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Injuries due to extremes of

temperature and pressure

Dr. Mehzabin Ahmed
Thermal Injuries

• Exposure to excessive boiling or
burning substances causes
• Burn Injuries
• Exposure to excessive ambient
temperatures causes
• Heat exhaustion

• Heat cramps
• Heat stroke
• Exposure to excessive electrical
currents causes
• Electrical burns
Thermal Injuries

• Partial-thickness burns • Full-thickness burn involves total

include epidermis and destruction of the epidermis and
superficial part of the dermis. In dermis, with loss of the dermal
partial-thickness burns, the appendages that would have
provided cells for epithelial
deeper portions of the dermal regeneration.
appendages are spared. – Third- degree burns
– First-degree burns (all the layers of the skin extending to
(epithelial involvement only) the subcutaneous fat)
– Second-degree burns – Fourth-degree burns
(both epidermis and superficial ( all the layers of the skin extending to
dermis) the underlying muscle and bone).
Common complications of burn injuries:

• Hypovolemic shock due to loss of fluids

• Injury to airways and lungs due to toxic substances in smoke

• Secondary infection in the open wounds

• Hypermetabolic state with excessive heat loss and increased need for
nutritional support

• Heat cramps result •Heat exhaustion is • Heat stroke is

from loss of probably the most associated with
electrolytes through common heat syndrome. high ambient
sweating. Cramping Its onset is sudden, with temperatures and
of voluntary muscles, prostration and collapse, high humidity.
usually in association and it results from a Thermoregulatory
with vigorous failure of the mechanisms fail,
exercise, is the cardiovascular system to sweating ceases,
hallmark. compensate for and core body
hypovolemia, secondary temperature rises.
to water depletion.

• Frostnip – the term is used for reversible injury due to subfreezing

conditions. Firm cold white areas appear on the face, ears and
extremities, which peel or blister in 24 to 72 hours.
• Immersion (trench) foot - the term is used for injury due to
prolonged exposure to wet cold at temperatures above freezing.
Immersion foot can be prevented by changing socks frequently and
keeping the feet and boots dry
• Frostbite - it involves exposed areas like fingers, hands, toes, ears,
nose and cheeks. Severe frostbite can result in blisters or ulcer
formation. As the frostbite progresses lack of blood supply causes
tissue death and gangrene may occur
Electrical Injuries

• The thermal effects of the passage of the electric

current depend on its intensity. High-intensity
current, such as lightning coursing along the skin,
produces linear arborizing burns known as
lightning marks.
• Sometimes intense current is conducted around
the victim (so-called flashover), blasting and
disrupting the clothing but doing little injury.
• When lightning is transmitted internally, it may
produce sufficient heat and steam to explode solid
organs, fracture bones, or char areas of organs.
Injuries due to sudden decrease in Atmospheric Pressure

• High altitude illness is

encountered in mountain
climbers in the rarefied
atmosphere of altitudes
above 4000 m.
• The lowered oxygen
tension produces
progressive mental
disorientation and may be
accompanied by
pulmonary edema.
Injuries due to sudden decrease in Atmospheric Pressure

•Decompression (Caisson) disease is

seen when people spend time at increased
atmospheric pressure and return to lower
pressures too rapidly. Dissolved gases
come out of solution and form minute
bubbles in the blood and tissues.
•Gas embolism may occur as a
complication of scuba diving, mechanical
positive-pressure ventilation, and
hyperbaric oxygen therapy.
Injuries due sudden increase in Atmospheric Pressure

• Blast Injury. This form of injury

obviously implies a violent increase in
pressure either in the atmosphere (air
blast) or in water (immersion blast).

• With air blast, the compression wave

impinges on the side toward the
explosion and so may collapse the
thorax or violently compress the
abdomen, with rupture of internal

• In immersion blast, the pressure is

supplied to the body from all sides,
inducing injuries similar to those of air
Common Blast Injuries