Travel Reference
In-Depth Information
cope with a reduced oxygen-carrying capacity of the blood due to carbon monoxide pois-
oningregardlessofthealtitude.Oxygenmaybelifesavinguntiltheindividualcanbeevac-
uated to lower altitude, particularly for the first hour or two after the burn while the carbon
monoxide is being eliminated.
ADDITIONAL MEASURES
Individuals with burns covering more than 20 to 25 percent of their body surface usually
develop paralysis of the stomach and intestines known as ileus. As they continue to swal-
low air and saliva, the paralyzed stomach becomes distended and they vomit. To avoid
these problems, a nasogastric tube should be inserted and gastric suction instituted. (Ap-
pendix B: Therapeutic Procedures). Fluids lost through the nasogastric tube should be re-
placed with Ringer's lactate or saline solution.
Dehydrationfollowingaburn,causedbytheoutpouringoffluidsintothetissues,greatly
increases the risk of thrombophlebitis. This complication should be anticipated and appro-
priately treated if it occurs. However, prevention by administering the required fluids and
avoiding dehydration is far more desirable.
A burn that involves the entire circumference of a body part is called a circumferential
burn. Full-thickness circumferential burns can present problems because the burned area
forms a hardened, dead area (eschar). The eschar does not stretch like normal skin. It con-
tracts. If the burn goes around an arm, leg, finger, or toe, the contraction can create a com-
partment syndrome (
Chapter 11: Fractures and Related Injuries
). If the burn goes around
thechest,contractioncanresultininabilitytoexpandthelungs,whichcausesmajorbreath-
ing problems. In either case, the solution is to use a scalpel to make one or more cuts
through the hard eschar, allow the cut edges to separate, and relieve the pressure from the
contracture and from fluid accumulation on blood vessels in the underlying tissue. Since
full-thickness burns destroy nerve endings, this process is painless.
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