walls, the patient is prescribed corticosteroid hormones such as prednisolone and hydrocortisone.
Oxygen therapy is performed to replenish oxygen deficiency.
The sign of elimination of shock is the normalization of blood pressure and diuresis of the patient! The norm of diuresis is the departure of the patient's urine in a volume of at least 50 milliliters regularly every hour!
Not everyone who burns gets a shock. The timely assistance provided allows either to prevent the shock from occurring in the affected person, or to stop the process in its easy phase. Timely, competently undertaken anti-shock measures are effective prevention of shock syndrome.
Related videos
Burn shock, intensive care, emergency care
On the video channel "Taras Polovinka".Find out how intensive therapy is performed with a burn shock state.
Reader's review
Ekaterina Alesheva ."There will be no burn disease, immediately you need to put grated raw potatoes to change it every three minutes until the redness and pain come. If the skin is not preserved, the effect will be as after the abrasion scars come off scars will not.
I saved myself, I want to glorify this method when I poured boiling water( half the surface of the body), my family, and I put potatoes on me for 4 hours. It took 5 buckets, I dried in the air( meaning - wound surface) in the room and ran into the kitchen garden to work.
First aid for burns: burns 1, 2, 3, 4 degrees
On the video channel "YEAR FACTS".
Burn - damage to body tissues caused by the action of high temperature or the action of certain chemicals( alkalis, acids, salts of heavy metals, etc.).The severity of the burn is determined by the size of the area and the depth of tissue damage. The larger the area and the deeper tissue damage, the heavier the burn injury is.
Burn center of the AS Vyshnevsky Institute of Surgery
On the video channel "IXVSITE".
Mass injuries in which more than 10 people are injured, burns in flames, steam, explosions of household gas, barotrauma, which damage the integrity of the eardrum, treat those who are considered even hopelessly sick. Doctors produce a whole complex of manipulations: from dressings that are held here twice a week, before skin grafting and plastic reconstructive medicine. Only here there are wards that are designed for patients with a large area and depth of burns.
Into the Burn Center of the Institute of Surgery named after A.V.Vishnevsky gets the most difficult patients from all over Russia. They provide high-tech assistance, but here, among other things, there are still half a century of tradition.
Reader, remember that burns are different, and what is suitable in one case - a light burn, will not work in more complex cases. Call the hospital for a surgeon!
Source of publication: http: //www.operabelno.ru/ profilaktika-i-lechenie-ozhogovogo-shoka-u-detej-i-vzroslyx /
