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Methodology
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Hyperkalemia-induced complete heart block
21-Dec-2014 1Department of Emergency Medicine Shohadaye Tajrish Hospital
Multi-Specialty Care for Second-Degree Pressure Cooker Explosion
31-Aug-2020 Partial and full-thickness burn injuries generally warrant immediate clinical (i.e. body surface area burn assessment
Inspection du second degré
du second degré. Bureau des inspecteurs du second. 2021-2022. Affaire suivie par : Philippe RAMBAUD. Tél : 02 62 48 14 75.
General anesthesia in a patient with asymptomatic second-degree
resting 12-lead electrocardiogram revealed second-degree 2:1 AV block. After discussion with the Although temporary cardiac pacing may be urgently.
HEC BSN 4 Year.pdf
Curriculum for Nursing at degree level was held at HEC Regional Centre Differentiate between delayed and immediate Hypersensitivity. Unit IV:.
Indications for permanent and temporary cardiac pacing
and first-degree atrioventricular (AV) block was seen in the emergency type II second-degree AV block occurs with a wide QRS pacing becomes a.
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Toward a Theory of Stakeholder Identification and Salience
The second question calls for a descriptive theory of stake- question of stakeholder salience-the degree to which managers give.
Clinical P
ractice Multi-Specialt y Care for Second-Degree Pressure Cooker Explosion 30--)30($1 Casey Schukow, OMS-III 1 , pillyIifiXI-ordykeVIrX'XI2 httpshYYdoiXorgY][Xc]fgbY[[]cX]eeafISpartan Medical R
esearch Journal V ol. 5, Issue 2, 2020 CONTEXT Although pressure c
ookers are very common kitchen utensils used in the United States, A@>K38 A8FA EXAMPLE CASE The e
xample patient described in this report was an African American female in her earlyEI:ABD7E7@F766GD;@9F:7EG??7DA8
38F7DEG887D;@9H3DK;@9>7H7>EA8E75
FAONCLUSIONS P
artial and full-thickness burn injuries generally warrant immediate clinical (i.e., body EGD835ODUCTION Found in appro
ximately one-ififth of households, pressure 5 AA=7DE3D7A@7A8F:7?AEF5A??A@>KGE765AA=;@967H;57E;@F:7+@;F76)F3F7E1 *:7E73;DF;9:FGF7@E;>E;@F7@6768ADCG;5=5
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;@67J76 A@' G4$76 D793D6;@9E7 H7D7 4GD@;@ A@63D ?3>F:75 Burn w
ounds are generally classiified by their extent of E=;@>3K K;@9679D77EA8;@F7DH7@F;A@)G
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,8 P artial thickness, or "second-degree", burns involve the 7B;67D?;E3EI 7>>3EF:767D?;E3@63D75>3EE;53>>K5:3D35
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Full thickness, or "third-degree
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5>73@64A@76,7 *:7E74GD@EA8
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7>KFA@AF473EB3;@8G>Schukow C, Nordyke BR. Multi-Specialty Care for Second-DegreeII"ressureIqooker
sxplosionIpurnIwnjuriesXSMRJ. 2020;5(2).doih][Xc]fgbY[[]cX]eeaf as the y may have destroyed dermal nerve ifibers.7 ,9 );@5 74A
76I;F:E53DF;EEG76,7
,10 As mortalit y rates secondary to severe burn wounds have 675D73E76 A H7D F;?73 ?3736FA?7@F3>B:KE; 53>3@6EA5;3>6;EFD7EE11 )53DE?3K5
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7EE12 Hypertrophic scars can be eff
ectively treated with long 35 FA@;6711,12
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75ADF;
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Other po
tential therapies for the management of burn I FADȦ modulators, fat grafting, and laser therapy.13 > F:AG9:;F?3K@A
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As most burns are of
ten occur at a mix of different 67B Figure 1. Pho
tographic images of patient's second-#$&0$$!30-1.-'$03//$02.01.3//$0(&'2 5$0$%2 -#'$050(12+.5$0(&'2'$1$/'.
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EX AMPLE PATIENT DESCRIPTION During the summer of 2020, an African American f emale ;@:7D73D>KF:;DF;7EBD7E7@F76FAGE3FF:7E75 A@63GF:ADOE5
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9?2. 8 ;5E;>H A8:7DFA
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7 5AH7D397 I3E;@;F;3F76 >F:AG9:@7 I7D A55>GE;H76D7EE;@9E?3KD7EG>F;@83EF7D:73>;@9D3F7ED7CG;D;@98
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ADE75A@6679D774GD@E18
The patient was released with prescrip
tions for a 400 ?9<3DA8F:7E;>H 7DEG>836;3L;@75D73?FA473BB>;76A@5
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Figure 2. Tw
o-month follow-up of Patient's Burn -)30($1'. 2.&0 /'1.!2 (-$# %2$0/ 2($-21(&-$#50(2
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e would have liked to have followed-up with F:7B3F;7@F;@F:75>;@;5EAA@7DF:3@FI A?A@F:EI73D7A
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B KDISCUSSION
In this patient
's case, various portions of her lesions were 35 K-:7@53D;@98
y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal3 burns greater than 20% TBSA in adults generally warrant 4GD@53D75
F;A@E15
In adults with sec
ond or third-degree burns greater than *);F:3E477@E:A I@F:3F83;>GD7FA;@;F;3F7;?
?76;3F7SG;6D7EGE5;F3F;A@53@>736FA?K A9>A4;@GD;3;7?GE5>75
7>>E;@GD;@73E3D7EG>FEA8;@ ?A9>A4;@GD;3;7 :7?A9>A4;@;@GD;@7?G>F;AD93@83;> GD7;7 7EB75;3>>KD7@3>3@6G>F;?3F7>K?ADF3>;FK16 '
3D F;3>3@68G>>F:;5=@7EE4GD@I
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7 AA8:;EAD:7DB3>?E16,22
A gain, the "Wallace Rule of 9s" is meant to provide a DAG9:7EF;?3F7A8*)8 AD36G>FEA8;673>:7;9:FI;F:$ D3@97EA847FI
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This assessment of var
ying distributions of TBSA 4DAG9:FA@4 K-;>>;3?E3@6-A:>97?GF:I3E7EE7@F;3>;@:A
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7ADGBB7D3;D I3K3>>A8I:;5:I
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FA?E2-4
Sinc e this patient did not present with any signs of infec F;A@3@6@A=@A
H7>A83@F;4;AF;5BDAB:K>3J;EF3D97F;@9?7F:;
Figure 3. Diagram of the W
allace Rule of 9s. $20($4$#4( /3!+("#., (-(*(/$#( 22 Figure 4. Diagram of "
Android" body shape with //0.
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Af ter we consoled this patient about the extent of her inMulti-Specialt y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal4 jur y and likely risk for permanent scarring, she expressed AB 76EF:;EB3F;7@F
OE>7E;A@E5A@F;@G76FA:73>:7D@7768AD5
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A>>AIGBB:A@75A@H7DE3F;A@EF:;EIA?3@:365
7@F7D67@K;@9FD3@EBADF3F;A@ADR@3@5;3>;EEG7E3E;?B76;@9 835
FADE &GD8GDF:7D 5A??G@;53F;A@E I;F::7D EG997EF76F:3FE:7G@67DEFAA6:7D5 A@6;F;A@3>A@9I;F:F:7 D73EA@;@947:;@6 AGDEG997EF76 FD73F?7@FB>3@ 7>7 ?7@FEEEG997EF76;@F:;EI 7DB3F;7@F?;E5A??G@;53F;A@5AG>65A@
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73@647?AD778875F;H7>K7
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C ONCLUSIONS
P artial and full-thickness burn wounds must be carefully 3EE7EE763@65>3EE;R76;@5>;@;5 43E763@67?7D97@FE7F
F;@9E3BBD75;3F;@9F:7>;=
K;@9$ E>A@9I;F:5A@E;67D3F;A@A8;?
?76;3F7SG;6D7EGE5;F3F;A@@776E8 AD?AD7E7H7D74GD@;@
F;A@E?3K47@77676;@36
6;F;A@FAI
FUNDING
quotesdbs_dbs46.pdfusesText_46
Burn w
ounds are generally classiified by their extent of E=;@>3KK;@9679D77EA8;@F7DH7@F;A@)G
B7DR5;3>ADPRDEF
A>H7A@>KF:7FAB7B;67D?;EA8F:7E=;@6,7 >F:AG9:F:7E7F
KB7EA8>7E;A@E3D7A8
7D3397@FEF:3FBDA?AF7E=;@D797@7D
3F;A@I;F:AGFE53DD;@97
,8 P artial thickness, or "second-degree", burns involve the 7B;67D?;E3EI7>>3EF:767D?;E3@63D75>3EE;53>>K5:3D35
F7D;LBAEGD76,7 *:767D?;E53@478GDF:7DEG453F79AD;L
76;@FA3EGB7DR5;3>ADP
B3B;>>3DKQ>7H7>3@63677BADPD7F;5G>3DQ>7
H7> *:7677B7D 34GD@ B7@7FD3F7EF:7 67D?;E;7 EG
B7DR5;3>67D?;EH
7@F:AG9:67D?3>@7DH7R47DEA8
F7@ D7?3;@;@F35
F ?AEFE75 A@6679D77 4GD@E;@6G5 7 7J
FD7?7B3;@6,7
Full thickness, or "third-degree
", burns involve all layers A8F:7E=;@3@6?3K;@HA>H7G@67D>K;@9EG45GF3@7AGE?GE
5>73@64A@76,7 *:7E74GD@EA8
F7@AH7DF>K3BB73DA@3EB75
FDG?8DA?I:;F7FA4>35=3@63D7>;=
7>KFA@AF473EB3;@8G>Schukow C, Nordyke BR. Multi-Specialty Care for Second-DegreeII"ressureIqooker
sxplosionIpurnIwnjuriesXSMRJ. 2020;5(2).doih][Xc]fgbY[[]cX]eeaf as the y may have destroyed dermal nerve ifibers.7 ,9 );@5 74A76I;F:E53DF;EEG76,7
,10 As mortalit y rates secondary to severe burn wounds have 675D73E76 A H7D F;?73 ?353>3@6EA5;3>6;EFD7EE11 )53DE?3K5
A@FD35F>736;@9FA;?
B3;D76?A4;>;F
KA8F:738875F76D79;A@3@6:KB7DFDAB:;53@6=
7EE12Hypertrophic scars can be eff
ectively treated with long 35FA@;6711,12
ADF;5AEF7DA;6E3D747>;7H76FA675D73E77J57E
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tential therapies for the management of burn I FADȦ modulators, fat grafting, and laser therapy.13 >F:AG9:;F?3K@A
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chological distress a primary concern ;@ @73D>KF:D77CG3DF7DE A836A>7E57@FE 3@636G>FE I;F:E53DD;@9 4GD@I
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76GD7E3@67?B;D;53@F;4;AF;5FD73F?7@FE9,15
As most burns are of
ten occur at a mix of different 67B Figure 1. Pho
tographic images of patient's second-#$&0$$!30-1.-'$03//$02.01.3//$0(&'2 5$0$%2 -#'$050(12+.5$0(&'2'$1$/'.
2.&0 /'15$0$2 *$- %2$02'$/ 2($-21(&-$# 50(2
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2$-".-1$-2are essential f
or the proper care and management of burn I AG@6H;5F;?E16
EX AMPLE PATIENT DESCRIPTION During the summer of 2020, an African American f emale ;@:7D73D>KF:;DF;7EBD7E7@F76FAGE3FF:7E75 A@63GF:ADOE5
FID;EF;9GD7I
77=BD;ADF:7B3
F;7@F:36GE763BD7EEGD75
H7DD7>73E;@9EF73?3@64A;>
;@9 I3F7DA@FA :7DE=;@ ??76;3F7>K38 F7D EG887D;@9 :7D4GD@EF:7B3F;7@F36?;F
F76FA83>>;@9;@FA3EF3F7A8E7H7D76;EFD7EE 3@6D7BADF76 :3H;@9477@ 7E5 ADF76 ;@FA3 5A>6E:A
F>3F7D3>ID;EF;9GD7
7 FADA>35*
7B3?;7,3>;G?F34>7FEFAFD73F:7D3@J;7F
A@6679D774GD@ED7CG;D7EBDAB:K>35F;53@
F;4;A JF7@FA8F:;EIA?3@OE;@3976:7DI A?AD4;6;F;7EI7D7G@D7?3D=34>77
J57BF8AD3PE7H7D7>KAH7DI7;9:FQ4A6K?3EE;@67J$ A8
9?2. 8 ;5E;>H A8:7DFA
F3>4A6KEGD83573D733@6355A?B3@;76I;F:3D73E A8B;@BA;@F 4>776;@9" 7D>;J 3@F;?;5DA4;3>43@6397 93GL
7 5AH7D397 I3E;@;F;3F76 >F:AG9:@7 I7D A55>GE;H76D7EE;@9E?3KD7EG>F;@83EF7D:73>;@9D3F7ED7CG;D;@98
7I7D6D7EE;@9 5:3@97EE;>H
7D EG>836;3L;@7D7?3;@E 3EF3@63D6 FAB;53>3@F;?;5DA4;3>FD73F?7@F8
ADE75A@6679D774GD@E18
The patient was released with prescrip
tions for a 400 ?9<3DA8F:7E;>H 7DEG>836;3L;@75D73?FA473BB>;76A@5
763;>K;75AH7DOO8G>>F:;5=@7EE
"7D>;J43@ 6397G@;FE3EI
7>>3E3BD7E5D;BF;A@8AD
?953BEG>7EA8 7@63KE8
KB:3D?35K3@6E:75A@RD?766GD
;@93>3F7D8 ):7I3E6;E5:3D976I;F:;@EFDG5 F;A@EFA8A>>AIGBI;F:3 4GD@5
7@F7D 8AD 8GDF:7D53D7 3@6?3@397?7@F A8:7D I
5;E;A@I3E9G;6764
K D75A??7@63F;A@A8F:7?7D;
F:;5=@7EE4GD@E9D73F7DF:3@
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AG>6 5A?B>;53F7 ?3@397?7@F3@6 D75AH7DKE:AG>647D78
7DD76FA34GD@57@F7D15
In order to manage the patient
's pain, she was also writ F7@3F:D7763KBD7E5D;B
F;A@A8:K6DA5A6A@7
?9357F3 ?;@AB:7@ ?9;7 %AD5A,;5A6;@F34>7FE;@EFDG5F768 ADA@7B;>>FA47F3=7@GBFAF:D77F;?7E363KAD3>>K*:;EB3;@ ?76;53F;A@I3E BD7E5D;4768 AD :7D38 F7D I7 :36D7
H;7 AD6A5G?7@F76B3F;7@F6DG9E77=;@947
:3H;AD 19 - 7D7H;7I76I;F:F:7B3F;7@F:AIFABDAB7D>KD7
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AG@6E3@6?76;53
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A@RD?76F:3FE:7I3E5A@F;@G;@9FAGE7
Figure 2. Tw
o-month follow-up of Patient's Burn -)30($1'. 2.&0 /'1.!2 (-$# %2$0/ 2($-21(&-$#50(2
2$-".-1$-20$4($5$#"0.//$#/'.2.1 -# &0$$#2./3!+(" 2(.-/$050(2
2$-".-1$-2Silvadene and w
et-dry gauze application cy cles over the B:A@73>F:AG9:I A?A@F:E38
F7DF:7;@;F;3>;@5;67@F
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7EE;A@3>E3FF:7I
AG@6 53D75>;@;5 6;6@A F 47>;7H7 E:7@77676 3@K9D38 F ;@9FA3;6;@F:7D7B3;DA84GD@I AG@6E @EF736E:7E3;6F:7
8 5 7;H76;9GD7
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;@9E3D7GE76A8 5GDD7@5
7A8435F7D;3>;@875F;A@E3FIAG@6E;F7E20
Although w
e would have liked to have followed-up with F:7B3F;7@F;@F:75>;@;5EAA@7DF:3@FI A?A@F:EI73D7A
A@H7DE3F;A@E I7 :36I;F: :7D3;676 ;@93G9;@9 F:;EI
;5EAA@7D8 AG@6E;@B7DEA@I7393;@A887D76:7DIAD6EA838
RD?3F;A@3@67@5
AGD397?7@F35=@AI>769;@9F:3FE:7I3EBAE;F;H
B KDISCUSSION
In this patient
's case, various portions of her lesions were 35 K-:7@53D;@98
y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal3 burns greater than 20% TBSA in adults generally warrant 4GD@53D75
F;A@E15
In adults with sec
ond or third-degree burns greater than *);F:3E477@E:A I@F:3F83;>GD7FA;@;F;3F7;?
?76;3F7SG;6D7EGE5;F3F;A@53@>736FA?K A9>A4;@GD;3;7?GE5>75
7>>E;@GD;@73E3D7EG>FEA8;@ ?A9>A4;@GD;3;7 :7?A9>A4;@;@GD;@7?G>F;AD93@83;> GD7;7 7EB75;3>>KD7@3>3@6G>F;?3F7>K?ADF3>;FK16 '
3D F;3>3@68G>>F:;5=@7EE4GD@I
AG@6E3>EA679D367F:7*KB75
F7;@D7B>357?7@F16 >F:AG9:
F:77 JF7@FA8F:;EB3F;7@FEOIAG@6EI7D7>7EEF:3@
)I 7@F:7>A53F;A@A8:7DIAG@6E3@6:;9:7D>;=
7>;:AA6 A85 A?B>;53F76 :73>;@9E75 A@63DK FA:7D :;9:$
*:7P- AG@6B3F;7@FEFA8AEF7D9G;63@5
7A@I:7F:7DAD@AFD787DD3>FA34GD@G@;F;E;@6;
53F76;9GD7
16 *:7B3>?;EF:7?3;@EF3KA8*)BD76;5
F;A@I:;5:D7BD7E7@FE3BBDA
J;?3F7>K
*);7I;F: AGF;@5>G6;@9F:7R@97DEADF:G?421 +E;@9F:79DA;@3E3@
7 AA8:;EAD:7DB3>?E16,22
A gain, the "Wallace Rule of 9s" is meant to provide a DAG9:7EF;?3F7A8*)8 AD36G>FEA8;673>:7;9:FI;F:$ D3@97EA847FI
77@FA$ 16 &47E7B3F;7@FE
$ :A I7H7D 479;@FA 53DDK 7J57EE I7;9:F 3@6EGD835 73D73E6;EBDABADF;A@3F7>K 16 &@7
EFG6K67?A@EFD3F76
:A F;H7>K3EAB
BAE76FA-
3>>357OE7EF;?3F7EA8
3@623 &4
E7D H;@9F:;E?7F:A6I7:363BBDAJ;?3F763
*);@F:;EB3F;7@F4 K7EF;?3F;@94GD@EGD83573D73A@F:73@
F7D;ADBADF;A@EA8:7D>78
FGBB7DFADEA3BBDAJ;?3F7>K
EGD835
73D73A@F:7D;9:FGBB7DFADEA3@634AGF
A@:7D>78
FID;EF;9GD7
*:;E E3?7 D7E73D5:9DAGB BDABAE765>3EE;8K;@9 A47E7B3F;7@FE;@FAGBB7D
4A6K3@6>AI7D4A6KBD76A?;
@3F77 J57EE4A6K?3EE53F79AD;7E23 *:78
AD?7DI7D7D7
8 835
73D73A8
;9GD7I:;>7F:7>3F F7DI7D7D787DD76FA3EP
This assessment of var
ying distributions of TBSA 4DAG9:FA@4 K-;>>;3?E3@6-A:>97?GF:I3E7EE7@F;3>;@:A
II753D768ADAGDB3F;7@F3EE:7:363$ A8@73D>K
I;F:3@P
@6DA;6Q4A6KE:3B7 @A H7DI7;9:FQB3F;7@F;7
$ *)3BBDAJ I3D D3@F767@AG9:5
F:;EIA?3@:36@AFEGEF3;@765A7J;EF;@9;@
7ADGBB7D3;D I3K3>>A8I:;5:I
H7D;FKA8BD7E7@F;@9EK?B
FA?E2-4
Sinc e this patient did not present with any signs of infec F;A@3@6@A=@A
H7>A83@F;4;AF;5BDAB:K>3J;EF3D97F;@9?7F:;
Figure 3. Diagram of the W
allace Rule of 9s. $20($4$#4( /3!+("#., (-(*(/$#( 22 Figure 4. Diagram of "
Android" body shape with //0.
6(, 2$2.01.!.#7130% "$ 0$ #$1(&- 2(.- 1$12(, 2$#!
72'$
123#70$%$0$-"$# !.4$0 5-31(-&*
$2"'!..* //.%( #0.".302$17.% 30$-.$+ .+$cillin-sensitiv e Staphyloc occus aureus ;7 5A??A@435F7
D;3;?B>;53F76;@5GF3@7AGEI
AG@6;@875F;A@I3E355A?
B>;E:76I;F:
75AH7D39724
Af ter we consoled this patient about the extent of her inMulti-Specialt y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal4 jur y and likely risk for permanent scarring, she expressed AB 76EF:;EB3F;7@F
OE>7E;A@E5A@F;@G76FA:73>:7D@7768AD5
GD;@98
A>>AIGBB:A@75A@H7DE3F;A@EF:;EIA?3@:365
7@F7D67@K;@9FD3@EBADF3F;A@ADR@3@5;3>;EEG7E3E;?B76;@9 835
FADE &GD8GDF:7D 5A??G@;53F;A@E I;F::7D EG997EF76F:3FE:7G@67DEFAA6:7D5 A@6;F;A@3>A@9I;F:F:7 D73EA@;@947:;@6 AGDEG997EF76 FD73F?7@FB>3@ 7>7 ?7@FEEEG997EF76;@F:;EI 7DB3F;7@F?;E5A??G@;53F;A@5AG>65A@
FD;4GF7FA?76;53>@A@36:7D7@5
73@647?AD778875F;H7>K7
JB>AD766GD;@9BD;?3DK53D77@5AG@F7DE25,26
C ONCLUSIONS
P artial and full-thickness burn wounds must be carefully 3EE7EE763@65>3EE;R76;@5>;@;5 43E763@67?7D97@FE7F
F;@9E3BBD75;3F;@9F:7>;=
K;@9$ E>A@9I;F:5A@E;67D3F;A@A8;?
?76;3F7SG;6D7EGE5;F3F;A@@776E8 AD?AD7E7H7D74GD@;@
F;A@E?3K47@77676;@36
F:7DG@67D>K;@96;E73E7EAD5A@
6;F;A@E14
Less e
xtensive second-degree burns can often be man3976;@5>;@;5E7F
F;@9EI;F:35A?4;@3F;A@F:7D3BKA87J
BAEGD7FA5
AA>I3F7D63;>K6D7EE;@9EI;F:3@F;4;AF;5A;@F
?7@FEAD5D73?E3@6B3;@?3@397?7@F @5A@FD3EFF:7?3@397?7@F A8F:;D6679D77 4GD@E;E F
KB;53>>K ?AD7;@
F7@E79 @
F:7 ?7D;53@GD@ EEA5;3F;A@D75
A? ?7@676F:3F4GD@B3F;7@FEI;F:3@K7JF7@FA8F:;D6679D774GD@EADI;67EBD736E75
A@6679D774GD@E47D787DD76FAEB75;3>;L
76GD7E3@67?B;D;53@F;4;AF;5FD73F?7@FE9,15
As most burns are of
ten occur at a mix of different 67BFigure 1. Pho
tographic images of patient's second-#$&0$$!30-1.-'$03//$02.01.3//$0(&'25$0$%2 -#'$050(12+.5$0(&'2'$1$/'.
2.&0 /'15$0$2 *$- %2$02'$/ 2($-21(&-$# 50(2
2$-".-1$-2%.0,0$4($5$#2'$;- +"0.//$#/'.
2.1 -# //0.4$#$ "'%.0/3!+(" 2(.-/$050(2
2$-".-1$-2are essential f
or the proper care and management of burn IAG@6H;5F;?E16
EX AMPLE PATIENT DESCRIPTION During the summer of 2020, an African American f emale ;@:7D73D>KF:;DF;7EBD7E7@F76FAGE3FF:7E75A@63GF:ADOE5
FID;EF;9GD7I
77=BD;ADF:7B3
F;7@F:36GE763BD7EEGD75
H7DD7>73E;@9EF73?3@64A;>
;@9 I3F7DA@FA :7DE=;@ ??76;3F7>K38F7D EG887D;@9 :7D4GD@EF:7B3F;7@F36?;F
F76FA83>>;@9;@FA3EF3F7A8E7H7D76;EFD7EE 3@6D7BADF76 :3H;@9477@ 7E5ADF76 ;@FA3 5A>6E:A
F>3F7D3>ID;EF;9GD7
7FADA>35*
7B3?;7,3>;G?F34>7FEFAFD73F:7D3@J;7F
A@6679D774GD@ED7CG;D7EBDAB:K>35F;53@
F;4;A JF7@FA8F:;EIA?3@OE;@A?AD4;6;F;7EI7D7G@D7?3D=34>77
J57BF8AD3PE7H7D7>KAH7DI7;9:FQ4A6K?3EE;@67J$ A8
9?2. 8 ;5E;>HA8:7DFA
F3>4A6KEGD83573D733@6355A?B3@;76I;F:3D73E A8B;@BA;@F 4>776;@9"7D>;J 3@F;?;5DA4;3>43@6397 93GL
7 5AH7D397 I3E;@;F;3F76 >F:AG9:@7 I7D A55>GE;H76D7EE;@9E?3KD7EG>F;@83EF7D:73>;@9D3F7ED7CG;D;@98
7I7D6D7EE;@9 5:3@97EE;>H
7D EG>836;3L;@7D7?3;@E 3EF3@63D6 FAB;53>3@F;?;5DA4;3>FD73F?7@F8
ADE75A@6679D774GD@E18
The patient was released with prescrip
tions for a 400 ?9<3DA8F:7E;>H7DEG>836;3L;@75D73?FA473BB>;76A@5
763;>K;75AH7DOO8G>>F:;5=@7EE
"7D>;J43@6397G@;FE3EI
7>>3E3BD7E5D;BF;A@8AD
?953BEG>7EA87@63KE8
KB:3D?35K3@6E:75A@RD?766GD
;@93>3F7D8 ):7I3E6;E5:3D976I;F:;@EFDG5F;A@EFA8A>>AIGBI;F:3 4GD@5
7@F7D 8AD 8GDF:7D53D7 3@6?3@397?7@F A8:7D I
5;E;A@I3E9G;6764
KD75A??7@63F;A@A8F:7?7D;
F:;5=@7EE4GD@E9D73F7DF:3@
FAF3>4A6KEGD83573D73*) 3@6BD77
J;EF;@9 ?76;53>5 A@6;F;A@E 79 :;9:7D$ F:3F5
AG>6 5A?B>;53F7 ?3@397?7@F3@6 D75AH7DKE:AG>647D78
7DD76FA34GD@57@F7D15
In order to manage the patient
's pain, she was also writF7@3F:D7763KBD7E5D;B
F;A@A8:K6DA5A6A@7
?9357F3 ?;@AB:7@ ?9;7 %AD5A,;5A6;@F34>7FE;@EFDG5F768 ADA@7B;>>FA47F3=7@GBFAF:D77F;?7E363KAD3>>K*:;EB3;@ ?76;53F;A@I3E BD7E5D;4768AD :7D38 F7D I7 :36D7
H;7AD6A5G?7@F76B3F;7@F6DG9E77=;@947
:3H;AD 19 -7D7H;7I76I;F:F:7B3F;7@F:AIFABDAB7D>KD7
EG?7:A?753D7?3@397?7@FA8:7DI
AG@6E3@6?76;53
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:7DIAG@6EIADE7@76*:7I
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5D73E767D
A@67D7634AGFF:77
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EFDG5F;A@E3@64GD@57@F7DD787DD3>);@5
A@RD?76F:3FE:7I3E5A@F;@G;@9FAGE7
Figure 2. Tw
o-month follow-up of Patient's Burn -)30($1'.2.&0 /'1.!2 (-$# %2$0/ 2($-21(&-$#50(2
2$-".-1$-20$4($5$#"0.//$#/'.2.1 -# &0$$#2./3!+(" 2(.-/$050(2
2$-".-1$-2Silvadene and w
et-dry gauze application cy cles over the B:A@73>F:AG9:IA?A@F:E38
F7DF:7;@;F;3>;@5;67@F
GD;@9F:;EH;E;FE:7EF3F76F:3FF:7BDA8
7EE;A@3>E3FF:7I
AG@6 53D75>;@;5 6;6@A F 47>;7H7 E:7@77676 3@K9D38 F ;@9FA3;6;@F:7D7B3;DA84GD@IAG@6E @EF736E:7E3;6F:7
8 57;H76;9GD7
>9;@3F7;E3@A@FAJ;54;A5A?B3F;4>7BA>K?7DF:3F;E@3FGD3>>KA4
F3;@768DA?4DAI@E73I77620 >9;@3F76D7EE
;@9E3D7GE76A85GDD7@5
7A8435F7D;3>;@875F;A@E3FIAG@6E;F7E20
Although w
e would have liked to have followed-up with F:7B3F;7@F;@F:75>;@;5EAA@7DF:3@FIA?A@F:EI73D7A
A@H7DE3F;A@E I7 :36I;F: :7D3;676 ;@93G9;@9 F:;EI
;5EAA@7D8AG@6E;@B7DEA@I7393;@A887D76:7DIAD6EA838
RD?3F;A@3@67@5
AGD397?7@F35=@AI>769;@9F:3FE:7I3EBAE;F;H
BKDISCUSSION
In this patient
's case, various portions of her lesions were 35K-:7@53D;@98
y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal3 burns greater than 20% TBSA in adults generally warrant4GD@53D75
F;A@E15
In adults with sec
ond or third-degree burns greater than *);F:3E477@E:AI@F:3F83;>GD7FA;@;F;3F7;?
?76;3F7SG;6D7EGE5;F3F;A@53@>736FA?KA9>A4;@GD;3;7?GE5>75
7>>E;@GD;@73E3D7EG>FEA8;@ ?A9>A4;@GD;3;7 :7?A9>A4;@;@GD;@7?G>F;AD93@83;> GD7;7 7EB75;3>>KD7@3>3@6G>F;?3F7>K?ADF3>;FK16 '
3D F;3>3@68G>>F:;5=@7EE4GD@I
AG@6E3>EA679D367F:7*KB75
F7;@D7B>357?7@F16 >F:AG9:
F:77 JF7@FA8F:;EB3F;7@FEOIAG@6EI7D7>7EEF:3@
)I 7@F:7>A53F;A@A8:7DIAG@6E3@6:;9:7D>;=
7>;:AA6 A85 A?B>;53F76 :73>;@9E75 A@63DK FA:7D :;9:$
*:7P- AG@6B3F;7@FEFA8AEF7D9G;63@5
7A@I:7F:7DAD@AFD787DD3>FA34GD@G@;F;E;@6;
53F76;9GD7
16 *:7B3>?;EF:7?3;@EF3KA8*)BD76;5
F;A@I:;5:D7BD7E7@FE3BBDA
J;?3F7>K
*);7I;F: AGF;@5>G6;@9F:7R@97DEADF:G?421 +E;@9F:79DA;@3E3@
7 AA8:;EAD:7DB3>?E16,22
A gain, the "Wallace Rule of 9s" is meant to provide a DAG9:7EF;?3F7A8*)8 AD36G>FEA8;673>:7;9:FI;F:$ D3@97EA847FI
77@FA$ 16 &47E7B3F;7@FE
$ :A I7H7D 479;@FA 53DDK 7J57EE I7;9:F 3@6EGD835 73D73E6;EBDABADF;A@3F7>K 16 &@7
EFG6K67?A@EFD3F76
:A F;H7>K3EAB
BAE76FA-
3>>357OE7EF;?3F7EA8
3@623 &4
E7D H;@9F:;E?7F:A6I7:363BBDAJ;?3F763
*);@F:;EB3F;7@F4 K7EF;?3F;@94GD@EGD83573D73A@F:73@
F7D;ADBADF;A@EA8:7D>78
FGBB7DFADEA3BBDAJ;?3F7>K
EGD835
73D73A@F:7D;9:FGBB7DFADEA3@634AGF
A@:7D>78
FID;EF;9GD7
*:;E E3?7 D7E73D5:9DAGB BDABAE765>3EE;8K;@9 A47E7B3F;7@FE;@FAGBB7D
4A6K3@6>AI7D4A6KBD76A?;
@3F77 J57EE4A6K?3EE53F79AD;7E23 *:78
AD?7DI7D7D7
8 835
73D73A8
;9GD7I:;>7F:7>3F F7DI7D7D787DD76FA3EP
This assessment of var
ying distributions of TBSA 4DAG9:FA@4 K-;>>;3?E3@6-A:>97?GF:I3E7EE7@F;3>;@:A
II753D768ADAGDB3F;7@F3EE:7:363$ A8@73D>K
I;F:3@P
@6DA;6Q4A6KE:3B7 @A H7DI7;9:FQB3F;7@F;7
$ *)3BBDAJ I3D D3@F767@AG9:5
F:;EIA?3@:36@AFEGEF3;@765A7J;EF;@9;@
7ADGBB7D3;D I3K3>>A8I:;5:I
H7D;FKA8BD7E7@F;@9EK?B
FA?E2-4
Sinc e this patient did not present with any signs of infec F;A@3@6@A=@A
H7>A83@F;4;AF;5BDAB:K>3J;EF3D97F;@9?7F:;
Figure 3. Diagram of the W
allace Rule of 9s. $20($4$#4( /3!+("#., (-(*(/$#( 22 Figure 4. Diagram of "
Android" body shape with //0.
6(, 2$2.01.!.#7130% "$ 0$ #$1(&- 2(.- 1$12(, 2$#!
72'$
123#70$%$0$-"$# !.4$0 5-31(-&*
$2"'!..* //.%( #0.".302$17.% 30$-.$+ .+$cillin-sensitiv e Staphyloc occus aureus ;7 5A??A@435F7
D;3;?B>;53F76;@5GF3@7AGEI
AG@6;@875F;A@I3E355A?
B>;E:76I;F:
75AH7D39724
Af ter we consoled this patient about the extent of her inMulti-Specialt y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal4 jur y and likely risk for permanent scarring, she expressed AB 76EF:;EB3F;7@F
OE>7E;A@E5A@F;@G76FA:73>:7D@7768AD5
GD;@98
A>>AIGBB:A@75A@H7DE3F;A@EF:;EIA?3@:365
7@F7D67@K;@9FD3@EBADF3F;A@ADR@3@5;3>;EEG7E3E;?B76;@9 835
FADE &GD8GDF:7D 5A??G@;53F;A@E I;F::7D EG997EF76F:3FE:7G@67DEFAA6:7D5 A@6;F;A@3>A@9I;F:F:7 D73EA@;@947:;@6 AGDEG997EF76 FD73F?7@FB>3@ 7>7 ?7@FEEEG997EF76;@F:;EI 7DB3F;7@F?;E5A??G@;53F;A@5AG>65A@
FD;4GF7FA?76;53>@A@36:7D7@5
73@647?AD778875F;H7>K7
JB>AD766GD;@9BD;?3DK53D77@5AG@F7DE25,26
C ONCLUSIONS
P artial and full-thickness burn wounds must be carefully 3EE7EE763@65>3EE;R76;@5>;@;5 43E763@67?7D97@FE7F
F;@9E3BBD75;3F;@9F:7>;=
K;@9$ E>A@9I;F:5A@E;67D3F;A@A8;?
?76;3F7SG;6D7EGE5;F3F;A@@776E8 AD?AD7E7H7D74GD@;@
F;A@E?3K47@77676;@36
7EB75;3>>KD7@3>3@6G>F;?3F7>K?ADF3>;FK16 '
3DF;3>3@68G>>F:;5=@7EE4GD@I
AG@6E3>EA679D367F:7*KB75
F7;@D7B>357?7@F16 >F:AG9:
F:77JF7@FA8F:;EB3F;7@FEOIAG@6EI7D7>7EEF:3@
)I7@F:7>A53F;A@A8:7DIAG@6E3@6:;9:7D>;=
7>;:AA6 A85 A?B>;53F76 :73>;@9E75 A@63DK FA:7D :;9:$
*:7P-AG@6B3F;7@FEFA8AEF7D9G;63@5
7A@I:7F:7DAD@AFD787DD3>FA34GD@G@;F;E;@6;
53F76;9GD7
16 *:7B3>?;EF:7?3;@EF3KA8*)BD76;5
F;A@I:;5:D7BD7E7@FE3BBDA
J;?3F7>K
*);7I;F:AGF;@5>G6;@9F:7R@97DEADF:G?421 +E;@9F:79DA;@3E3@
7AA8:;EAD:7DB3>?E16,22
A gain, the "Wallace Rule of 9s" is meant to provide a DAG9:7EF;?3F7A8*)8AD36G>FEA8;673>:7;9:FI;F:$ D3@97EA847FI
77@FA$ 16 &47E7B3F;7@FE
$ :A I7H7D 479;@FA 53DDK 7J57EE I7;9:F 3@6EGD835 73D73E6;EBDABADF;A@3F7>K16 &@7
EFG6K67?A@EFD3F76
:AF;H7>K3EAB
BAE76FA-
3>>357OE7EF;?3F7EA8
3@623 &4
E7DH;@9F:;E?7F:A6I7:363BBDAJ;?3F763
*);@F:;EB3F;7@F4K7EF;?3F;@94GD@EGD83573D73A@F:73@
F7D;ADBADF;A@EA8:7D>78
FGBB7DFADEA3BBDAJ;?3F7>K
EGD835
73D73A@F:7D;9:FGBB7DFADEA3@634AGF
A@:7D>78
FID;EF;9GD7
*:;E E3?7 D7E73D5:9DAGB BDABAE765>3EE;8K;@9A47E7B3F;7@FE;@FAGBB7D
4A6K3@6>AI7D4A6KBD76A?;
@3F77J57EE4A6K?3EE53F79AD;7E23 *:78
AD?7DI7D7D7
8 83573D73A8
;9GD7I:;>7F:7>3FF7DI7D7D787DD76FA3EP
This assessment of var
ying distributions of TBSA 4DAG9:FA@4K-;>>;3?E3@6-A:>97?GF:I3E7EE7@F;3>;@:A
II753D768ADAGDB3F;7@F3EE:7:363$ A8@73D>K
I;F:3@P
@6DA;6Q4A6KE:3B7 @AH7DI7;9:FQB3F;7@F;7
$ *)3BBDAJ I3DD3@F767@AG9:5
F:;EIA?3@:36@AFEGEF3;@765A7J;EF;@9;@
I3K3>>A8I:;5:I
H7D;FKA8BD7E7@F;@9EK?B
FA?E2-4
Sinc e this patient did not present with any signs of infecF;A@3@6@A=@A
H7>A83@F;4;AF;5BDAB:K>3J;EF3D97F;@9?7F:;
Figure 3. Diagram of the W
allace Rule of 9s. $20($4$#4( /3!+("#., (-(*(/$#( 22Figure 4. Diagram of "
Android" body shape with //0.
6(, 2$2.01.!.#7130% "$ 0$ #$1(&- 2(.- 1$12(, 2$#!
72'$123#70$%$0$-"$# !.4$0 5-31(-&*
$2"'!..* //.%( #0.".302$17.% 30$-.$+ .+$cillin-sensitiv e Staphyloc occus aureus ;75A??A@435F7
D;3;?B>;53F76;@5GF3@7AGEI
AG@6;@875F;A@I3E355A?
B>;E:76I;F:
75AH7D39724
Af ter we consoled this patient about the extent of her inMulti-Specialt y Care for Second-Degree Pressure Cooker Explosion Burn InjuriesSpartan Medic al Research Journal4 jur y and likely risk for permanent scarring, she expressed AB76EF:;EB3F;7@F
OE>7E;A@E5A@F;@G76FA:73>:7D@7768AD5
GD;@98
A>>AIGBB:A@75A@H7DE3F;A@EF:;EIA?3@:365
7@F7D67@K;@9FD3@EBADF3F;A@ADR@3@5;3>;EEG7E3E;?B76;@9 835
FADE &GD8GDF:7D 5A??G@;53F;A@E I;F::7D EG997EF76F:3FE:7G@67DEFAA6:7D5 A@6;F;A@3>A@9I;F:F:7 D73EA@;@947:;@6 AGDEG997EF76 FD73F?7@FB>3@ 7>7 ?7@FEEEG997EF76;@F:;EI7DB3F;7@F?;E5A??G@;53F;A@5AG>65A@
FD;4GF7FA?76;53>@A@36:7D7@5
73@647?AD778875F;H7>K7
JB>AD766GD;@9BD;?3DK53D77@5AG@F7DE25,26
CONCLUSIONS
P artial and full-thickness burn wounds must be carefully 3EE7EE763@65>3EE;R76;@5>;@;543E763@67?7D97@FE7F
F;@9E3BBD75;3F;@9F:7>;=
K;@9$ E>A@9I;F:5A@E;67D3F;A@A8;?
?76;3F7SG;6D7EGE5;F3F;A@@776E8AD?AD7E7H7D74GD@;@
6;F;A@FAI
FUNDING
quotesdbs_dbs46.pdfusesText_46
[PDF] Le second degré - Le salaire du père et du fils
[PDF] le second degré DM
[PDF] Le second degré fonction
[PDF] Le second degré- exercice du tableau
[PDF] Le Second Degré: MAths
[PDF] le second degrés
[PDF] Le second degrés (problème)
[PDF] Le second degrès : Résolution d'une équation
[PDF] le secret de l'abbaye film
[PDF] le secret de la cathédrale
[PDF] le secret des pyramides d'egypte
[PDF] le secret professionnel définition
[PDF] Le seigneur sans visage
[PDF] Le seisme au Japon
[PDF] le séisme du kanto 1923 et la marée noir de l'exxon valdez 1989
[PDF] le second degré DM
[PDF] Le second degré fonction
[PDF] Le second degré- exercice du tableau
[PDF] Le Second Degré: MAths
[PDF] le second degrés
[PDF] Le second degrés (problème)
[PDF] Le second degrès : Résolution d'une équation
[PDF] le secret de l'abbaye film
[PDF] le secret de la cathédrale
[PDF] le secret des pyramides d'egypte
[PDF] le secret professionnel définition
[PDF] Le seigneur sans visage
[PDF] Le seisme au Japon
[PDF] le séisme du kanto 1923 et la marée noir de l'exxon valdez 1989
