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E- 1st degree – sunburns –reddish brownish and painful
D- 2nd degree-partial part skin is swollen and intact, blisters and vesicles
S – 3rd degree – red, brown and white –no pain – white

Major burns or area of concerned
1. Face neck and chest – may inhale a smoke –inhaled heat –respiratory complication
2. Hands and feet –distal part – poor blood supply – contarctures
3. Perineum – Elimination is affected
First Aide
1. Stop the effect of the heat – irrigate the burns
2. Stop drop and roll over
Complication/ Stages
1. Shock –primary neurogenic
ANS fails to response to stress – pain – neurogenic shock
2. Fluid Loss /Fluid Mobilization
- oliguric –dilation of the blood volume –shifting of the body fluid
- hematocrit-sodium shifting –hyponatremia- decrease blood volume
- Concentration of the hematocrit –increase sodium –decrease potassium –decrease amount of the
a. Replace fluid
b. Give the Pain reliever
c. Inspect the Foley catheter – monitoring of the I and O –check 30 to 60 cc/hour
d. Fluid – Plain Lr and isotonic – observe for the cardiac overloading
e. Cradle bed –put the top sheet over the bed cradle-avoid touching the legs
f. Monitor for the hyperkalemia – Kayexalate

3. Fluid remobilization /Tissue sloughing
- Infection – after 3 days to 1 week
1. Place patient in reverse isolation
2. Sterile linens
3. Surgical hand washing
4. Sterile gown
- Most common colonizer of the wound-pseudomonas-hospital acquired
- Dressing application of topical antibacterial
- Drugs –sofamylon (meferide acetate)
- 1st stages –rehab –contractures, eschar –thickening of the tissues


- Poison is anything that kills or injures through its chemical actions.
- Latin word—potare—meaning to drink.
- But poisons can also enter the body in other ways:
o By breathing
o Through the skin
o By IV injection
o From exposure to radiation

Intentional or Unintentional.
1. Intentional poisoning is the result of a person taking or giving a substance with the intention of causing harm.
Suicide and assault
2. Unintentional poisoning if the person taking or giving a substance did not mean to cause harm
Use of drugs or chemicals for recreational purposes in excessive amounts, such as an “overdose.”

Signs and Symptoms
 Burns or redness around the mouth and lips
 Breath that smells like chemicals, such as gasoline or paint thinner
 Burns, stains and odors on the person, on his or her clothing, or on the furniture, floor, rugs or other objects in the
surrounding area
 Empty medication bottles or scattered pills
 Vomiting, difficulty breathing, sleepiness, confusion or other unexpected signs

First aid

What to do while waiting for help:
 If the person has been exposed to poisonous fumes, such as carbon monoxide, get him or her into fresh air
 If the person swallowed the poison, remove anything remaining in the mouth.

needle. then poisoning would be suspected. . they may cause signs and symptoms not typical of any single poison. read the label and follow instructions for accidental poisoning  Follow treatment directions that are given by the poison control center. fire. . . Aspiration means breathing the vomit into the lungs and possibly drowning.Taken a sleeping pill or sedative. these liquids can easily enter the lungs and cause severe damage.If more than 1 person has the same signs and symptoms. This flushes the entire gastrointestinal tract before the poison gets absorbed.  One ounce equals 30 mL. • Once the poison is stuck to the charcoal in the intestine. . the poison has either been absorbed in the stomach or has passed farther down the intestinal tract where it cannot be vomited up. Flush the skin or eyes with cool or lukewarm water. it has already chemically burned the mouth and esophagus once and would do so again when vomited. and 911 or equivalent) near your home phones. . Once the poison has moved past the stomach.If the person is already vomiting from the poisoning. water. In rare cases. o The dose for adults and teenagers is 15-30 mL. . . Elimination: Get rid of the unabsorbed poison before it can do any harm. Poisoning Treatment Self-Care at Home . These people are at an extremely high risk of "aspirating" the vomit. skin or eyes. Whole bowel irrigation requires drinking a large quantity of a fluid called GoLYTELY. . . When the cause of the poisoning is unknown .If the victim swallowed a caustic substance. the physician may use ipecac to cause vomiting.Do not use ipecac. ask these questions: • Do I need to make the person throw up? • Is there an antidote I can give at home? . such as lye or Drano. which has or may cause the person to become unconscious.If you phone a poison control center.Place the telephone number (along with police. This is likely only for an hour or 2 after ingestion. .  Take the poison container (or any pill bottles) with you to the hospital. Identify your closest poison control center from a comprehensive list of toll-free telephone numbers for poison control centers in all states at the American Association of Poison Control Centers. repeat the initial dose one time only.If the person has swallowed a solid foreign object such as a pin. . soft. and they have a common exposure source. Medical Treatment . . or paint thinner. such as contaminated food. If the person is unconscious. • Activated charcoal • Acts as a "super" absorber of many poisons. or workplace environment.Vomiting will rid the body of poison only if the poison is still in the stomach.  1 tablespoon equals 15 mL  1 teaspoon equals 5 mL. other methods are needed.When 2 or more poisons act together. o If the victim has not vomited in 20-30 minutes. . . o The dose for infants aged 6-12 months is 5 mL. coin. such as gasoline. o Ipecac comes in a 2-ounce bottle. plastic tube into the windpipe to protect the person from suffocating in his or her own vomit and to provide artificial breathing. When not to induce vomiting . . there is no need for ipecac to bring about vomiting. lithium. Activated charcoal has no taste.A big part of figuring out what poisoning has occurred is connecting the signs and symptoms to each other and to other available information. . causes vomiting in 20-30 minutes. It does not work with alcohol. the doctor will put a flexible.If the victim swallowed a petroleum product. kerosene. the poison cannot get absorbed into the bloodstream. o The dose for children aged 1-12 years is 15 mL. when swallowed. caustics. fishhook. Vomiting increases the chance of this happening.  If the suspected poison is a household cleaner or other chemical. activated charcoal needs to be given as soon as possible after the poisoning. After that time.  If the poison spilled on the person's clothing. do not make the person vomit. To be effective. The victim may lose consciousness and accidentally breathe the vomit into the lungs. but the gritty texture sometimes causes the person to vomit.Syrup of ipecac is a liquid that. or petroleum products. such as by using a shower for 20 minutes or until help arrives. remove the clothing.