SHORT CASE

BURN INJURY
 IDENTITY

Name : Tn. M

Age : 18 Years Old

Sex : Male

Doctor in charge : dr. Saktrio D. Subarno, Sp.BP-RE

 PRIMARY SURVEY
A (Airway)

• Clear

B (Breathing)

• Respiratory rate 34x/m, SpO2 96%, spontaneous, symmetrical, reguler, thoracoabdominal type

C (Circulation)

• BP 200/106, HR 72x/m, reguler, low CRT >2 Second

D (Disability)

• GCS E4V5M6, pupil isochoric, Direct & indirect pupil Reflex +/+

E (Exposure)

• Temperature 36,6 °C/axillar

 Secondary Survey
Chief Complain
• burns to the neck and arms

Mechanism of Trauma
• On 12/11/2022 at around 16.30 pm, at his house when he was about to turn off the
stove fire and tried to douse her with water so that the fire spread to her neck and left
arm
History of Trauma
• History of unconscious (-)
• There was no history of nausea and vomiting
• History of bleeding from the mouth (-)
• History of alcohol consumption (-) drugs (-)
• History of wound care (-)
 Generalized State

The patient was compos mentis , with severe illness, GCS E1V2M1

BP 120/80, Heart rate 80x/m, reguler, low, CRT > 2 second

Respiratory rate 22x/m, symmetric, regular, SpO2 97%

Temperature 36,6°C (axillary)

 Status Present

Head Neck
• normally • normally

Face Chest
• normally • normally

Nose Abdomen
• normally
• normally

Mouth Ekstremitas Superior

• normally
• normally
Ekstremitas inferior
Ears
• normally
• normally
 Localized State

Colli Region
Inspection: Burns with an area of ​4.5% have been epithelialized (-), erythema (+)
- Edema (-), hematoma (-), bleeding (-), bulla (+)
• Palpation: tenderness (+)
 Localized State

Superior Extremity
Inspection: looks like burns in the left brachial and antebrachialis region with an area of ​2% have
experienced epithelialization (-), erythema (+). Edema (-), hematoma (-), bleeding (-), bulla (+
• Palpation: Tenderness (+)
DOCUMENTATION
Pre- op
DOCUMENTATION
Post - op
Diagnosis
Mid dermal - Burn Injury ec. Flame
ASSESMENT
Mid dermal - Burn Injury ec. Flame
6,5%
 Management
Non Farmacology
• Education
• Consult to plastic surgeon
Farmacology
• IVFD RL 1000 cc/24 jam
• Inj. Ranitidin 50mg/8 h/IV
• Inj. Ketorolac 30 mg/8 h/IV
• Inj. Ceftriaxone 1 g/12 h/IV
• Vitamin C 1 / 24h
 Management
Farmacology
• Vitamin C 1 / h jam>>>Vitamin C for 24 hours
immediately after a major burn significantly
reduces resuscitation volume, body weight, and
edema, and improves lung function through a
significant reduction in the length of time required
for mechanical ventilation
 Management
Farmacology
• Inj. pantoprazol>>>in severe burns can cause stress
ulcers which are acute mucosal lesions in the upper
digestive tract that can be found in the stomach and
duodenum. In stress ulcers, wounds that appear are
superficial erosions and do not penetrate the epithelial
lining, so it is necessary to use PPI drugs (omeprazole,
lansoprazole, pantoprazole) and histamine 2 receptor
antagonists (ranitidine).
Literature
Review
 Introduction
The injuries can be caused by friction, cold, heat,
radiation, chemical or electric sources, but the majority
of burn injuries are caused by heat from hot liquids, solids
or fire. Although all burn injuries involve tissue
destruction due to energy transfer, different causes can
be associated with different physiological and
pathophysiological responses.
 • 90% of burns occurring in low- and
middle- income areas
• WHO estimates that 11 million burn
injuries of all types occur annually
worldwide, 180,000 of which are fatal
23,24
• the majority of injuries occurring in
young children (1–15.9 years of age)
and in those of working age (20–59
years of age)
• Nearly twice as many men are injured
as women

Epidemiol- 60% 40%

ogy
 Clasification
Thermal
• Exposure to flame or a hot object

Chemial :
• Exposure to acid, alkali or organic substances

Electrical :
• Result from the conversion of electrical energy into heat. Extent of injury depends on
the type of current, the pathway of flow, local tissue resistance, and duration of
contact
Radiation :
• Result from radiant energy being transferred to the body resulting in production of
cellular toxins
Burn Depth
 TOTAL BODY SURFACE AREA
(TBSA)
• Superficial burns are not involved in the calculation
• Lund and Browder Chart is the most accurate because it adjusts for age
• Rule of nines divides the body – adequate for initial assessment for adult burns
Management
THANK YOU