Quemaduras. Nuevos retos que plantearse / Burns, new challenges to take on

Estudio descriptivo transversal que muestra las características de las quemaduras atendidas en un Centro de Atención Primaria (CAP) de ámbito urbano en Barcelona durante el periodo comprendido desde 19/7/2005 hasta 11/8/2007 (N=93). Los pacientes menores de 15 años fueron excluidos. El 88% (82; IC del 95% 81,41-94,59) de las quemaduras se debió a un agente térmico. El aceite de cocina es el primer elemento causal (24; 27%; IC del 95% 17,99-36,01). El 70% de las heridas señaló dérmicas superficiales (65; IC del 95% 60,70-79,30). El 61% (57; IC del 95% 51,70-70,30) se localizó en EESS (extremidades superiores). La superficie corporal quemada media registrada indicó 0,0076% (mediana=0,005%; rango=0,0001-0,5000%). El mayor número de heridas se observó en los varones de 31 a 45 años (17%; 16; IC del 95% 9,38-24,62). Se precisan programas de educación para la salud centrados en la prevención y actuación ante una quemadura. Estudios como éste pueden resultar útiles a la hora de iniciar estrategias preventivas o educativas (AU)

This article concerns a transversal descriptive study which shows the characteristics of burns treated in a Primary Health Care Center in an urban environment in Barcelona from 19 July 2005 until 11 August 2007 (N=93). Patients younger than 15 were excluded from this study. 88% (82; IC of 95% 81,41-94,59) of the burns treated were caused by a thermal agent. Kitchen cooking oil ranks first as the cause of burns (24; 27%; IC of 95% 17,99-36,01). 70% of the burns studied had signs of superficial skin damage (65; IC of 95% 60,70-79,30). 61% (57; IC of 95% 51,70-70,30) of these burns were located on upper extremities. The average recorded body surface burned was 0.0076% (median=0,005%; range=0,0001-0,5000%). The greatest number of wounds were observed among men aged 31 to 45 (17%; 16; IC of 95% 9,38-24,62). Educational health programs which focus on prevention of, and first aid care for, burns are needed. Studies like this one may prove useful when starting preventive or educational strategies (AU)

[Incidents of cutaneous alteration secondary to external electrical cardioversion]. / Incidencia de las alteraciones cutáneas secundarias a la cardioversión eléctrica externa.

External electrical cardioversion is a technique basically used as treatment of choice in supraventricular arrhythmias, atrial fibrillation standing out for its frequency. This procedure consists in the application of one or several synchronized electrical discharges through the patient's chest to revert cardiac rhythm to sinus rhythm. One of the complications is generally the appearance of the skin alterations, pain or intense local heat. The objectives of this study were to describe the skin lesions that appeared after an external electrical cardioversion procedure and to evaluate the information received by the patients on discharge. A descriptive study was conducted, using a sample of 68 patients who underwent cardioversion between January 1 and December 30 1, 2004. Mean age was 62.71 years, of which 76.5% were males diagnosed of atrial fibrillation in 82.4% of the cases. Erythema appeared in more than 80% of the cases, with the mean duration of 4.76 days. A total of 13.2% developed second-degree burn. Although 92.5% considered written information on the care after the procedure necessary, less than 11% had received it. It is concluded that the prevalence of the skin alterations after cardioversion is elevated, one of the causal factors being lack of information. There is a significant deficiency of knowledge on skin care after the procedure.

Incidencia de las alteraciones cutáneas secundarias a la cardioversión eléctrica externa / Incidents of cutaneous alteration secondary to external electrical cardioversion

La cardioversión eléctrica externa es una técnica utilizada básicamente como tratamiento de elección en arritmias supraventriculares, y que por su frecuencia destaca la fibrilación auricular. Este procedimiento consiste en la aplicación de una o varias descargas eléctricas sincronizadas a través del tórax del paciente para conseguir revertir el ritmo cardíaco anómalo a ritmo sinusal. Una de las complicaciones suele ser la aparición de alteraciones cutáneas, dolor y calor local intenso. Los objetivos de este estudio fueron describir las lesiones cutáneas aparecidas tras el procedimiento de cardioversión eléctrica externa y evaluar la información recibida por los pacientes al alta. Se ha llevado a cabo un estudio descriptivo en 68 pacientes, que fueron sometidos a cardioversión entre el 1 de enero y el 31 de diciembre de 2004. La edad media fue de 62,71 años, el 76,5% fueron varones diagnosticados en un 82,4% de fibrilación auricular. El eritema apareció en más del 80% de los casos, con una duración media de 4,76 días, y el 13,2% desarrolló una quemadura de segundo grado. Aunque el 92,5% ha considerado necesaria la información escrita acerca de los cuidados tras el procedimiento, menos de un 11% la ha recibido. Se concluye que la prevalencia de las alteraciones cutáneas tras cardioversión es elevada, y uno de los factores causales es la falta de información, presentando un importante déficit de conocimientos acerca del cuidado de la piel tras el procedimiento

External electrical cardioversion is a technique basically used as treatment of choice in supraventricular arrhythmias, atrial fibrillation standing out for its frequency. This procedure consists in the application of one or several synchronized electrical discharges through the patient's chest to revert cardiac rhythm to sinus rhythm. One of the complications is generally the appearance of the skin alterations, pain or intense local heat. The objectives of this study were to describe the skin lesions that appeared after an external electrical cardioversion procedure and to evaluate the information received by the patients on discharge. A descriptive study was conducted, using a sample of 68 patients who underwent cardioversion between January 1 and December 30 1, 2004. Mean age was 62.71 years, of which 76.5% were males diagnosed of atrial fibrillation in 82.4% of the cases. Erythema appeared in more than 80% of the cases, with the mean duration of 4.76 days. A total of 13.2% developed second-degree burn. Although 92.5% considered written information on the care after the procedure necessary, less than 11% had received it. It is concluded that the prevalence of the skin alterations after cardioversion is elevated, one of the causal factors being lack of information. There is a significant deficiency of knowledge on skin care after the procedure

Cuidado de enfermagem à vítima de queimadura por descarga elétrica: enfocando os diagnósticos de enfermagem / Nursing care to the victim burned by electric discharge approaching the nursing diagnose

Objetiva-se relatar a assistência de enfermagem prestada ao paciente vítima de queimadura por descarga elétrica e apresentar os principais diagnósticos de enfermagem. Estudo descritivo em que se utilizou o estudo de caso. Desenvolveu-se no período de maio a agosto de 2003, no Centro de Tratamentode de Queimados do Instituto Dr. José Frota. Foram traçados diagnósticos de enfermagem: dor relacionada com lesão do tecido e nervo; déficit de volume hídrico relacionado com aumento da permeabilidade capilar. A assistência de enfermagem é imprescindível desde a admissão até a alta do paciente, realizando cuidados com base científica, com assistência direcionada e sistematizada.

The neurological complications of electrical injury: a nursing case management perspective.

High-energy electrical injury, whether from lightning strike or electrical shock, occurs primarily in the workplace. Neurological dysfunction can be a devastating complication of electrical injury. A review of the literature was undertaken to develop a better understanding of the epidemiology, mechanisms of injury and neuropathology associated with this type of injury. The numerous challenges inherent in the management of these complex cases were illustrated by three case studies.

Nurse-aid management of burns.

With over 75% of burns occurring in the home it is essential that nurses are aware of the main principles of treatment. This article outlines the nurse-aid management of burns to help reduce the severity of the damage.

Management of acute burns and burn shock resuscitation.

Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications.