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

IV. Table of contents of teaching

Structurally-logical chart of theme

V. Reference basis of action

Algorithm of helping medical first to victims with thermal burns

1 stage is stopping of action of thermal agent

2 stage is evacuation from the reserved apartments and providing of access of fresh air

3 stage are the cardiopulmonary reanimation (in the case of burn of face and respiratory tracts providing them permeability)

4 stage is removal of clothes from the damaged areas of body

5 stage is anaesthetizing, including by the local cooling

6 stage is imposition of aseptic bandage

7 stage is shrouding of patient, warm alkaline drink (at the burns of extremities|limbs| is transporting|transport| immobilization)

8 stage is transporting of victim in medical establishment

Algorithm of determination of violation of algesthesia for differential diagnostics of superficial and deep burns

Algorithm of implementation of a treatment of a burned surface

1. A primary treatment is conducted in the case of burns of any degree, except for victims with the signs of burned shock (conduct this manipulation them after liquidation of the shock state).

2. Anaesthetizing (mainly is common anaesthetizing).

3. Careful, minimum traumatic, sparing cleaning of a burned surface from dir, free shreds of epidermis, foreign bodies, by the serviette saturated with Novocain.

4. Wash an burned surface by solutions of antiseptics.

5. Large tense bubbles outside process by antiseptic and cut near foundation, evacuate the exudate of bubbles.

6. Subsequent treatment is depending on a select method (opened or closed).

Date: 2015-02-03; view: 797