![]() ![]() If shock Treatment Shock is a state of organ hypoperfusion with resultant cellular dysfunction and death. Burns are classified by depth (superficial and deep partial-thickness, and full-thickness). Initial fluid volume is guided by treatment of clinically evident shock ( 1 Treatment references Burns are injuries of skin or other tissue caused by thermal, radiation, chemical, or electrical contact. Children have proportionally larger heads and smaller lower extremities, so the percentage TBSA is more accurately estimated using the Lund-Browder chart ( ). The uninvolved area can be subtracted from the 9% area of the arm to more accurately calculate the burned surface area of the arm. For example, if an arm (which would represent 9% if totally involved) is not completely burned, the patient's hand size can be used as a template to estimate the extent of scattered uninvolved (or involved) areas. The hand size method is particularly helpful in calculating the burn surface area of a partially burned area. For adults, the percentage TBSA for parts of the body is estimated by the rule of nines ( ) for smaller scattered burns, estimates can be based on the size of the patient’s entire opened hand (not the palm only), which is about 1% of TBSA. The percentage of TBSA involved is calculated only partial-thickness and full-thickness burns are included in this calculation ( 1 Diagnosis reference Burns are injuries of skin or other tissue caused by thermal, radiation, chemical, or electrical contact. ![]() read more and acute kidney injury Acute Kidney Injury (AKI) Acute kidney injury is a rapid decrease in renal function over days to weeks, causing an accumulation of nitrogenous products in the blood (azotemia) with or without reduction in amount of urine. Common causes are hypotension or sepsis that causes renal hypoperfusion and nephrotoxic. Rhabdomyolysis causing myoglobinuria or hemolysis causing hemoglobinuria can lead to acute tubular necrosis Acute Tubular Necrosis (ATN) Acute tubular necrosis (ATN) is kidney injury characterized by acute tubular cell injury and dysfunction. read more or hemolysis can result from deep thermal or electrical burns of muscle or from muscle ischemia due to constricting eschars. Symptoms and signs include muscle weakness, myalgias, and reddish-brown urine, although this triad is. Rhabdomyolysis Rhabdomyolysis Rhabdomyolysis is a clinical syndrome involving the breakdown of skeletal muscle tissue. Metabolic acidosis may result from shock. read more, and hypokalemia Hypokalemia Hypokalemia is serum potassium concentration < 3.5 mEq/L (< 3.5 mmol/L) caused by a deficit in total body potassium stores or abnormal movement of potassium into cells. Clinical features include muscle weakness. Causes include alcohol use disorder, burns, starvation, and diuretic use. read more, hypophosphatemia Hypophosphatemia Hypophosphatemia is a serum phosphate concentration < 2.5 mg/dL (0.81 mmol/L). Causes include inadequate magnesium intake and absorption or increased excretion due to hypercalcemia or drugs. Dilutional electrolyte deficiencies can develop they include hypomagnesemia Hypomagnesemia Hypomagnesemia is serum magnesium concentration < 1.8 mg/dL (< 0.70 mmol/L). Metabolic abnormalities may include hypoalbuminemia that is partly due to hemodilution (secondary to replacement fluids) and partly due to protein loss into the extravascular space through damaged capillaries.
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