PENJAGAAN PESAKIT

TERBAKAR DAN MELECUR

OBJEKTIF
Menerangkan ciri-ciri klinikal keadaan
pesakit yang mengalami terbakar dan
melecur
Menjelaskan tindakan penjagaan
kejururawatan umum dari aspek
pemakanan, penjagaan kawasan
kecederaan, latihan, fisioterapi dan
pemberian ubat-ubatan
Menerangkan komplikasi-komplikasi yang
boleh berlaku

DEFINISI
Terbakar
Kecederaan dan kehancuran koagalutif
lapisan kulit akibat haba kepanasan kering

Melecur
Kecederaan dan kehancuran koagalutif
lapisan kulit akibat haba kepanasan lembab

KEBAKARAN KERING
KEBAKARAN LEMBAB

airway burn

Radiation burn

PENYEBAB
Haba kering
Therma
Elektrik
Radiasi

Kelembapan
Bahan kimia
Wap
Cecair
Alkaline burn injury

CIRI-CIRI KLINIKAL
Ciri kerosakan tisu mengikut kedalaman
dan jenis terbakar / melecur
Renjatan neurogenik
Renjatan hipovolumik
Berlaku infeksi

RAWATAN DAN KEJURURAWATAN

Rawatan kecemasan
Rawatan dalam wad

KOMPLIKASI

Renjatan
Toksemia Kimia
Kontraktur
Kecacatan fizikal dan mental
Septisaemia
Parut keloid

KOMPLIKASI
Infeksi
Anaemia
Paralisis

PARUT KELOID

KONTRAKTUR

RAWATAN UNIT KECEMASAN

Minor burns
Prevent from shock
Cool the burns (under running water @
immerse in water)
Cover the burn with a sterile gauze
Application of SSD
Analgesic (Morphine @ Pethidine)
Anti-tetanus injection

RAWATAN UNIT KECEMASAN

Cautions
Dont use ice
Dont break blisters

Major burns
Dont remove burnt cloth (but if possible try to
remove it include jeweleries)
Dont immerse severe large burn in cool water
Shock treatment
Check for ABC
Cover the area of burn
Fluid replacement

RAWATAN DALAM WAD

Refer to burns unit
For further management

Monitoring vital signs hourly

BP, pulse, respiration

Monitoring ABC
Appropriate fluid and oxygen therapy

Diet
Full high protein diet

RAWATAN DALAM WAD

Dressing
Daily @ b.d dressing
Change rapidly dressing
Avoid to bandage the wound

Burns wound care

To avoid infection
Aseptic technique
Universal precaution technique
Precaution of nosocomial infection

RAWATAN DALAM WAD

Antibiotic and analgesic
Follow the regimen and doctors order
Broad spectrum antibiotic
Hourly @ p.r.n analgesic

Surgery
Skin grafting
To avoid permenant keloid and contracture

Physiotherapy
To ambulate and restore limbs function

FLUID REPLACEMENT
To all burn wounds 20% TBSA
Crystalloid fluid are administered
thourgh 2 large-bore catheters (14G
16G)
Ringers lactate used during 24 hours
after burns injury
2 commonly used formulas

I.
II.

Parkland formula (4ml X kg X %TBSA)

Modified Brooke formula (2ml X kg X
%TBSA)