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Thermal injuries PowerPoint Presentation

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Description : Check out this medical titled "Thermal injuries" by Dr.Jashwant.

This medical talks about Thermal injuries, injuries caused by exposure to heat, fire, or extreme cold. They can range from mild burns to life-threatening conditions, depending on the severity of the exposure.

There are three main types of thermal injuries: burns, frostbite, and hypothermia.

Burns occur when the skin and/or underlying tissue is damaged by heat, electricity, chemicals, or radiation. They can range from minor, first-degree burns that affect only the outer layer of skin, to more severe second-degree and third-degree burns that involve deeper layers of tissue and can cause blistering, scarring, and nerve damage.

Frostbite occurs when body tissues freeze due to exposure to extreme cold. It usually affects the fingers, toes, nose, ears, and cheeks, and can cause permanent damage if not treated promptly.

Hypothermia occurs when the bodys core temperature drops below normal due to prolonged exposure to cold weather or immersion in cold water. Symptoms include shivering, confusion, and loss of coordination, and severe cases can be life-threatening.

Treatment for thermal injuries depends on the type and severity of the injury, but may include first aid measures such as cooling the burn with water, wrapping the affected area in a warm blanket for frostbite, and rewarming the body slowly for hypothermia. In more severe cases, medical attention and hospitalization may be necessary.

Tags : Thermal injuries, burns, frostbite, hypothermia, Emergency Medicine, Emergency Medicine

Published on : Apr 14, 2023 | Views : 780 | Downloads : 0

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Slide 1-

Thermal injuries Presented by Dr.Jashwant Guidance by Dr. Ganesh Govekar Dr. S.D. Kalele
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Classification Due to exposure to extreme cold a)General effects: Hypothermia b)Local effects: Frost bite, Trench foot 2.Due to exposure to extreme heat a)General effects: Heat stroke, heat cramps, heat exhaustion b)Local effects: Burns, scald
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Cold Local effects Factors influencing: 1.Body built & physique 2.Age 3.Clothing 4.Medium of exposure Pathology : 1.vasoconstriction: Paleness & blanching of skin 2.vasoparalysis& vasodilatation: Erythema, swelling, oedema
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3.Blister formation: May involve skin, subcutaneous tissues, muscles, nerves -Tissues may be frozen, stiff, hard, necrotic Frost bite: -Infarction of peripheral digits& redness, oedema, necrosis beyond line of demarcation -Exposure to dry cold -Temp< 2.5°C -Also affects nose, ear, face
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Trench foot: Immersion foot -Exposure to wet cold -Temp: 5 to8°C -Blister formation & dry gangrene General effects: -Hypothermia 1st stage: cold & shivering 2nd stage: shivering stops, temp<32°C -Depressed, lethargic, drowsy, sllepy,stupor, coma 3rd stage: Temp<27°C,Fatal
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P.M. findings: External: -Rigor mortis starts late, stay longer -P.M.L. bright red in colour -Generalised oedema Internal : -Organs congested -Ice crystals in blood vessels, heart, interstial tissues -Blood bright red -Necrosis of pancreas
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Medico legal importance: -Accidental -Homicidal -Suicidal not common
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Heat General effects: 1.Heat cramps: Minor’s cramps, stoker’s cramps, fireman’s cramps 2.Heat prostration: Heat exhaustion, heat syncope, heat collapse 3.Heat hyperpyrexia: Heat stroke, sun stroke P.M. findings: -P.M. caloricity -R.M. appears early, passes off early -Decomposition starts early -organs congested
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Burns Definition: An injury caused by application of heat or chemical substances to external or internal surfaces of body, causes destruction of tissues. Injury(sec. 44 IPC): Any harm whatever illegally caused to any person in body, mind, reputation, property. Hurt(sec.319 IPC): Any bodily pain, disease, infirmity caused to any person Heat: Min.Temp-44°C for 5-6 hours -Temp. 65°C for 2 seconds
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Causes : -Flame -Hot liquids -Chemical, corrosive -X rays -U.V. rays Electric(Joule) Flash burn Explosions Brush burns, friction burns Cement (concret) burns
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Degree of burns: Dupuytren: 1st : Reddening 2nd : Blistering 3rd : Skin partially destroyed, extremely painful :Scar, no contracture, singeing of hair 4th : Skin completely destroyed :Scar, not painful 5th :Subcutaneous tissues, deep fascia :great scaring, deformity 6th : Muscles, bones.
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Blister
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Wilson: 1st degree(1st&2nd of Dupuytren): Epidermal 2nd degree(3rd&4th of Dupuytren): Dermo-Epidermal 3rd degree(5th&6th of Dupuytren): Deep Clinical:1. Superficial 2. Deep
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Effects depends on: 1.Intensity of heat 2.Duration of exposure 3.Extent of surface involved: rule of nine 4.Site 5.Age :child & old more susceptible 6.Sex : women more susceptible
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Causes of death: Shock: Primary (neurogenic) within few hours Secondary (hypovolemic) within 1-2 days 2.Toxemia: Toxic substances produced due to burns/ destruction 3.Sepsis : >4-5 days 4. Biochemical disturbances 5. Acute renal failure 6.G.I.T. disturbances: Curling's ulcer, haemorrhage in intestine 7. Asphyxia : CO& CO2 poisoning
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8. Glottic &/ pulmonary Odema 9.Pyemia, gangrene, tetanus 10.Accidental injury 11. Marjolin’s ulcer 12.Pumonary embolism 13. Inflammation of internal organs Meningitis, peritonitis, pleurasy, bronchitis, bronchopneumonia
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Difference
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Post mortem findings: External: -Burnt area -Pugilistic attitude -Kerosene smell -Singeing of hair -Heat rupture: Due to desiccation Over fatty areas Intact vessels & nerves Irregular margins
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Internal : 1.Heat heamatoma : -On parietotemporal region -Soft, friable, light chocolate colour, may be pink due to co -Honey comb 2.Skull fracture(thermal fracture): -Rapid increase in I/C pressure leads displacement of fragment outward -Involves outer table only -On parietal bones just above temporo parietal region
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3.Brain : -Shrunken, firm, yellow to light brown -Dura leathery 4.Trachea : carbon particles 5. Organs: Congested 6.Liver:Centrilobular necrosis
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Difference :
Slide 22-

ppt slide no 22 content not found
Slide 23-

Scald
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Medico legal importance: 1.Actual cause of death 2.Accidental, suicidal, or homicidal 3.Postmortem burning 4.Indentification 5.Preternatural combustion
Slide 25-

Electrocution Injuries caused depends upon: 1.Kind of current: AC or DC 2.Amount of current: CV/R 3.Path of current 4.Duration of flow Local effects: Joule burns: Specific & Diagnostic of contact with electricity -At point of entry of current Crater: Round, shallow, pale floor
Slide 26-

Entry wound
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-When voltage very high & skin offers considerable resistance  Sufficient heat produced  Burning, Scorching, blackening, charring M/E: -Coagulation of dermis -Separation of epidermis -Flattening of cell
Slide 28-

Exit: -Usually on body part in contact with earth(bare sole) -If exit site Hard, thick, dry(sole)→ Rupture of tissues -Generation of heat → burning General features: -Tingling, Numbness -Painless -Stunned -Suspended animation
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Exit wound
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-Mental confusion -Lack of Response -Retrograde Amnesias -Practical Deafness -Defective vision -Vertigo -If current passes through base of brain  Failure of vital centers -If current passes through Heart→ VF
Slide 31-

Causes of death: 1.Very low intensity→ VF 2.Paralysis of respiratory centre 3. Paralysis of respiratory muscles 4.Mechanical injury
Slide 32-

“Factors Affecting fatality”:- Site of contact Wet body- Wash/Sweat/Bath -Thick epidermis: Sole/Palm - Dermis removed area - High voltage - Charring→↓conductivityof tissue 2. Duration of Contact- Severity High voltage - (m) Conv. → throw victim Low voltage – (m) Spasm contraction – Not allow Separation 3. Heart Disease 4. Earthing
Slide 33-

P.M. changes: External: -Examination of scene -Entry &exit wound Internal: -Asphyxial findings -Lungs & brain → Congested & odematous -Petechial haemorrhages along line of passage of current -
Slide 34-

Medicolegal importance: -Accidental -Suicidal -Homicidal -Judicial
Slide 35-

LIGHTENING Lightening : There is discharge of electricity between the clouds Lightening Stroke :When charge Jumps from clouds to Earth It Chooses the easiest (Not-Shortest) Path and hence it sometimes takes a wandering zigzag path When lightening strikes a person a potential of 1000×106Volt cause to pass 20,000 Amp Current through body → induces lethal electrocution.
Slide 36-

- It is of DC type. -Strikes a near by metallic object it may give rise to induced Voltage. Atmospheric gas becomes heated to 20000 C° ↓ Explosive expansion ↓ Blast effect Devastating
Slide 37-

AUTOPSY FINDINGS:- (A) Ext – a) Linear Burns: 6 - 25MP in width - Linear - Moist surface of skin b) Arborescent Burns – Formation of Superficial Thin Tortious Marking over skin Branching pattern of tree ↓ Filigree Burns (Fern like) - in low voltage
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c) Surface Burns – Due to Heating up metallic object d) Magnetized object (Sometimes) e) Mechanical Injuries – due to blast effect (expansion/Regressive of area) (B) Other Effects – Clothes may be torn Shoes may burst open Tympanic membrane Burst open
Slide 39-

C) Internal – Injuries from may extend to s/c/m/bone - Bone Injuries – Periosteal elevation - Patechial He – Brain spinal cord - Chromatolysis & Fragmentation of Axons - Organs – Congested
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