Öz
Yanıklar, kişinin sağlığı ve yaşam kalitesi üzerinde önemli etkileri olabilen ve ölüme yol açabilen, önlenebilir ancak potansiyel olarak yaşamı değiştirebilen yaralanmalardır. Sebep oldukları morbidite ve mortalite ile yanıklar, birey ve toplum için büyük bir sorundur. Yanıklar her zaman her yerde oluşabilirler ve genelde gerçekleştiklerinde etrafta sağlık personeli bulunmamakla birlikte yaralıya müdahale için sağlık personelinin gelmesini beklemek zaman kaybıdır. Yanık yönetimi oldukça karmaşık ve çok yönlüdür ancak yüksek kaliteli yanık bakımı, yaralanmadan hemen sonra ilk yardımla başlar. Yanık durumunda, araştırmalar uygun ilk yardımın erken uygulanmasının yaralanma sonrasında hasta sonuçlarını iyileştirdiğini göstermektedir. Yanıkta ilk yardım iki aşamada uygulanabilir. Bunlar; yanığın olduğu kaza bölgesinde gerçekleştirilecek işlemler ve yanığa uğrayanların ilgili tedavi birimlerine ulaştırılmasından sonra gerçekleştirilecek işlemlerdir. Yanık birinci basamakta sık karşılaşılabilen, çoğu aile hekimlerince tedavi edilebilen, tedavisi uzun sürebilen ve pahalı olabilen, tedaviye rağmen kötü ve kalıcı sonuçları olabilen bir travmadır. Tedavisinden çok önlenmesi önem arz etmekte olup, ilk yardım prognozda çok önemlidir ve bu konuda toplumun bilgi sahibi olması gerekmektedir. Bu kapsamda birinci basamakta çalışan sağlık personelince yanığın tanınması, yanık derecesinin ve sevk kriterlerinin bilinmesi, yanık derecesine göre tedavilerin ayarlanarak uygulanması önem arz etmektedir. Birinci basamak sağlık kuruluşlarında yanık hastasına uygulanabilecek tedavi ve işlemler kısıtlı olmakla birlikte hastanın zamanında ve doğru sevki önemlidir. Bundan dolayı birinci basamak sağlık kuruluşlarında yanık yönetimi için uygulanacak algoritmaların hazırlanması gerekmektedir. Bu amaçla çalışmamızda güncel veriler ele alınarak birinci basamak sağlık kuruluşlarında yanık yönetimi için algoritma oluşturulmaya çalışılmıştır.
Anahtar Kelimeler
Yanıklar Birinci basamak Kurum ve Yönetim Sağlık Hizmetleri Yönetimi
Destekleyen Kurum
Çalışmayı maddi olarak destekleyen kişi/kuruluş yoktur.
Proje Numarası
-
Kaynakça
- 1. (WHO) WHO. Burns [Internet]. [cited 2022 May 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/burns
- 2. Bennett CV, Maguire S, Nuttall D, Lindberg DM, Moulton S, Bajaj L, et al. First aid for children’s burns in the US and UK: An urgent call to establish and promote international standards. Burns. 2019 Mar 1;45(2):440–9.
- 3. Duke JM, Boyd JH, Rea S, Randall SM, Wood FM. Long-term mortality among older adults with burn injury: a population-based study in Australia. Bull World Health Organ. 2015 Jun;93:400–6.
- 4. ISBI Practice Guidelines Committee. Advisory Subcommittee, Steering Subcommittee. ISBI practice guidelines for burn care, part. 2:1617–706.
- 5. Moehrlen T, Landolt MA, Meuli M, Moehrlen U. Non intentional burns in children: Analyzing prevention and acute treatment in a highly developed country. Burns. 2019 Dec 1;45(8):1908–17.
- 6. Zor F, Ersöz N, Külahçi Y, Kapi E, Bozkurt M. Birinci basamak yanık tedavisinde altın standartlar. Dicle Tıp Dergisi. 2009 Sep 1;36(3):219–25.
- 7. Monafo WW, Bessey PQ. Total Burn Care, 2nd edn. Herndon DN, Ed. London, United Kingdom: WB Saunders; 2002.
- 8. Fadeyibi IO, Ibrahim NA, Mustafa IA, Ugburo AO, Adejumo AO, Buari A. Practice of first aid in burn related injuries in a developing country. Burns. 2015 Sep 1;41(6):1322–32.
- 9. Kara Ġ, Güloğlu C, Aldemir M. Okul öncesi çocukları bekleyen önemli bir tehlike: ev kazaları. Sendrom. 2004;16(4):78–82.
- 10. Atabey A. Yanıklar [Internet]. Ders Notları presented at: Plastik, Rekonstrüktif ve Estetik Cerrahi; İzmir Dokuz Eylül Üniversitesi Tıp Fakültesi. Available from: http://atabey. ipras. net/yanik
- 11. Polat SA, Çelik G T, Pirinçci E, Güllüdağ E, Yıldız M. Kaza Nedeniyle Acil Servise Başvuran Hastaların Retrospektif Olarak Değerlendirilmesi [Internet]. Sözel Sunum presented at: Fırat Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı 8. Ulusal Halk Saglığı Kongres; 2002 Sep 23; Elazığ. Available from: http://www. dicle. edu. tr/~halks/m9. 10. htm
- 12. Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Annals of Emergency Medicine. 2020 Jan 1;75(1):75–85.
- 13. Harish V, Li Z, Maitz PKM. First aid is associated with improved outcomes in large body surface area burns. Burns. 2019 Dec 1;45(8):1743–8.
- 14. Harish V, Tiwari N, Fisher OM, Li Z, Maitz PKM. First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients. Burns. 2019 Mar 1;45(2):433–9.
- 15. Zideman DA, Buck EDJD, Singletary EM, Cassan P, Chalkias AF, Evans TR, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. First aid. Resuscitation. 2015 Oct 1;95:278–87.
- 16. Sarı O, Onar T, Aydoğan Ü. Birinci basamakta yara ve yanık bakımı Wound and burn management in primary care. Smyrna Tıp Dergisi. 2011;(1):53–8.
- 17. Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Injury Prevention. 2019 Aug 1;25(4):301–6.
- 18. Nurmatov UB, Mullen S, Quinn-Scoggins H, Mann M, Kemp A. The effectiveness and cost-effectiveness of first aid interventions for burns given to caregivers of children: A systematic review. Burns. 2018 May 1;44(3):512–23.
- 19. Ramzy PI, Barret JP, Herndon DN. Thermal injury. Crit Care Clin. 1999 Apr;15(2):333–52, ix.
- 20. Brandt CP, Coffee T, Yurko L, Yowler CJ, Fratianne RB. Triage of Minor Burn Wounds: Avoiding the Emergency Department. The Journal of Burn Care & Rehabilitation. 2000 Jan 1;21(1):26–8.
- 21. Shrivastava P, Goel A. Pre-hospital care in burn injury. Indian J Plast Surg. 2010;43(3):15.
- 22. Bezuhly M, Gomez M, Fish JS. Emergency department management of minor burn injuries in Ontario, Canada. Burns. 2004 Mar;30(2):160–4.
- 23. Barret-Nerin J, Herndon DN. Principles and practice of burn surgery. Springer Science & Business; 2005.
- 24. Morgan ED, Bledsoe SC, Barker J. Ambulatory Management of Burns. AFP. 2000 Nov 1;62(9):2015–26.
- 25. Grunwald TB, Garner WL. Acute Burns: Plastic and Reconstructive Surgery. 2008 May;121(5):311e–9e.
- 26. Muehlberger T, Ottomann C, Toman N, Daigeler A, Lehnhardt M. Emergency pre-hospital care of burn patients. The Surgeon. 2010 Apr;8(2):101–4.
- 27. Lönnecker S, Schoder V. Hypothermie bei brandverletzten Patienten – Einflüsse der präklinischen Behandlung. Chirurg. 2001 Feb;72(2):164–7.
- 28. Haberal M, Abali AES, Karakayali H. Fluid management in major burn injuries. Indian J Plast Surg. 2010 Sep;43(S 1):S29–36.
- 29. Morgan ED, Miser WF, Marx JA, Grayzel J. Treatment of minor thermal burns. UpToDate; 2014.
- 30. Sheridan R. Outpatient Burn Care in the Emergency Department: Pediatric Emergency Care. 2005 Jul;21(7):449–56.
- 31. Vivó C, Galeiras R, del Caz MDP. Initial evaluation and management of the critical burn patient. Medicina Intensiva. 2016;40(1):49–59.
- 32. Kagan RJ, Warden GD. Care of minor burn injuries: an analysis of burn clinic and emergency room charges. The Journal of burn care & rehabilitation. 2001;22(5):337–40.
- 33. Orgill DP, Piccolo N. Escharotomy and Decompressive Therapies in Burns: Journal of Burn Care & Research. 2009 Sep;30(5):759–68.
- 34. Tompkins D, Rossi LA. Care of out patient burns. Burns. 2004 Dec;30(8):A7–9.
- 35. Patel PP, Vasquez SA, Granick MS, Rhee ST. Topical Antimicrobials in Pediatric Burn Wound Management. Journal of Craniofacial Surgery. 2008 Jul;19(4):913–22.
- 36. O’Brien SP, Billmire DA. Prevention and Management of Outpatient Pediatric Burns. Journal of Craniofacial Surgery. 2008 Jul;19(4):1034–9.
- 37. Heimbach D, Engrav L, Grube B, Marvin J. Burn depth: A review. World J Surg. 1992 Jan;16(1):10–5.
- 38. Moss LS, MS, APRN, NP-C, CWS. Treatment of the Burn Patient in Primary Care. Advances in Skin & Wound Care. 2010 Nov;23(11):517–24.
- 39. Koyuncuer DA. Yanıklı Hastalarda Hastaneye Sevk ya da Hastaneye Yatırma Kriterleri. 2004;13(7):249–51.
Öz
Burns are preventable but potentially life-altering injuries that can have significant effects on a person's health and quality of life and can lead to death. With the morbidity and mortality they cause, burns are a major problem for the individual and society. Burns can ocur any time, any where, and it is a waste of time to wait for medical personel to come to intervene, although there is usually no medical personel around when they occur. Burn management is complex and multifaceted, but high-quality burn care begins with first aid immediately after injury. In the case of burns, research shows that the early administration of appropriate first aid improves patient outcomes after injury. First aid for burns can be applied in two stages. These; These are the procedures to be carried out in the accident area where the burn occurred and the procedures to be carried out after the burns are delivered to the relevant treatment units. Burn is a trauma that can be encountered frequently in primary care, can be treated by most family physicians, its treatment can be long and expensive, and it can have bad and permanent results despite treatment. Prevention is more important than treatment, first aid is very important in prognosis and the society should be informed about this issue. In this context, it is important to recognize the burn, to know the burn degree and referral criteria, and to adjust and apply the treatments according to the burn degree by the health personel working in the primary care. Although the treatments and procedures that can be applied to burn patients in primary healthcare institutions are limited, timely and correct referral of the patient is important. Therefore, it is necessary to prepare algorithms to be applied for burn management in primary healthcare institutions. For this purpose, we tried to create an algorithm for burn management in primary health care institutions by considering current data in our study.
Anahtar Kelimeler
Burns Primary Care Organization and Administration Health Services Administration
Proje Numarası
-
Kaynakça
- 1. (WHO) WHO. Burns [Internet]. [cited 2022 May 4]. Available from: https://www.who.int/news-room/fact-sheets/detail/burns
- 2. Bennett CV, Maguire S, Nuttall D, Lindberg DM, Moulton S, Bajaj L, et al. First aid for children’s burns in the US and UK: An urgent call to establish and promote international standards. Burns. 2019 Mar 1;45(2):440–9.
- 3. Duke JM, Boyd JH, Rea S, Randall SM, Wood FM. Long-term mortality among older adults with burn injury: a population-based study in Australia. Bull World Health Organ. 2015 Jun;93:400–6.
- 4. ISBI Practice Guidelines Committee. Advisory Subcommittee, Steering Subcommittee. ISBI practice guidelines for burn care, part. 2:1617–706.
- 5. Moehrlen T, Landolt MA, Meuli M, Moehrlen U. Non intentional burns in children: Analyzing prevention and acute treatment in a highly developed country. Burns. 2019 Dec 1;45(8):1908–17.
- 6. Zor F, Ersöz N, Külahçi Y, Kapi E, Bozkurt M. Birinci basamak yanık tedavisinde altın standartlar. Dicle Tıp Dergisi. 2009 Sep 1;36(3):219–25.
- 7. Monafo WW, Bessey PQ. Total Burn Care, 2nd edn. Herndon DN, Ed. London, United Kingdom: WB Saunders; 2002.
- 8. Fadeyibi IO, Ibrahim NA, Mustafa IA, Ugburo AO, Adejumo AO, Buari A. Practice of first aid in burn related injuries in a developing country. Burns. 2015 Sep 1;41(6):1322–32.
- 9. Kara Ġ, Güloğlu C, Aldemir M. Okul öncesi çocukları bekleyen önemli bir tehlike: ev kazaları. Sendrom. 2004;16(4):78–82.
- 10. Atabey A. Yanıklar [Internet]. Ders Notları presented at: Plastik, Rekonstrüktif ve Estetik Cerrahi; İzmir Dokuz Eylül Üniversitesi Tıp Fakültesi. Available from: http://atabey. ipras. net/yanik
- 11. Polat SA, Çelik G T, Pirinçci E, Güllüdağ E, Yıldız M. Kaza Nedeniyle Acil Servise Başvuran Hastaların Retrospektif Olarak Değerlendirilmesi [Internet]. Sözel Sunum presented at: Fırat Üniversitesi Tıp Fakültesi Halk Sağlığı Anabilim Dalı 8. Ulusal Halk Saglığı Kongres; 2002 Sep 23; Elazığ. Available from: http://www. dicle. edu. tr/~halks/m9. 10. htm
- 12. Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Annals of Emergency Medicine. 2020 Jan 1;75(1):75–85.
- 13. Harish V, Li Z, Maitz PKM. First aid is associated with improved outcomes in large body surface area burns. Burns. 2019 Dec 1;45(8):1743–8.
- 14. Harish V, Tiwari N, Fisher OM, Li Z, Maitz PKM. First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients. Burns. 2019 Mar 1;45(2):433–9.
- 15. Zideman DA, Buck EDJD, Singletary EM, Cassan P, Chalkias AF, Evans TR, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 9. First aid. Resuscitation. 2015 Oct 1;95:278–87.
- 16. Sarı O, Onar T, Aydoğan Ü. Birinci basamakta yara ve yanık bakımı Wound and burn management in primary care. Smyrna Tıp Dergisi. 2011;(1):53–8.
- 17. Burgess JD, Watt KA, Kimble RM, Cameron CM. Knowledge of childhood burn risks and burn first aid: Cool Runnings. Injury Prevention. 2019 Aug 1;25(4):301–6.
- 18. Nurmatov UB, Mullen S, Quinn-Scoggins H, Mann M, Kemp A. The effectiveness and cost-effectiveness of first aid interventions for burns given to caregivers of children: A systematic review. Burns. 2018 May 1;44(3):512–23.
- 19. Ramzy PI, Barret JP, Herndon DN. Thermal injury. Crit Care Clin. 1999 Apr;15(2):333–52, ix.
- 20. Brandt CP, Coffee T, Yurko L, Yowler CJ, Fratianne RB. Triage of Minor Burn Wounds: Avoiding the Emergency Department. The Journal of Burn Care & Rehabilitation. 2000 Jan 1;21(1):26–8.
- 21. Shrivastava P, Goel A. Pre-hospital care in burn injury. Indian J Plast Surg. 2010;43(3):15.
- 22. Bezuhly M, Gomez M, Fish JS. Emergency department management of minor burn injuries in Ontario, Canada. Burns. 2004 Mar;30(2):160–4.
- 23. Barret-Nerin J, Herndon DN. Principles and practice of burn surgery. Springer Science & Business; 2005.
- 24. Morgan ED, Bledsoe SC, Barker J. Ambulatory Management of Burns. AFP. 2000 Nov 1;62(9):2015–26.
- 25. Grunwald TB, Garner WL. Acute Burns: Plastic and Reconstructive Surgery. 2008 May;121(5):311e–9e.
- 26. Muehlberger T, Ottomann C, Toman N, Daigeler A, Lehnhardt M. Emergency pre-hospital care of burn patients. The Surgeon. 2010 Apr;8(2):101–4.
- 27. Lönnecker S, Schoder V. Hypothermie bei brandverletzten Patienten – Einflüsse der präklinischen Behandlung. Chirurg. 2001 Feb;72(2):164–7.
- 28. Haberal M, Abali AES, Karakayali H. Fluid management in major burn injuries. Indian J Plast Surg. 2010 Sep;43(S 1):S29–36.
- 29. Morgan ED, Miser WF, Marx JA, Grayzel J. Treatment of minor thermal burns. UpToDate; 2014.
- 30. Sheridan R. Outpatient Burn Care in the Emergency Department: Pediatric Emergency Care. 2005 Jul;21(7):449–56.
- 31. Vivó C, Galeiras R, del Caz MDP. Initial evaluation and management of the critical burn patient. Medicina Intensiva. 2016;40(1):49–59.
- 32. Kagan RJ, Warden GD. Care of minor burn injuries: an analysis of burn clinic and emergency room charges. The Journal of burn care & rehabilitation. 2001;22(5):337–40.
- 33. Orgill DP, Piccolo N. Escharotomy and Decompressive Therapies in Burns: Journal of Burn Care & Research. 2009 Sep;30(5):759–68.
- 34. Tompkins D, Rossi LA. Care of out patient burns. Burns. 2004 Dec;30(8):A7–9.
- 35. Patel PP, Vasquez SA, Granick MS, Rhee ST. Topical Antimicrobials in Pediatric Burn Wound Management. Journal of Craniofacial Surgery. 2008 Jul;19(4):913–22.
- 36. O’Brien SP, Billmire DA. Prevention and Management of Outpatient Pediatric Burns. Journal of Craniofacial Surgery. 2008 Jul;19(4):1034–9.
- 37. Heimbach D, Engrav L, Grube B, Marvin J. Burn depth: A review. World J Surg. 1992 Jan;16(1):10–5.
- 38. Moss LS, MS, APRN, NP-C, CWS. Treatment of the Burn Patient in Primary Care. Advances in Skin & Wound Care. 2010 Nov;23(11):517–24.
- 39. Koyuncuer DA. Yanıklı Hastalarda Hastaneye Sevk ya da Hastaneye Yatırma Kriterleri. 2004;13(7):249–51.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Derleme |
| Yazarlar | |
| Proje Numarası | - |
| Erken Görünüm Tarihi | 23 Haziran 2023 |
| Yayımlanma Tarihi | 30 Haziran 2023 |
| Kabul Tarihi | 28 Nisan 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 32 Sayı: 2 |
