Diagnosis of burns
Last reviewed: 23.04.2024
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As the clinical picture develops rapidly, burns are examined as soon as possible after stabilization of the patient's condition. Localization and depth of burn surfaces are recorded on burn diagrams. Burns with signs of both deep burns with partial lesion and complete damage to the dermis are accounted for as complete lesions until there is a possibility of more precise differentiation. With burns, the percentage of burn surface is counted; Consider only burns with partial and complete damage to the dermis. In adults, the percentage of the burned body surface is determined by the rule of nines; with small scattered burns, the area estimate is based on the size of the palm of the victim, which is usually 1% of the surface of his body. Children have a large head and small lower limbs, so the burn surface area is more accurately determined by the Lund-Browder tables.
If the patient is shown hospitalization, determine the concentration of hemoglobin and hematocrit, electrolytes
Blood plasma, urea and nitrogen, creatinine, albumin, total protein, phosphate, ionized Ca. The ECG is taken off, urine is analyzed for myoglobin, chest radiograph is performed. Suspicions of myoglobinuria occur in the case of dark staining of urine or a positive test, consisting in the absence of red blood cells with microscopy of blood. The blood test must be repeated in dynamics.
Attachment of infection is judged by the presence of exudate from wounds, slowing healing or systemic signs (fever, leukocytosis). If the diagnosis is unclear, the infection can be confirmed with a biopsy, sowing the exudate from the wound surface is not always reliable.