Mea Kākau: Clyde Lopez
Lā O Ka Hana: 24 Iulai 2021
HōʻAno Hou I Ka Lā: 15 Nowemapa 2024
Anonim
Burns Nursing Care, Treatment, Degrees, Pathophysiology,  Management, NCLEX Review
Wikiō: Burns Nursing Care, Treatment, Degrees, Pathophysiology, Management, NCLEX Review

Kū pinepine nā Burns e ka hoʻopili pololei a pololei ʻole paha me ka wela, ke au uila, radiation, a i ʻole nā ​​ʻākena kemika. Hiki i nā Burns ke alakaʻi i ka make cell, kahi e koi ai i ka haukapila a hiki i ka make.

ʻEkolu pae o ka wela.

  • Hoʻopili wale nā ​​puhi kēkelē mua i ka papa waho o ka ʻili. Hoʻokumu lākou i kaʻeha, kaʻulaʻula, a me ka pehu.
  • Hoʻopili ka lua o ka ʻelua kekelē i ka ʻaoʻao i waho a i lalo o ka ʻili. Hāpai lākou i ka ʻeha, ʻulaʻula, pehu, a me ka pā. Kapa ʻia lākou he ʻāpana mānoanoa.
  • Hoʻopili ke kuni ʻekolu i nā papa hohonu o ka ʻili. Kāhea ʻia lākou he puhi mānoanoa piha. Hana lākou i keʻokeʻo a ʻeleʻele hoʻi, i kuni ʻia ka ʻili. Pōpō paha ka ʻili.

Hāʻule ʻo Burns i ʻelua mau pūʻulu.

ʻO nā lapalapa liʻiliʻi:

  • Kuni ke kēkelē mua ma nā wahi āpau o ke kino
  • Puni ke kekelē ʻelua ma lalo o 2 a 3 ʻīniha (5 a 7.5 centimetera) ka laulā

ʻO nā kuni nui ka:

  • ʻO ke kuni ʻekolu kekelē
  • Puni ke kekelē ʻelua ma mua o 2 a 3 paha ʻīniha (5 a 7.5 centimita) ka laulā
  • ʻO ka wela ʻelua degere ma nā lima, nā wāwae, ke alo, ke ʻūlū, ka ʻūhā, a i ʻole ma luna o kahi ami nui

Hiki iā ʻoe ke ʻoi aku ma mua o hoʻokahi ʻano ʻo ke kuni i ka manawa.


Pono nā burns nui i kahi mālama olakino wikiwiki. Hiki i kēia ke kōkua i ka pale ʻana i ka scarring, kīnā ʻole, a me ka deformity.

ʻO ke kuni i ka maka, nā lima, nā wāwae, a me nā genital hiki ke koʻikoʻi koʻikoʻi.

ʻO nā keiki ma lalo o ka makahiki 4 a me nā mākua ma luna o ka makahiki 60 he ʻoi aku ka nui o ka pilikia a me ka make ʻana mai nā wela nui no ka mea ʻoi aku ka lahilahi o ko lākou ʻili ma mua o nā hui o nā makahiki.

ʻO nā kumu o ke ahi mai ka hapanui a ka liʻiliʻi ka liʻiliʻi.

  • Ke ahi / lapalapa
  • Scalding mai ka mahu a i ʻole nā ​​wai wela
  • Hoʻopā i nā mea wela
  • ʻO ke ahi uila
  • ʻO ke kuni kemikala

Hiki i nā Burns ke hopena o kekahi o kēia mau mea:

  • ʻO ke ahi hale a me nā ʻoihana
  • Nā ulia kaʻa
  • Ke pāʻani nei me nā pāʻani
  • Nā hoʻomehana hakahaka hewa, nā umu ahi, a i ʻole nā ​​pono hana
  • Hoʻohana palekana ʻole o ke ahiahi a me nā ahi ʻē aʻe
  • Nā pōpilikia kīhini, e like me ke keiki e lālau ana i kahi hao wela a i ʻole e pā i ke kapuahi a i ʻole ka umu

Hiki iā ʻoe ke puhi i kou mau ʻāpana air inā ʻoe e hanu i ka uahi, ka mahu, ka ea wela, a i ʻole nā ​​uahi kemika i nā wahi ʻino maikaʻi ʻole.


Hiki i nā hōʻailona Burn ke hoʻopili pū:

  • Pālehu ʻole ʻia (ʻaʻole haki) a i ʻole haki a e kahe ana ka wai.
  • Pain - Ehia mau ʻeha āu e pili ʻole ai i ka pae o ka wela. ʻO ke ahi ʻoi loa ke kolohe ʻole.
  • ʻIli peeling.
  • Shock - Nānā i ka ʻili mae a me ka clammy, nāwaliwali, nā lehelehe polū a me nā manamana lima, a me ka hōʻemi o ka makaʻala.
  • ʻŌhū.
  • ʻUlaʻula, keʻokeʻo, a i ʻole ʻili kuni ʻia.

Hiki paha iā ʻoe ke kuni i ke ala ʻāpana inā loaʻa iā ʻoe:

  • ʻO ka wela ma ke poʻo, ka maka, ka ʻāʻī, nā kuʻemaka, a i ʻole nā ​​hulu ihu
  • ʻO nā lehelehe a me ka waha i kuni ʻia
  • ʻ Clelo huna
  • Hanu paʻakikī
  • Mele ʻeleʻele, ʻeleʻele-ʻeleʻele
  • Hoʻololi leo
  • ʻUhihi

Ma mua o ka hāʻawi ʻana i ke kōkua mua, he mea nui e hoʻoholo i ke ʻano o ka wela o ke kanaka. Inā ʻaʻole ʻoe maopopo, mālama iā ia ma ke ahi nui. Pono nā wela nui i ka mālama olakino koke. Kāhea i kāu helu pilikia kūloko a i ʻole 911.

PUHI MANUAHI

Inā ʻaʻohe haki ka ʻili:

  • Holo i ka wai anuanu ma luna o ka wahi o ka puhi ʻana a hoʻowali paha iā ia i loko o kahi wai ʻauʻau (ʻaʻole ka wai hau). E mālama i ka wahi ma lalo o ka wai ma kahi o 5 a 30 mau minuke. ʻO kahi kāwele maʻemaʻe, anuanu, a pulu hoʻi e kōkua i ka hōʻemi ʻana i ka ʻeha.
  • E hōʻoluʻolu a hoʻokūpaʻa i ke kanaka.
  • Ma hope o ka pīpī ʻana a pulu ʻana paha i ka wela, e uhi iā ia me kahi kapa maloʻo, sterile a i ʻole nā ​​kapa maʻemaʻe.
  • Palekana i ke ahi mai kaomi a me ka hakakā.
  • Hiki i ka ibuprofen over-the-counter a i ʻole acetaminophen ke kōkua i ke kōkua ʻana i ka ʻeha a me ka pehu. Mai hāʻawi i ka aspirin i nā keiki ma lalo o 12.
  • Ke hoʻomaʻalili ka ʻili, hiki ke kōkua i ka wai onaona hoʻoluʻu i loko me ka ʻaloe.

E hoʻōla pinepine ke kuni liʻiliʻi me ka ʻole o ka lapaʻau hou aʻe. E hōʻoia i ke ʻano o ke kanaka no kā lākou tetanus vaccine.


NA POHAKU MAKAHI

Inā ahi ke ahi, e haʻi i ke kanaka e kū, hāʻule, a ʻōwili. A laila, e hāhai i kēia mau kaʻina hana:

  • Hoʻopili i ke kanaka i nā mea mānoanoa; e like me ka huluhulu a i ʻole ka pulupulu, kapeta, a i ʻole ʻahu. Kōkua kēia i ke kinai ʻana i ke ahi.
  • E ninini i ka wai i ke kanaka.
  • Kāhea iā 911 a i ʻole kāu helu kūloko kūloko.
  • E hōʻoia i ka hoʻopā hou ʻole ʻana o ke kanaka i nā mea puhi a puhi paha.
  • Mai wehe i nā lole kuni i paʻa i ka ʻili.
  • E hōʻoia i ka hanu ʻana o ke kanaka. Inā pono, e hoʻomaka i ka hanu hoʻopakele a me CPR.
  • Uhi i ka wahi wela me kahi kapa maloʻo maloʻo maloʻo (inā loaʻa) a i ʻole ka lole maʻemaʻe. E hana ana kahi pepa inā nui ka wahi i puhi ʻia. Mai hoʻopili i kahi hamo. Hōʻalo i ka haki ʻana i nā palapū wela.
  • Inā i puhi ʻia nā manamana lima a me nā manamana wāwae paha, e hoʻokaʻawale iā lākou me nā mea maloʻo maloʻo, sterile, ʻaʻohe lāʻau.
  • E hoʻokiʻekiʻe i ka ʻāpana o ke kino i puhi ʻia ma luna o ka pae o ka puʻuwai.
  • Palekana i ka wahi wela mai ke kaomi a me ka hakakā.
  • Inā he ʻeha uila i hana i ke ahi, mai hoʻopili pono i ka mea i hōʻeha ʻia. E hoʻohana i kahi mea hao ʻole e hoʻokaʻawale i ke kanaka mai nā kaula i hōʻike ʻia ma mua o ka hoʻomaka ʻana i ke kōkua mua.

Pono ʻoe e pale i ka haʻalulu. Inā ʻaʻohe poʻo o ke kanaka, ʻāʻī, kua, a ʻeha hoʻi ka wāwae, e hāhai i kēia mau kaʻina.

  • E hoʻomoe i ke kanaka
  • E hāpai i nā wāwae ma kahi o 12 ʻīniha (30 kenimika)
  • E uhi i ke kanaka me ka ʻahu a i ʻole ka ʻahuʻula

E hoʻomau i ka nānā ʻana i ka pulsa o ke kanaka, ka nui o ka hanu ʻana, a me ke kahe o ke koko a hiki i ka hōʻea ʻana o ke kōkua olakino.

ʻO nā mea pono ʻole e hana ʻia no ke ahi nā:

  • Mai hoʻopili i ka aila, ka bata, ka hau, nā lāʻau lapaʻau, ka kirīmiʻi, ka ʻehu aila, a i ʻole nā ​​lāʻau āpau o ka home i kahi wela nui.
  • MAI hanu, puhi, a ʻūmū paha i ke ahi.
  • Mai hoʻopilikia i ka ʻili mae a make paha.
  • Mai wehe i nā lole i paʻa i ka ʻili.
  • MAI hāʻawi aku i ka mea i ka waha inā he ʻā nui.
  • MAI hoʻokomo i kahi wela i loko o ka wai anuanu. Hiki i kēia ke hoʻonāukiuki.
  • MAI hoʻokau i kahi uluna ma lalo o ke poʻo o ke kanaka inā aia kahi ʻāʻā ahi e wela. Hiki i kēia ke pani i nā alaloa.

Kāhea iā 911 a i ʻole ka helu kūloko kūloko inā:

  • Nui loa ka wela, e like me ka nui o kou poho lima a ʻoi aku paha.
  • Nui ka puhi ʻana (kekelē kolu).
  • ʻAʻole maopopo iā ʻoe ke koʻikoʻi.
  • Hoʻokumu ʻia ke ahi e nā kemika a i ʻole ka uila.
  • Hōʻike ke kanaka i nā hōʻailona o ka pīhoihoi.
  • Hanu akula ke kanaka i ka uahi.
  • ʻO ka hoʻomāinoino kino ka mea i ʻike ʻia a kuhi ʻia paha ke kumu o ka wela.
  • Aia kekahi mau hōʻailona ʻē aʻe e pili ana i ke ahi.

No nā kuni liʻiliʻi, kāhea i kāu kahu mālama inā loaʻa iā ʻoe ka ʻeha ma hope o 48 mau hola.

Kāhea koke i kahi mea hāʻawi inā ulu nā hōʻailona o ka maʻi. Aia kēia mau hōʻailona:

  • ʻO ke kahe a i ʻole ka nū mai ka ʻili i puhi ʻia
  • Fiva
  • Hoʻonui i ka ʻeha
  • Hoʻolahalaha nā ʻulaʻula mai ka wela
  • Nā pehu lymph pehu

Kāhea pū kekahi i kahi mea hoʻolako inā loaʻa nā ʻōuli o ka make wai me kahi wela.

  • Hoemi i ka urination
  • Puʻupuʻu
  • ʻIli maloʻo
  • ʻEha poʻo
  • ʻĀlohilohi
  • Nusea (me ka ʻole o ka luaʻi)
  • Ka makewai

ʻO nā keiki, nā poʻe ʻelemākule, a me nā mea me ka ʻōnaehana pale nawaliwali (e laʻa, mai HIV) e ʻike koke ʻia.

E hana ka mea hāʻawi i ka mōʻaukala a me ka hoʻokolokolo kino. E hana ʻia nā hoʻāʻo a me nā kaʻina hana inā pono.

Pākuʻi ʻia kēia mau mea:

  • Kākoʻo Airway a me ka hanu ʻana, e like me ka pale maka, pūhaka ma o ka waha i loko o ka trachea, a i ʻole ka mīkini hanu (ventilator) no ka wela nui a i ʻole nā ​​mea e pili ana i ka maka a i ʻole ke ala ea
  • ʻO nā hoʻāʻo ʻana i ke koko a me ka mimi inā kūʻiʻi a i ʻole nā ​​pilikia ʻē aʻe
  • ʻO ka x-ray umauma no ka maka a i ʻole ke ahi i hōʻea i ke ahi
  • ECG (electrocardiogram, a i ʻole ka huli ʻana o ka puʻuwai), inā kūpikipiki a i ʻole nā ​​pilikia ʻē aʻe i loaʻa
  • Nā wai kūpikipiki (fluids through a vein), inā kūʻiwa a i ʻole nā ​​pilikia ʻē aʻe i loaʻa
  • Nā lāʻau no ke kōkua ʻana i ka ʻeha a me ka pale ʻana i ka maʻi
  • ʻO nā aila a i ʻole nā ​​kalima i hoʻopili ʻia i nā wahi i puhi ʻia
  • ʻO ka pale ʻana o Tetanus, inā ʻaʻole kū i kēia lā

E pili ka hopena i ka ʻano (kekelē), ka nui, a me kahi o ka wela. Aia ia i ka pili inā ua hoʻopili ʻia nā mea o loko, a inā ua loaʻa kekahi ʻeha ʻē aʻe. Hiki i nā Burns ke waiho i nā scars paʻa mau. Hiki iā lākou ke maʻalahi i ka mahana a me ka māmā ma mua o ka ʻili maʻamau. ʻO nā wahi maʻalahi, e like me nā maka, ihu, a pepeiao paha, ʻeha ʻeha a ua lilo ka hana maʻamau.

Me nā ʻā ʻana o ke ala ea, he emi paha ka liʻiliʻi o ka hanu ʻana o ke kanaka a me ka pohō mau o ka māmā. ʻO nā wela nui e hoʻopili i nā hono ke hopena i nā ʻaelike, waiho i ka hui me ka hoʻoliʻiliʻi o ka neʻe a me ka hoʻemi ʻana i ka hana.

I mea e pale aku ai i ka wela ʻana:

  • E hoʻouka i nā mea puhi uahi i kou home. E hōʻoia a hoʻololi i nā pila i kēlā me kēia manawa.
  • E aʻo i nā keiki e pili ana i ka palekana ahi a me ka makaʻu o nā pāʻani a me nā ahi.
  • E mālama i nā keiki mai ka piʻi ʻana ma luna o ke kapuahi a i ʻole hopu i nā mea wela e like me ka hao a me nā puka umu.
  • E hoʻohuli i nā lima ipuhao i hope o ke kapuahi i hiki ʻole i nā keiki ke lālau iā lākou a ʻaʻole hiki iā lākou ke kīkē hewa.
  • E hoʻokau i nā mea puhi ahi i nā wahi nui i ka home, ka hana, a me ke kula.
  • Wehe i nā kaula uila mai ka papahele a mālama iā lākou i kahi hiki ʻole.
  • E ʻike e pili ana a hoʻomaʻamaʻa i nā ala pakele ahi ma ka home, ka hana, a me ke kula.
  • E hoʻonohonoho i ka mahana hoʻomehana wai ma 120 ° F (48.8 ° C) a i ʻole emi.

Mu ke kēkelē ʻekahi; Pau ke kekelē ʻelua; Kuni kēkelē kolu

  • Burns
  • Puhi, ʻehu - pili loa
  • Kuni, wela - pani
  • Puhi ahi
  • ʻIli
  • Kuni kēkelē mua
  • Puni kekelē ʻelua
  • Kuni ʻekolu kekelē
  • Pahu liʻiliʻi - kōkua mua - series

ʻO Christiani DC. Nā hōʻeha kino a me nā kemika o nā māmā. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 94.

ʻO AJ Sing, Lee CC. Wela wela. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 56.

CD Voigt, Celis M, Voigt DW. Mālama i ke ahi i waho. I: Herndon DN, hoʻoponopono. Ka Mālama Kālā Burn. 5th lā. Piladelapia, PA: Elsevier; 2018: chap 6.

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