Burns: First Degree
What is it?
A burn is an injury to the tissues of the body. Burns are classified according to the amount of tissue they affect and how deep they are. A first-degree burn is the least serious type of burn because it injures only the top layers of skin, called the epidermis.
Who gets it?
Anyone can get a first-degree burn. It is difficult to say how many people are affected each year because most do not need to seek medical treatment. Children are especially at risk for first-degree burns from hot water that is greater than 120 degrees Fahrenheit (49 degrees Celsius). Children and the elderly are more likely to experience complications from burns.
What causes it?
First-degree burns are most often caused by brief contact with either dry or moist heat (called a thermal burn) or chemicals; spending too much time in the sun (sunburn); or friction (such as by rubbing the skin against a rug or rope). When a burn is caused by hot water or steam, it is called a scald. The most common sources of heat that cause first-degree burns are hot water, cigarettes, hot grease, and hot beverages.
What are the symptoms?
Skin with a first-degree burn is red, sore, and sensitive to the touch. It may also be moist, slightly swollen, or itchy. Sunburns are often accompanied by headache and low fever. When lightly pressed, the reddened skin whitens, which is called blanching. First-degree burns do not blister and do not leave a scar. See a doctor immediately if a burn is on the face, hands, feet, or genitals; is caused by an electrical source; or covers a very large area.
How is it diagnosed?
Your doctor will examine the burned area and classify it according to the amount of tissue affected and the depth of the burn. He or she will ask how the burn occurred. If the patient is a child, the doctor will ask further questions to ensure the patient is not a victim of child abuse. Doctors assess the severity of a burn by determining what percentage of the total body surface area (BSA) is affected. In patients older than nine years, they apply what’s called the “rule of nines” to determine the percentage of BSA. For example, the genital area is considered 1% of BSA. The head and neck are 9%. Burns on each arm, including the hand, is also 9% of BSA. Each leg, including the foot, is 18%. The front of the torso is 18%, as is the back of the torso, including the buttocks. In children younger than nine, the palm of the child’s hand is used as a measure of 1% of BSA. First-degree burns that cover less than 15% of an adult's body or less than 10% of a child's body are considered minor. First-degree burns that cover 15 to 25% of an adult's body, or 10 to 20% of a child's body, are moderate burns. Those that cover more than 25% of an adult's body or more than 20% of a child's body, as well as those on the face, hands, feet, or genitals, are critical.
What is the treatment?
Minor burns can be treated at home. First, remove any clothing or jewelry from the injured area. Then, hold the burned area under cool running water for around 10 minutes to stop the burning process. You can also use a clean towel or wash cloth moistened with cold water. However, don’t use ice or ice water because they will further damage the tissue. You can place a dry, sterile gauze pad over the burn, but do not use any bandages with adhesive. It is important for the bandage to be loose so the burn gets air. Never apply butter or oils. They make it more difficult for the burn to heal and can actually make the burn worse because the heat can’t escape. You can, however, gently wash the area with an antiseptic cleanser and apply an aloe-based cream to relieve pain. Pain relievers such as acetaminophen, ibuprofen, or aspirin can help with inflammation and pain, and should be used according to directions. Never give aspirin to a child under the age of 18 because of the risk of a serious illness called Reye’s syndrome. Chemical burns are treated a little differently. For liquid chemicals, first remove any clothing or other items that the chemicals have spilled on. Then, thoroughly wash any chemicals off the skin under running water for 15 to 30 minutes. For dry chemicals, use large amounts of water to flush the chemicals from the skin. Never use small amounts of water because they may actually activate the chemicals. If no water is available, use a clean cloth to brush any dry chemicals off the skin. Loosely cover the burn with a dry, sterile bandage. Different chemicals have different effects, so you should always check the chemical label, if possible, for additional directions. Always see a doctor if the chemicals have gotten into the eyes or mouth. First-degree burns usually heal very quickly. The burned skin may peel after a few days, but should not scar. Vitamins C and E, and zinc may help the burn to heal, but should be taken only in safe amounts. Call your doctor immediately if redness and pain do not decrease within a few days; if the redness, pain, swelling, or fever increase; or if there are signs of infection, such as red streaks radiating outward from the burn. Moderate and critical burns should be treated at a hospital. Use the above guidelines for emergency first aid.
Self-care tips
Many burns occur at home and could have been prevented. You can avoid first-degree burns by handling hot liquids and objects carefully. Make sure electrical cords are in good condition, household chemicals are safely stored and labeled, and hot beverages and objects are out of reach of small children. When handling chemicals, wear protective gloves and eyewear, and follow label directions for safe handling. Never wear clothing with long, loose sleeves while cooking or around any type of open fire. Never put a child into a tub unless you have first tested the water temperature. You can guard against burns from hot water by keeping your hot water heater set lower than 120 degrees Fahrenheit (49 degrees Celsius). Children should also sleep in flame-resistant pajamas or nightgowns. Do not smoke, or make sure discarded cigarettes are completely extinguished. Teach your children fire safety and make sure they do not have access to matches or lighters. You can also protect you and your family from burns by making sure you have operating smoke detectors on every floor of your house. Also check the temperature of a child’s car seat or seat belt before buckling the child in. Even these objects can cause burns after a period of time in direct sunlight. Never allow children to handle fireworks without adult supervision. Fireworks are a leading cause of burns and other injuries. You can avoid sunburns by using a sunscreen of at least a 15 SPF rating. Apply sunscreen liberally at least 20 minutes before sun exposure and reapply after swimming or sweating. Avoid spending time in the sun from 10 a.m. to 3 p.m., when the rays are strongest.
http://www.nursingnotesforall.blogspot.com
A fracture is a break or crack in a bone.
Anyone can fracture a bone. Those with low bone density (osteoporosis), bone tumors, certain cancers, or a brittle bone disease called osteogenesis imperfecta are at higher risk for bone fractures. Children and adults who are extremely active and participate in contact sports are also more likely to experience bone fractures. After middle age, women are more likely than men to suffer bone fractures because of diseases that affect bone strength.
Causes of Bone Fracture
A fracture is most often caused by some type of trauma to a bone. This trauma might occur as a result of a fall, physical abuse, motor vehicle accident, or disease. Normal, everyday activities can cause bone fractures in people with diseases that weaken the bones.
Symptoms Bone Fracture
In general, a bone fracture results in pain, swelling, and, sometimes, bruising from internal bleeding. The patient cannot bear weight or pressure on the injured area, and may be unable to move it without severe pain. The soft tissues around the broken bone may also be injured. The area around or below the fracture may feel numb or paralyzed due to a loss of pulse in that area. There are many different types of fractures. These include a closed or simple, fracture, in which the skin around the fractured bone is not broken. An open, or compound, fracture, does include a break in the skin, revealing the bone and making the wound more susceptible to infection. A fracture is called complete if the break is the whole way through the bone, and incomplete (or greenstick) if the break is partial. Greenstick fractures are more commonly seen in children.
Stress fractures are small cracks in a bone that occur over time as a result of repeated activities that put stress on the bone. There are many other classifications of fractures according to characteristics such as where they occur and their appearance. A person can have just one fracture or multiple fractures at the same time.
Diagnosed of Bone Fracture
A bone fracture is diagnosed by a physical examination and x-rays of the injured area. However, some types of fractures are difficult to see on an x-ray. In this case, your doctor may order other diagnostic imaging tests, such as computed tomography (CT), magnetic resonance imaging (MRI), or bone scans. Open fractures require additional laboratory tests to determine whether blood has been lost and if there is infection.
Treatment of Bone Fracture
The treatment for a bone fracture depends upon the type and location of the fracture and the patient’s age and medical history. When a fracture is suspected, the affected area should be immobilized to prevent any further damage. Minor fractures can be treated in the office of an orthopedic specialist. Orthopedics is the branch of medicine that deals with the treatment of injuries to or disorders of the skeletal system. More severe fractures, such as those that are open, multiple, or to the hip or back, are treated in a hospital. Most fractures are immobilized with a cast, brace, splint, or sling. If there is severe swelling, your doctor may wait until the swelling has gone down before casting the fracture.
Stress fractures often require no more than rest, ice packs, anti-inflammatory medicines, and temporarily discontinuing the activity that has caused the injury. If a fracture results in the bone being misaligned, the doctor must realign the bone through a procedure called fracture reduction. This may be done manually and/or through traction, which holds the bone in place for period of time using weights and pulleys.
Surgery may be necessary when a fracture is open, severe, or has resulted in severe injury to the surrounding tissues. Severe fractures may require internal devices, such as screws, rods, or plates, to hold the bone in place or replace lost bone during the healing process. Bone grafts, where healthy bone is taken from another area of the body to fill in the fracture, may also be used. The length of time it takes for a bone fracture to heal and the need for physical therapy after treatment depend upon the severity of the fracture and the age and health of the patient.Prevented Mangment
Bone fractures should be treated as quickly as possible to avoid complications and ensure complete healing. Weight-bearing exercise and sufficient amounts of calcium in the diet help strengthen the bones and prevent bone fractures. You can also help prevent bone fractures and other automobile-related injuries by wearing a seat belt when riding in a motor vehicle. People who participate in contact sports should wear appropriate protective gear. Doctors recommend estrogen therapy for women over the age of 50. This, as well as calcium supplements, can help lower the risk of osteoporosis and related bone injuries.
Angina is a temporary pain or tightness that may start in the chest and will sometimes spread to other parts of your upper body. It may start suddenly and may last only a few minutes. Angina will usually occur when there are extra demands placed on the heart, such as during exercise, exposure to extreme hot or cold conditions, windy weather, or during periods of emotional stress. Some people may develop angina at rest or after eating large meals when blood flow must increase to aid in the digestion of foods.
Symptoms of Angina
The symptoms of angina may vary from person to person. The symptoms may even vary with each episode. They can include a tightness, pressure, aching, or burning behind the breastbone. This sensation may spread or radiate to the arms, neck, jaw, back, or between the shoulder blades.
Other symptoms may include nausea, sweating, shortness of breath, or weakness.
Causes of Angina
Angina is caused by a shortage of oxygen and other nutrients reaching the heart muscle. The pain of angina is produced when the heart muscle is starved for oxygen, a condition called ischemia.
Angina occurs most often when the coronary arteries of your heart become narrowed or clogged with deposits of fatty plaque-like substances. This disease is called atherosclerosis.
If you think you are having angina, you should follow these steps:
1. STOP what you are doing. SIT DOWN AND REST.
2. If the symptoms are not gone in 2 to 3 minutes, place a nitroglycerin tablet under your tongue and let it dissolve. You may feel a slight sense of stinging or burning under your tongue,this means the nitroglycerin is working to help relieve your angina.
3. Wait 3 to 5 minutes. If your angina is still present, take a second nitroglycerin tablet.
4. Again, wait 3 to 5 minutes. If the symptoms remain, take a third nitroglycerin tablet.
5. If your angina has not subsided after the third nitroglycerin tablet or after 15 minutes since you first began experiencing discomfort, call an ambulance or have someone drive you to the nearest emergency room.
DO NOT IGNORE THESE WARNING SYMPTOMS!!!!
Helpful Hints about Nitroglycerin tablets.
The burning sensation described earlier is not always an indication that the tablet is fresh. The best way to know if your tablets are fresh is to replace them approximately every 6 months.
Another helpful hint is to "check mark" the bottle every time you open it. Once you get to six "check marks" replace the bottle.
All formations of nitroglycerin should be kept at room temperature. The sublingual (under your tongue) tablets are especially susceptible to moisture. They should NOT be kept in bathrooms or kitchens because of higher degrees of moisture there.If carrying nitroglycerin sublingual tablets with you, you may want to check with your pharmacist for devices to aid you in carrying your nitroglycerin bottle (e.g. a metal cylinder on a chain around your neck).
When Should You Contact Your Family Physician?
Call your physician WITHIN 24 HOURS for any of the following:
This is the first time you have ever experienced angina.
You experience angina while resting.
Your angina is occurring more frequently, has changed location, or is more severe than in the past.
The nitroglycerin tablets do not work as quickly as they have in the past.
Your angina has awakened you during the night.
If your angina has reoccurred following a cardiac catheterization, angioplasty, or open heart surgery procedure(s).
What Can You Do to Avoid Angina?
Many people can control their angina by following their medication regimen prescribed by their physician and by making life-style changes that lower the heart's workload and reduce stress. Other things you can do may include:
* Stop smoking (smoking makes the heart work harder)
* Lose excess weight
* Start an exercise program
* Lower your blood cholesterol levels
* Avoid eating heavy meals and rest after eating
* AVOID outside activities on EXTREMELY HOT OR COLD DAYS
* Reduce your stress.
