Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occu...Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.展开更多
In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections(NI) in severely burned patients. The continiually changing epidemiology is partially related to gre...In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections(NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag(Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help thecontrol of infection in these immunocomprimised patients. Strict infection control practices(physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms.展开更多
The aerosol optical properties and chemical components of PM2.1(particulate matter with a diameter of 2.1μm or less)were investigated at Mount Gongga on the eastern slope of the Tibetan Plateau from April 2012 to Dec...The aerosol optical properties and chemical components of PM2.1(particulate matter with a diameter of 2.1μm or less)were investigated at Mount Gongga on the eastern slope of the Tibetan Plateau from April 2012 to December 2014.The annual mean aerosol optical depth(AOD)was 0.35±0.23,and the?ngstr?m exponent was 1.0±0.38.The AOD exhibited higher values in summer and winter,but lower values in spring and autumn.Dividing the observational periods into dry and wet seasons,the authors found that the concentrations of K^+,elemental carbon,secondary inorganic aerosols,and primary and secondary organic carbon in the dry(wet)season were 0.29(0.21),0.88(0.60),7.4(4.5),7.5(5.1),and 3.9(12)μg m?3,respectively.Combined with trajectory analysis,the authors found that higher concentrations of K^+,elemental carbon,and primary organic carbon indicated the effects of biomass burning from Southeast Asia during the dry season.However,the oxidation of volatile organic compounds was the main source of aerosols during the wet season,which originated from the Sichuan Basin.展开更多
We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doub...We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doubt whether applying this strategy to every patient during a mass burn event could be realistic.Of note,while there is an undisputed consensus that early burn wound excision is the gold standard of burn care,what‘early’actually means is still debated.Depending on the authors,the corresponding time limit typically varies from 24 h to a few days[2,3].展开更多
Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of H...Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of time-criticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.展开更多
Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged ...Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged over 60 years were treated. The mean age of the 27 women and 26 men was 76 years (60 - 102 years), with an average of 33.2% of total burn surface area. 25 patients (47.2%) had severe inhalation injury, 77.4% of the patients suffered full thickness burn injuries. Mean ABSI Score was 12. Relevant additional diseases were coronary heart disease, heart insufficiency, hypertension, COPD, adiposity and chronic alcoholism. Results: 22 patients were treated by early operative intervention (day 0 - 4), 13 of these patients survived further process. In 17 cases first operative procedure could take place only at a later date, 14 patients deceased before operation. 26 patients developed pneumonia. The total morbidity amounted to 26 of 53 patients (49%). A total of 19 injured with a burn index over 80 survived. 9 of them had an index of more than 100. Usual indices as the “Zellweger Index” and the ABSI-Score are not adequate to determine the prognosis of thermal injuries in the elderly. Conclusion: The treatment of elderly with burn trauma is affected by many factors. Compared to younger patients the increased incidence of an inhalation injury is decisive for the prognosis of older patients. The frequency of pre-existing diseases is clearly largely than with younger burn injured patients. These prognostically relevant parameters were not sufficiently considered by established score systems.展开更多
文摘Burn injury is a major public health concern,with an estimated 180,000 deaths each year associated with burn-related infections.The majority of these occur in low-and middle-income countries,and almost two-thirds occur in the World Health Organization African and South-East Asia Regions.There is a risk of an escalation of burn injury site infections if nurses who are directly involved in burn care do not develop a mechanism to mitigate this risk in the coming years.Hence,this study aims at explaining what burn injuries are and how nurses can prevent the occurrence of infection among burn victims.This review analyzed published studies using keywords such as burn injury,infection in burn patients,and nurses’involvement in infection prevention and control(IPC)on search engines such as PubMed,Science Direct,and Google Scholar.The literature was retrieved and reviewed for eligibility to capture just the variables indicated in this seminar objective;the date range chosen in the literature search was from 2015 to 2023.The study found that many patients die from burn injuries as a result of exposure to infection and most nurses are not adequately informed about infection control.The study also found that nurses’responsibilities include proper hand hygiene,wound care,the use of personal protective equipment,antibiotic medication,cleaning the patient’s surroundings,and preventing patient cross-contamination.Burn injuries pose a significant risk to patients,necessitating infection control and prevention.Therefore,nurses in burn units should be informed on IPC practices and also educate patients,families,and coworkers on their importance.
文摘In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections(NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood stream infections. Universal application of early excision of burned tissues has made a substantial improvement in the control of wound-related infections in burns. Additionally, the development of new technologies in wound care have helped to decrease morbidity and mortality in severe burn victims. Many examples can be given of the successful control of wound infection, such as the application of an appropriate antibiotic solution to invasive wound infection sites with simultaneous vacuum-assisted closure, optimal preservation of viable tissues with waterjet debridement systems, edema and exudate controlling dressings impregnated with Ag(Silvercel, Aquacell-Ag). The burned patient is at high risk for NI. Invasive interventions including intravenous and urinary chateterization, and entubation pose a further risk of NIs. The use of newly designed antimicrobial impregnated chateters or silicone devices may help thecontrol of infection in these immunocomprimised patients. Strict infection control practices(physical isolation in a private room, use of gloves and gowns during patient contact) and appropriate empirical antimicrobial therapy guided by laboratory surveillance culture as well as routine microbial burn wound culture are essential to help reduce the incidance of infections due to antibiotic resistant microorganisms.
基金supported by the National Basic Research Program of China[grant numbers 2016YFC0202001 and 973Program 2014CB441200]the National Natural Science Foundation of China[grant numbers 41375036 and41305076]
文摘The aerosol optical properties and chemical components of PM2.1(particulate matter with a diameter of 2.1μm or less)were investigated at Mount Gongga on the eastern slope of the Tibetan Plateau from April 2012 to December 2014.The annual mean aerosol optical depth(AOD)was 0.35±0.23,and the?ngstr?m exponent was 1.0±0.38.The AOD exhibited higher values in summer and winter,but lower values in spring and autumn.Dividing the observational periods into dry and wet seasons,the authors found that the concentrations of K^+,elemental carbon,secondary inorganic aerosols,and primary and secondary organic carbon in the dry(wet)season were 0.29(0.21),0.88(0.60),7.4(4.5),7.5(5.1),and 3.9(12)μg m?3,respectively.Combined with trajectory analysis,the authors found that higher concentrations of K^+,elemental carbon,and primary organic carbon indicated the effects of biomass burning from Southeast Asia during the dry season.However,the oxidation of volatile organic compounds was the main source of aerosols during the wet season,which originated from the Sichuan Basin.
文摘We read with interest the letter by Surowiecka et al.[1]about early burn wound excision in mass casualty events.We couldn’t agree more with their statement about the benefit of early burn wound excision.Still,we doubt whether applying this strategy to every patient during a mass burn event could be realistic.Of note,while there is an undisputed consensus that early burn wound excision is the gold standard of burn care,what‘early’actually means is still debated.Depending on the authors,the corresponding time limit typically varies from 24 h to a few days[2,3].
文摘Helicopter Emergency Medical Services (HEMS) use in civilian medical transport has its roots in the use of rotor-wing trauma transport in the military setting. Much of the literature and evidence based?on the use of HEMS is therefore related to scene and interfacility transport of injured patients. Regionalization of care and increased understanding of time-criticality of various non-trauma conditions has contributed to growing utilization of HEMS for non-trauma conditions over recent decades. It is common for HEMS to be utilized for a variety of non-trauma situations ranging from neonatal and obstetrics transports to cardiac and stroke transports. The purpose of this review is to overview the use of HEMS for non-trauma, focusing on situations in which there is evidence addressing possible HEMS utility.
文摘Objective: Geriatric patients represent a separate group in the treatment of burn injury regarding pathogenesis, pathophysiology and therapeutic procedure. Methods: From 2000 to 2010 on our burn unit 53 patients aged over 60 years were treated. The mean age of the 27 women and 26 men was 76 years (60 - 102 years), with an average of 33.2% of total burn surface area. 25 patients (47.2%) had severe inhalation injury, 77.4% of the patients suffered full thickness burn injuries. Mean ABSI Score was 12. Relevant additional diseases were coronary heart disease, heart insufficiency, hypertension, COPD, adiposity and chronic alcoholism. Results: 22 patients were treated by early operative intervention (day 0 - 4), 13 of these patients survived further process. In 17 cases first operative procedure could take place only at a later date, 14 patients deceased before operation. 26 patients developed pneumonia. The total morbidity amounted to 26 of 53 patients (49%). A total of 19 injured with a burn index over 80 survived. 9 of them had an index of more than 100. Usual indices as the “Zellweger Index” and the ABSI-Score are not adequate to determine the prognosis of thermal injuries in the elderly. Conclusion: The treatment of elderly with burn trauma is affected by many factors. Compared to younger patients the increased incidence of an inhalation injury is decisive for the prognosis of older patients. The frequency of pre-existing diseases is clearly largely than with younger burn injured patients. These prognostically relevant parameters were not sufficiently considered by established score systems.
文摘目的观察对大面积烧伤患者实施集束化护理联合银离子藻酸盐敷料对中心静脉导管相关性感染的影响。方法选取2017年1月1日至2023年12月31日在广西医科大学第一附属医院烧伤整形外科住院治疗经创面留置中心静脉导管(Peripherally Inserted Central Catheter,PICC)大面积烧伤的110例患者为研究对象。对患者实施随机分组,每组55例。对照组实施常规护理,观察组实施集束化护理联合使用银离子藻酸盐敷料。结果与对照组相比,观察组穿刺部位创面深度较浅,差异有统计学意义(P<0.05)。观察组创面愈合时间明显短于对照组,差异有统计学意义(P<0.05)。观察组创面愈合时间明显短于对照组,差异有统计学意义(P<0.05)。结论对大面积烧伤患者创面静脉导管实施集束化护理联合使用银离子藻酸盐敷料,能够显著减少感染,促进创面愈合,且创面深度较浅。
