Show At NURSING.com, we believe Black Lives Matter ✊🏿, No Human Is Illegal 🤝, Love Is Love 🏳️🌈, Women`s Rights Are Human Rights 👩, Science Is Real 🔬, Water Is Life 🌊, Injustice Anywhere Is A Threat To Justice Everywhere ☮️. AccessibilitySitemapDrug List The emergent phase of a burn injury is from initial injury to ~72 hours post burn (Pessina & Orroth, 2008). Medical ManagementDuring the emergent phase, the medical team attempts to stabilize the patient. This may include fluid resuscitation, establishment of adequate tissue perfusion, and achievement of cardiopulmonary stability. Associated injuries, such as fractures, are evaluated and treated during this time (Garren & Kelly, 2006; Pessina & Orroth, 2008). Inhalation InjuryAn important consideration in the emergent phase is the possibility of an inhalation injury. Damage to the upper airway as a result of inhaling hot particles or noxious gases results in an inhalation injury. The respiratory epithelium is damaged, which impairs gas exchange. Inhalation injuries can significantly increase the risk of mortality. Singed eyebrows, soot around the nostrils, and facial edema are indications of inhalation injury. Edema can also develop in the airway and constrict breathing. Thus, patients with significant burn injuries are usually intubated to maintain an open airway until the risk of airway closure has decreased (Church et al., 2006; Pessina & Orroth, 2008). Figure 5: Airway Burn  Escharotomy and FasciotomyCirculation can be compromised when burn injuries "girdle" a body segment. This is due to the inelasticity of the eschar combined with increased internal pressure within fascial compartments. Local increases in pressure in the extremities compress blood vessels and reduce blood flow. Symptoms of increased compartmental pressure include: parasthesias, coldness and decreased/absent pulse in the extremities. In the trunk, inelastic eschar can act as a corset, limiting lung expansion and preventing adequate respiration. In both cases, surgical intervention (escharotomy and/or fasciotomy) is required to relieve pressure and prevent tissue death. Escharotomy: a surgical incision through the eschar Fasciotomy: a deeper inscision extending through the fascia *Unless exposed tendon is present, the escharotomy region can be mobilized during therapy* (Pessina & Orroth, 2008) Dressings After the initial burn assessment, the nursing staff applies dressings. The functions of dressings include:
Debriding is the removal of dead tissue from the wound site. In general, the nursing staff changes the dressings; however, by periodically participating in dressing removal and application, the OT makes opportunities to view the healing wounds. This allows the OT to monitor healing and adjust the therapy program accordingly (Pessina & Orroth, 2008). Contracture FormationPatients with burn injuries are at significant risk for contractures. Wound contracture is a normal physiological response to an open wound. However, when combined with prolonged immobilization, it creates an opportunity for permanent soft tissue contracture. Contractures are defines as an inability to perform full ROM of a joint (Schneider, Holavanahalli, Helm, Goldstein & Kowalske, 2006). Contractures tend to occur in predictable patterns, usually flexed, shortened positions (e.g., elbow flexion, shoulder adduction, knee flexion) and can considerably limit the patient's ability to perform activities of daily living (ADLs). For example, decreased elbow extension may limit a person's ability to dress (Pessina & Orroth, 2008). Figure 6: Contracture before and after surgical repair Image retrieved from: http://www.shrinershospitalcincinnati.org/burns/burn-reconstruction/ What are some patient priorities during the emergent phase of burn management?During the emergent phase, the priority of client care involves maintaining an adequate airway and treating the client for burn shock. The eyes should be irrigated with water immediately if a chemical burn occurs.
What are the nursing interventions for burns?Nursing interventions. Assess temperature and vital signs and characteristics of urine and sputum every 1–4 hours.. Monitor white blood cells, burn wound healing status and invasive catheter sites.. Ensure appropriate protective isolation; provide meticulous wound care; educate visitors in burn unit guidelines.. What happens in emergent phase of burn?The emergent (resuscitative) phase of burn management begins at the time of burn injury. The focus of this phase is to address the immediate and potentially fatal problems caused by the burn injury. Assessing the patient's burns will determine the plan of treatment (refer to the Picmonic "Burns Assessment").
What is the highest priority when caring for the burn patient?The main priorities in burn emergency care are as follows: blood circulation, respiration and airway management. After a primary stabilization in respiration and blood circulation, it is important to examine and classify the injuries in terms of the burn percentage.
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What are the priority nursing interventions during the emergent phase of burn injury?
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