Bỏng vừa phải: (1) một phần, độ dày bỏng của BSA 15-25% ở những bệnh nhân có nguy cơ thấp, (2) BSA 10-20% bệnh nhân có nguy cơ cao, (3) độ dày, bỏng 30-10% BSA; này không bao gồm bỏng độ dày một phần của bàn tay, mặt, chân, đáy chậu, | CUTANEOUS INJURIES 483 - FIGURE 19-3 Lund and Browder chart for adults. Moderate burns 1 partial-thickness burns of 15-25 BSA in low-risk patients 2 10-20 BSA in high-risk patients 3 full-thickness burns of 3-10 BSA this excludes partial-thickness burns of the hands face feet perineum or circumferential burns of an extremity. These patients generally require hospitalization Minor burns 1 partial-thickness burns involving 15 BSA in low-risk patients 2 10 in high-risk patients and 3 full-thickness burns of 2 without other injuries. These patients can be treated as outpatients. Removal of the burning agent and cooling will minimize the burn. However caution needs to be taken not to cause hypothermia. Airway management can be lifesaving and needs to be performed as early as possible in patients with inhalation injuries or severe extensive burns. All burn patients with exposure to smoke should be placed on 100 humidified oxygen. Fluid resuscitation should be initiated early. Patients with major and moderate burns have extraordinary fluid requirements. There are many methods to estimate the fluid requirements of burn patients. The most commonly used is the Parkland formula see Table 19-9 . The goal of the volume resuscitation should be to maintain a urine output of mL kg h. Pain management should be given parentally. Tetanus toxoid should be administered when necessary. Prophylactic antibiotics are not indicated. 484 CHAPTER 19 TRAUMATIC DISORDERS RELATIVE PERCENTAGES OF AREAS AFFECTED BY GROWTH AREA BIRTH AGE 1 YR. I AGE 5 YR. A - of head 9 4 8 6 6 4 B - A of one thigh 2 A 3Y 4 c - v of one leg 2 h 2 4 2 h AGE 10 YR. AGE 15 YR. ADULT 5 4 4 4 4 4 4 4 3 3 4 3 4 - FIGURE 19-4 Lund and Browder chart Relative percentage of burns by age. Large wounds should be covered with dry sterile dressings. Small wounds can be covered with saline-soaked dressings to provide cooling and comfort but caution must be taken to avoid hypothermia. Eventually small wounds that do not .
