Methodical development for practical employment №19 Module №1 Thematic module №4

Theme: Burns. Burned disease

І. Actuality of theme

The thermal defeats take second seat among all types of traumas. It is explained by a power intensity of a production, wide use of aggressive liquids current of high tension, and also neglect by the rules of safety, in the way of life and on production. Treatment of burned disease is the important problem of surgery. Growth of accidents of burned trauma, combination of it with other types of damages requires from the doctor of good knowledge of features of this type of damage, methods of helping first and modern methods of treatment. A burned disease results in the heavy disorders of functions of organs and systems of an organism as a result of surplus irritation of the peripheral nervous ends, loss by the organism of albumen, liquid, salts. The timely and competently given first aid allows to decrease harmful influence of burned trauma on an organism. Study of the theme is important for all medical specialties in the plan of accordance of the first medical aid.

The general answer of an organism for a burned trauma depends on a depth and area of a burn. He achieves a maximum at suffering with the burned disease having an area more than 15%. All complex of clinical, anatomy-morphological, biochemical, immunological, exchanges and other disorders, changes and violations arising up in the organism of a victim with a burn, beginning from a moment its origin and to final completion (convalescences or deaths), carries the name “burned disease”.

For doctors knowledge of staging of a burned disease ability to forecast possibility of its development is very important. The stages of this illness need different tactical approaches in relation to treatment. The correct and timely help at a burned disease can considerably improve the result of treatment of a burn and even to rescue life to victims.

II. Aims teaching

1. To know determination and classification of burns (α=II).

2. To know the methods of determination of area of burn (α=II).

3. To know the methods of prognostication of motion of burns (α=II).

4. To know the local and commons changes in an organism at burns (α=III).

5. To know determination of burned disease. Etiology, pathogenesis, clinical picture of every stage (α=II).

6. To be able to give first medical help at thermal and chemical burns (α=III).

7. To be able to estimate the depth of burn, determine the area of burn, estimate weight of burn (α=III).

8. To be able to conduct the treatment of a burned surface (α=III).

9. To be able to conduct local treatment of burns (α=III).

10. To capture the method of composition of the medicinal program to victims with burned shock (α=III).

11. To be able to make the complex of medical measures at the different stages of burned disease (α=III).

ІII. Providing of initial level of knowledge’s - abilities

Literature:

The basic literature:

1. Butyrsky A. General surgery. – Simferopol. 2004.

2. Schevchenko S.I. and others. Surgery. – Kharcov. 2004

The additional literature:

1. Kushnir R. Lectures of General surgery. – 2005.

2. Lyapis M.A. Methods of examination of a surgical patient. – 2004.

3. Methodological recommendations on surgical patients care. – Vinnitsa medical national university. 2006.

Tests for verification of initial level of knowledge

1. Indicate the methods of determination of area of burn of body:

1. “rule of foot”

2. “rule of ten”

3. B.N.Postnicov’s method (1949) (+)

4. On the special standard tables (+)

5. Viliarevsky’s method

2. From local symptoms at the burn of П degree note everything except for:

1. Sickliness

2. Numbness (+)

3. Bubbles

4. Edema

5. Hypoesthesia (+)

3. Scorched disease will emerge at adult victims with ?

1. Superficial burn 15% (+)

2. Deep burn 12% (+)

3. Superficial burn 9% and deep burn 9%

4. Deep burn 6%

5. Deep burn 5% and superficial 8%

4. Prognosis at burns is defined:

1. On Pirogov’s index

2. On the index of Franc (+)

3. By rule of nine

4. By rule of hundred (+)

5. On of Postnicov’s index

5. Eliminate the incorrectly indicated stages of flow of scorched disease:

1. Reduction

2. Sharp kidney insufficiency (+)

3. Sharp toxemia

4. Burned shock

5. Hemoconcentration (+)

6. Eliminate the incorrectly indicated stages of flow of scorched disease:

1. Reduction

2. Chronic kidney insufficiency (+)

3. Burned shock

4. Hemodilution (+)

5. Septicotoxemia

7. It is characteristic for burned shock:

1. Unexpressed erectile phase

2. Expressed erectile phase (+)

3. Centralization of circulation of blood (+)

4. Absence of torpid phase

5. Increase of CBV (circulating blood volume)

8. It is characteristic for burned shock:

1. Unexpressed erectile phase

2. Depositing of blood in shocks organs (+)

3. Centralization of circulation of blood (+)

4. Absence of torpid phase

5. Increase CVP

9. There is all at burns shock, except for:

1. Olygo- or anury

2. Increase of CBV (+)

3. Increase of relative closeness of urine

4. azotemia, proteinemia, hemoglobinemia

5. Increase CVP (+)

10. Scorched disease at adults can develop at deep burns:

1. 3%

2. 7%

3. 10% (+)

4. 15% (+)

5. 8%

11. Scorched disease at adults can develop at superficial burns:

1. 3%

2. 10%

3. 14%

4. 20% (+)

5. 25% (+)

12. Specify the clinical signs of burned shock

13. Specify the clinical signs of sharp toxemia

14. Specify the clinical signs of septicotoxemia