Medicine, not transcription
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# Automatic raw audio transcription (00:00 - 45:12)
alright class today we cover burns and cutaneous pathophysiology initial management is critical especially in severe burns survival depends on first hours remember skin layers epidermis most superficial barrier against microbes and solar radiation waterproof via keratin except palms and soles due to stratum lucidum then dermis with collagen provides turgor and mechanical tension if suture opens it's because dermis wasn't anchored starling forces hydrostatic vs oncotic pressure when burned barrier is lost fluid extravasates hypovolemic shock...
we classify burns: first degree epidermal, second degree superficial and deep dermal, third degree full thickness, fourth degree involving muscle or bone. rule of 9s head 9 percent, anterior torso 18, posterior 18, upper extremity 9 each, lower 18 each, perineum 1 percent. parkland formula lactated ringer 4 ml per kg per percent burn, half in first 8 hours rest over next 16 hours target urine output 0.5 to 1 ml per kg per hour...
infectious complications pseudomonas staphylococcus aureus septic shock hypothermia from skin loss dressings surgical debridement escharotomy skin grafts hydrocolloid silver sulfadiazine...
airway management is priority if smoke inhalation suspected stridor soot in nares facial burns early intubation before laryngeal edema closes the airway...
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