Question

Develop a concept map of the responses of the assigned system to burn injury. identify aspects important to patient survival during the resuscitation and acute phase of the burn injury , Include lab values that may be impacted one of the following body systems:

 Respiratory

 Cardiovascular

 Neurological

 Gastrointestinal

 Renal

 Psychosocial

Answer 1

Burns effects on organs systems:

Patients with more severe burn injuries, especially those associated with fires or explosions, should be assessed carefully for multiple trauma, and care should be assessed carefully for multiple trauma.

Respiratory system:

• Laryngeal Obstruction
• Bronchospasm
• Mucosal slough
• Infection
• Bronchiolar plugging
• Atelectasis
• Thermal damage to airway above vocal cords
• Vocal cord edema its causes respiratory obstruction
• The systematic response triggered by burns and resuscitative measure may cause pulmonary damage edema in acute phase

Respiratory alkalosis and electrolyte disturbance may be affected on respiratory system leads systematic imbalance.

Cardiovascular System effects:

Immediately after injury, myocardial function may be depressed; however this typically improves with in the three days. This depression in myocardial function may be caused by circulating myocardial depressants or persisting hypervolemia, despite aggressive fluid therapy and lack of classic signs of hypo perfusion. A hyper dynamic cardiovascular response then occurs, with an up to two fold increase in cardiac output.

Neurological system effects:

Cellular hypoxia increase to intracranial pressure cerebral edema formation and other signs of CNS dysfunction can include agitation, ataxia abnormal posturing, and transient loss of consciousness, seizures and even shock.

After deep burn injury, cutaneous nerve regeneration will occur with the migration of new nerve fibers from the wound bed or from the collateral sprouting of the nerve fibers from adjacent uninjured area. This nerve regeneration process is imperfect. It was reported that 71% of extensively burned victims suffers from abnormal sensation and 36% from chronic pain. Critical illness polyneuropathy in burn patients is an under reported condition in burn patients      

Gastrointestinal system effects:

After a thermal injury, blood flow to bowel disease by nearly 60% of baseline and stays decreased for up to 4 hours intra-abdominal hypertension and secondary abdominal compartment syndrome.

Intra-abdominal pressure (IAP) can be altered by decreased abdominal wall compliance resulting from circumferential torso burns and tension secondary to pain or discomfort. As IAP increases, IAH will eventually result. If IAH goes unnoticed of left untreated, ACS develop resulting in pressure- induced organ dysfunction and failure. ACS is commonly associated with prolonged IAP Pressure of >20mm Hg. Percutaneous drainage and escharotomy may reduce IAP in the case of the abdominal burns. The standard treatment is laparotomy, with mortality rates reported to be as high as 75% in patients with ACS.

Renal system:

   Acute renal failure is burn population has been problematic, with various studies reporting ranges from 0.5 to 30% AKI related to thermal injury is most likely to occur at two distinct time points, early during resuscitation or late to secondary to sepsis early AKI has been shown to be associated with early multiple organ dysfunction and higher mortality risk. Increasing size and depth of burns are key factors determining AKI. Prevention of AKI requires early aggressive fluid resuscitation and preservation of normal renal perfusion global parameters of perfusion (lactate, base deficit, and central venous saturation) are more appropriate than urine output alone in reflecting the degree and recovery from hypo perfused state or state of shock.

Psychological response:

Physical traumas such as burn injury and painful and intrusive medical procedures required to treat them can be profoundly traumatizing. The emotional response to any trauma is intense fear, horror, helplessness to affect the outcome there is inherent in traumatic incident, a threat to basic security and safety.