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1、.word格式整理版烧烫伤的程度划分一、I度烧烫伤（红斑性烧伤）：伤及皮肤表皮，表现为受伤处皮肤轻度红、肿、热、痛，感觉过敏，无水泡 ；3-7 天愈合，不留瘢痕。二、（1）浅II度烧烫伤（水疱性烧伤）：伤及真皮乳头层，水疱较大，疱壁厚，基地潮湿，表现为受伤处皮肤 疼痛剧烈、感觉过敏，有水泡 ；水泡拨离后可见创面均匀发红、潮湿、水肿明显；2周愈合，不留瘢痕，可有色素沉着。（2）.深II度烧烫伤：伤及真皮深层，创面水疱较小、疱壁厚，去皮后基地红白相间，可见网状血管栓塞。表现为受伤皮肤痛觉较迟钝，可有或无水泡，基底苍白，间有红色斑点；拔毛时可感觉疼痛；3-4周痊愈，留有瘢痕。三、III度烧烫伤(焦痂
2、性烧伤)：伤及皮肤全层，达肌肉或骨骼层，皮肤感觉消失，无弹性，干燥，无水泡， 蜡白、焦黄或碳化；拔毛时无疼痛。严重的烧伤不仅损伤皮肤，还可深达肌肉、骨骼甚至引起全身变化如休克感 染等。愈合慢，愈合后疤痕增生。Burn ClassificationNote: The list below shows 4 burn degrees. While most of the public does not recognize the 4 th degree, it is the correct term. The table below, with 3 degrees, is also correct.
3、 Both are acceptable.Determining burn depth is important. Things to consider are temperature, mechanism, duration of contact, blood flow to skin, and anatomic location. Epidermal depth varies with body surface, which can offer varying degrees of thermal protection. Older adults and young children al
4、so have thinner skin.First degree:Includes only the outer layer of skin, the epidermisSkin is usually red and very painfulEquivalent to superficial sunburn without blistersDry in appearanceHealing occurs in 3-5 days, injured epithelium peels away from the healthy skinHospitalization is for pain cont
5、rol and maybe fluid imbalanceSecond degree: Can be classified as partial or full thickness.Partial thicknessBlisters can be presentInvolve the entire epidermis and upper layers of the dermisWound will be pink, red in color, painful and wet appearingWound will blanch when pressure is appliedShould he
6、al in several weeks (10-21 days) without grafting , scarring is usually minimalFull thicknessCan be red or white in appearance, but will appear dry.Involves the destruction of the entire epidermis and most of the dermisSensation can be present, but diminishedBlanching is sluggish or absentFull thick
7、ness will most likely need excision & skin grafting to healThird degree:All layers of the skin are destroyedExtends into the subcutaneous tissuesAreas can appear, black or white and will be dryCan appear leathery in textureWill not blanch when pressure is appliedNo painFouth degree: Full thickness t
8、hat extends into muscle and bone.FirstSecond(Superficial or Deep)Thind (Full Thickness)Depth (how deep the burn is)EpitheliumEpithelium and top aspects of the dermisEpithelium and dermisHow tie wound looksNo Nisters； dry pinkoozing blisters; IVfoist, white, pink, to redLeathery； dry, no elasticity:
9、charredSunburn, scald1g酬 flarneScalJrflah Bums, cnemicalsConiactwith flans, hot surface, hot liquids, chemical, electricLevel of Pa in (serisationPainful, tender, ana soreery painfulr电iy little pain, or no painHealing TimeTwo to tue flays: peelingSuperficial. five to21 days. Deep: 21-35 daysSmail ar
10、eas ma/ take months to heat; lares 2 re as need grafting.ScarringNo scarring: ma have discolors tic nMinimal to no scarring: may dis col orationScarring presentBurn injury is the destruction of the layers of the skin and associated structures.范文.范例.参考分享.word格式整理版范文.范例.参考分享Anatomy of Skin:The Skin/ S
11、ensory Nerve Ending小 Nerre-Dennis-Subciifaneous TissueCapillariesArterioleSw/eat GlandMuscle Fat, Collagen, Fibroblasts皮脂腺真皮神经汗腺导管Liwrw -hf4 AmI毛囊hvrMk*r汗腺ww4 立工肌WMK脂肪细胞推脉WR动脉Types of Bum InjuryThermalFlash Exppsi 口 ns of natural gms, propaie. gd5oline andcttisrHannTatjle I quids ht&nbt heal for ave
12、r bri0f ?4riDd or time. CIctNng is 口rY*cti汨 urilis it nit熊.Flame - Exposure to pro on seo. intense heal. House nresjm proper use oTnammaoi&iiqjias. auto nob le accl cents, ignited cothin c from stive theater;.Scalds-Burns caused bi hotliquds. /.aler. nil. crease. tarr ol. Water at 140 decrees F. aea
13、les a deec burn in 3 secands, Out dt 156 degpeE5 T will GcUsettieSame irjur in 1 aecard. (Soffee is 16D degrees just treiAfef) CircuTifer&ntial burns should ra er suspiacn ofnon-acciderta! traurra -ar reads to be lenced ei：ner w/itrian adhesive rsnoti sciiuiicn oi petroleumdressingsContact Result To
14、m h-st metal5, plastics方营。r口l$,匚鼻n 匕ggry d目ep.ChemicalCaused by stronc acids w alkali substances. Thev continue to cause damage untilttie aaemtis inacVvated. Alkali sutslances usudlljr cduse morw &ewre injury sirce thy isad witu the Ipids in tie skin.ElectricalCmuw 0dl by either AC 3 DC ctirrnL Curr
15、eM foil owe fht pathisi-tdnc and caucus irijury in arassotne rtnanre contacte ntiy site, in ey car not ce jucig ed irom tne ext&nai inury am rw. men vol 仲 ge 1,000 vots. lew voltage _ 1,000 /Ms and lightening.匚 ectncal sums are Ihermal sums from ver/ high heat.F! ad logicalGauses Dy alpria beta or g
16、amma radiaton- mey may need io nave some t/pe of aecoritaminanon aonetc stop the injjR烧伤的致伤原因1,热力（热水、蒸汽、火焰）2,化学物质（强酸、强碱）3,电4,放射线烧伤的病理生理分期1,休克期：伤后48-72h内-大量体液渗出，2-3h最快，8h达到高峰，48h开始回吸收，此期易发生低容量 性休克。2,感染期：72h后-皮肤生理屏障被破坏。创面、渗液黎宇细菌生长繁殖，产生毒素。感染烧伤创面脓毒症。3,修复期：伤后5-8天开始-I度烧伤，3-7天自行修复。浅II度烧伤，2周愈合，有色素沉着。深II度烧伤,
17、3-4周愈合，留有瘢痕。III度烧伤，靠皮肤移植修复，留有瘢痕，影响功能。临床表现和诊断1,烧伤面积：手掌法：伤员本人五指并拢的手掌面积为体表总面积的1%,五指自然分开的手掌面积为1.25%,适用于小面积烧伤的评估。2,九分法:at九分漆标推部位而积儿童面积发都3%线整直都3%1乂 9% =9兆9品十门龄）呢莓邰3%双上苣8%而上瞄取前臂歌18*球手躯干前面13瞩*干堇平后面 金阴】观1 乂3父日2伍21%击牌5%取大腿21%两下附双小腱13%舶髭46 %-。2-年龄）%不足1%建工.L学因丹都青款帕叶够人,曲F型瑁时较如，应根器隼龄计中3.word格式整理版烧伤的严重程度：根据烧伤深度与面积
18、判断轻度烧伤：n 0面积9%中度烧伤：II 面积10%-29%m0面积不足10%重度烧伤：总烧伤面积达30%-49%或田面积达10%-19%IT、烧伤并休克、吸入性损伤特重烧伤：总烧伤面积50%m0 20%已有严重并发症吸入性损伤诊断依据：* 吸入火焰、蒸汽、浓烟等* 燃烧现场相对封闭* 口鼻周围、面、颈部有深度烧伤* 呼吸道刺激症状：声哑、呼吸困难、哮鸣音、咳炭末样痰特殊类型烧伤的特点1,电击伤：入口”损伤比出口 ”严重入口 ”皮肤焦裂样洞穴出入口之间深部组织不规则进行性坏死局部反应重、全身反应轻2,化学烧伤硫酸、硝酸、盐酸、石碳酸等少见水疱皮革样焦痂创面蜡白/青灰色疼痛剧烈范文.范例参考分享