Yanıkta Acil, Acilde Yanık
Yanıklı hastalar ile ilk karşılaşan hekimler genellikle acil servis çalışanlarıdır. Hasta acil servise geldiğinde, özellikle majör yanıklı hastalarda neler yapılması gerektiği önemle üzerinde durulması gereken bir konudur. Çünkü hastaları bir yanık merkezine göndermeden önce ilk tedavi olarak yapılması gereken müdahaleler hayat kurtarıcı olabilir. Bu çalışmada acil yanık tedavisi hakkında literatür gözden geçirilerek tüm hekimlere yol gösterebilecek kısa bilgiler halinde sunulmuştur. Ayrıca bu çalışmada ilk karşılaşan hekim yanıklı hastayı nasıl değerlendirmeli, nelere dikkat etmeli, sıvı replasmanını hangi esaslara göre yapmalı, yanık yarasına yaklaşım nasıl olmalı gibi sorulara cevaplar verilmeye çalışılmıştır.
Emergency in Burn, Burn in Emergency
Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed.
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- 1. Endorf FW, Ahrenholz D. Burn management. Curr Opin Crit Care. 2011; 17(6): 601-605.
- 2. Brusselaers N, Monstrey S, Vogelaers D, Hoste E, Blot S. Severe burn injury in Europe: a systematic review of the incidence, etiology, morbidity, and mortality. Crit Care. 2010; 14(5): R188.
- 3. Moss LS. Treatment of the burn patient in primary care. Adv Skin Wound Care. 2010; 23(11): 517-524.
- 4. Muehlberger T, Ottomann C, Toman N, Daigeler A, Lehnhardt M. Emergency pre-hospital care of burn patients. Surgeon. 2010; 8(2): 101-104.
- 5. Williams FN, Herndon DN, Jeschke MG. The hypermetabolic response to burn injury and interventions to modify this response. Clin Plast Surg. 2009; 36(4): 583-596.
- 6. Latenser BA. Critical care of the burn patient: the first 48 hours. Crit Care Med. 2009; 37(10): 2819-2826.
- 7. Brandt CP, Coffee T, Yurko L, Yowler CJ, Fratianne RB. Triage of minor burn wounds: Avoiding the emergency department. J. Burn Care Rehabilitation. 2000; 21; 26-28.
- 8. Kagan RJ, Warden GD. Care of minor burn injuries: An analysis of burn clinic and emergency room charges. J. Burn Care Rehabilitation. 2001; 22: 337-340.
- 9. Carter JE, Neff LP, Holmes JH. 4th. Adherence to burn center referral criteria: are patients appropriately being referred? J Burn Care Res. 2010; 31(1): 26-30.
- 10. Menters DM, Jenkens ME, Warden GD. Outpatient burn management. Nurs. Clin. N. Am. 1997; 32: 343-364.
- 11. Mandal A. Quality and cost-effects in burn care. Burns. 2007; 33(4): 414-417.
- 12. Turegun M, Sengezer M, Selmanpakoglu M, Celikoz N, Nisanci M. The last ten years in a burn centre in Ankara, Turkey: an analysis of 5264 cases. Burns. 1997; 23: 584-590.
- 13. Kowalske KJ. Burn wound care. Phys Med Rehabil Clin N Am. 2011; 22(2): 213-227.
- 14. Latha B, Babu M. The involvement of free radicals in burn injury: a review. Burns. 2001; 27: 309-317.
- 15. Lloyd EC, Rodgers BC, Michener M, Williams MS. Outpatient burns: prevention and care. Am Fam Physician. 2012; 85(1): 25-32.
- 16. Atiyeh BS, Gunn SW, Hayek SN. State of the art in burn treatment. World J Surg. 2005; 29(2): 131-148.
- 17. Pruitt BA Jr, McManus AT, Kim SH, Goodwin CW. Burn wound infections: current status. World J Surg. 1998; 22(2): 135-145.
- 18. Herndon DN, Spies M. Modern burn care. Semin Pediatr Surg. 2001; 10(1): 28-31.
- 19. Chipp E, Milner CS, Blackburn AV. Sepsis in burns: a review of current practice and future therapies. Ann Plast Surg. 2010; 65(2): 228-236.
- 20. Kuyumcu M, Şen H, Özkan S. Anesthesia in Burn Injury Patients. TAF Preventive Medicine Bulletin. 2011; 10(3): 351-360
- 21. Sever C, Sahin C. Pre-expanded Supraclavicular Flap for Post-burn Neck Contractures Archives of Clinical and Experimental Surgery (ACES). 2012; 1(1): 61-62.
- 22. Walker SR. Anesthetic Burns - A Burn Injury Due to A Combination of Local Anaesthetic and Heat Pack. Arch Clin Exp Surg. Online First: 05 May, 2012.