Burns Essays

Skin Disorders/Burns Essays Skin Disorders/Burns Essay Skin Disorders/Burns Essay The incidence of burn injuries has been declining during the past several decades. Approximately 2 million people require medical attention for burn injury in the United States each year (Kao Garner, 2000). The risk of death increases significantly if the patient has sustained both a cutaneous burn injury and a smoke inhalation injury.Young children and elderly people are at particularly high risk for burn injury. The skin in people in these two age groups is thin and fragile; therefore, even a limited period of contact with a source of heat can create a full-thickness burn. The National Center for Injury Prevention and Control lists â€Å"fire/burn† among the categories of the 1998 Unintentional Injuries and Adverse Effects.Most burn injuries occur in the home, usually in the kitchen while cooking and in the bathroom by means of scalds or improper use of electrical appliances around water sources (Gordon Goodwin, 2001). Careless cooking is one of the leading causes of household fires in the United States. The U.S. Fire Administration reports that nearly one third of all residential fires begin in the kitchen. The major factors contributing to cooking fires include unattended cooking, grease, and combustible materials on the stovetop.Burns can also occur from work-related injuries. Education to prevent burn injuries in the workplace should include safe handling of chemicals and chemical products and increasing awareness of the potential for injuries caused by hot objects and substances. The national Institute for Burn Medicine, which collects statistical data from burn centers throughout the United States, notes that most patients (75%) are victims of their own actions. Contributing to the statistics are scalds in toddlers, school-age children playing with matches, electrical injury in teenage boys, and smoking in adults combined with the use of drugs and alcohol. One of the major culprits of burn injuries is the inappropriate u se of gasoline. The U.S. Home Product Report, 1993-1997 (2001), indicated that there were over 140,000 gasoline-related fires and approximately 500 people died from gasoline-related injuries during this period.Many burns can be prevented. Medical personnel can play an active role in preventing fires and burns by teaching prevention concepts and promoting the use of smoke alarms has had the greatest impact on decreasing fire deaths in the United States.There are four major goals relating to burns:PreventionInstitution of lifesaving measures for the severely burned personPrevention of disability and disfigurement through early, specialized, individualized treatmentRehabilitation through reconstructive surgery and rehabilitative programsII. DiscussionA. Classification of BurnsBurn injuries are described according to the depth of the injury and the extent of body surface area injured.a.)  Ã‚  Ã‚   Burn DepthBurns are classified according to the depth of tissue destruction as superfici al partial-thickness injuries, deep partial-thickness injuries, or full-thickness injuries. Burn depth determines whether epithelialization will occur. Determining burn depth can be difficult even for the experienced burn care provider.In a superficial partial-thickness burn, the epidermis is destroyed or injured and a portion of the dermis may be injured. The damaged skin may be painful and appear red and dry, as in sunburn, or it may blister.A deep partial-thickness burn involves destruction of the epidermis and upper layers of the dermis and injury to deeper portions of the dermis. The wound is painful, appears red, and exudes fluid. Capillary refill follows tissue blanching. Hair follicles remain intact. Deep partial-thickness burns take longer to heal and are more likely to result in hypertrophic scars.A full-thickness burn involves total destruction of epidermis and dermis and, in some cases, underlying tissue as well. Wound color ranges widely from white to red, brown, or bla ck. The burned are is painless because nerve fibers are destroyed. The wound appears leathery; hair follicles and sweat glands are destroyed.The following factors are considered in determining the depth of the burn: ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How the injury occurred ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Causative agent, such as flame, or scalding liquid ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Temperature of the burning agent ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Duration of contact with the agent ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Thickness of the skinB. Management of the Patient with a Burn InjuryBurn care must be planned according to the burn depth and local response, the extent of the injury, and the presence of a systematic response. Burn care then proceeds through three phases: emergent/resuscitative phase, acute/intermediate phase, and rehabilitation phase. Although priorities exist for each of the phases, the phases overlap, and assessment and management of specific problem s and complications are not limited to these phases but take place throughout burn care.C. Planning and GoalsThe major goals for the patient may include restoration of normal fluid balance, absence of infection, attainment of anabolic state and normal weight, improved skin integrity, reduction of pain and discomfort, optimal physical mobility, adequate patient and family coping, adequate patient and family knowledge of burn treatment, and absence of complications. Achieving these goals requires a collaborative, interdisciplinary approach to patient management.III. ConclusionContinued assessment of the burn patient during the early weeks after the burn injury-focuses in hemodynamic alterations, wound healing, pain and psychosocial responses, and early detection of complications.Other significant and ongoing assessment focus on pain and psychosocial responses, daily body weights, caloric intake, general hydration, and serum electrolyte, hemoglobin, and hematocrit levels. Assessment fo r excessive bleeding from blood vessels adjacent to areas of surgical exploration and debridement is necessary as well.

How to Use Delphi to Build a Custom Windows Explorer

How to Use Delphi to Build a Custom Windows Explorer Windows Explorer is what you use in the Windows operating system to browse for files and folders. You can create a similar structure with Delphi so that the same content is populated within your programs user interface. Common dialog boxes are used in Delphi to open and save a file in an application. If you want to use customized file managers and directory browsing dialogs, you have to deal with file system Delphi components. The Win 3.1 VCL palette group includes several components that allow you to build your own custom File Open or File Save dialog box: TFileListBox, TDirectoryListBox, TDriveComboBox, and TFilterComboBox. Navigating Files The file system components allow us to select a drive, see the hierarchical directory structure of a disk, and see the names of the files in a given directory. All of the file system components are designed to work together. For example, your code checks what the user has done to, say, a DriveComboBox and then passes this information on to a DirectoryListBox. The changes in DirectoryListBox are then passed to a FileListBox in which the user can select the file(s) needed. Designing the Dialog Form Start a new Delphi application and select the Win 3.1 tab of the Component palette. Then do the following: Place one TFileListBox, TDirectoryListBox, TDriveComboBox, and TFilterComboBox component on a form, keeping all of their default namesAdd one TEdit (named FileNameEdit) and one TLabel (call it DirLabel).Include a few labels with captions, like File Name, Directory, List Files of Type, and Drives. To show the currently selected path as a string in a DirLabel components caption, assign the Labels name to the DirectoryListBoxs DirLabel property. If you want to display the selected filename in an EditBox (FileNameEdit), you have to assign the Edit objects Name (FileNameEdit) to the FileListBoxs FileEdit property. More Lines of Code When you have all the file system components on the form, you just have to set the DirectoryListBox.Drive property and the FileListBox.Directory property in order for the components to communicate and show what the user wants to see. For example, when the user selects a new drive, Delphi activates the DriveComboBox OnChange event handler. Make it look like this:   procedure TForm1.DriveComboBox1Change(Sender: TObject) ;beginDirectoryListBox1.Drive : DriveComboBox1.Drive;end; This code changes the display in the DirectoryListBox by activating its OnChange event Handler:   procedure TForm1.DirectoryListBox1Change(Sender: TObject) ;beginFileListBox1.Directory : DirectoryListBox1.Directory;end; In order to see what file the user has selected, you need to use the OnDblClick event of the FileListBox:   procedure TForm1.FileListBox1DblClick(Sender: TObject) ;beginShowmessage(Selected: FileListBox1.FileName) ;end; Remember that the Windows convention is to have a double-click choose the file, not a single click. This is important when you work with a FileListBox because using an arrow key to move through a FileListBox would call any OnClick handler that you have written. Filtering the Display Use a FilterComboBox to control the type of files that are displayed in a FileListBox. After setting the FilterComboBoxs FileList property to the name of a FileListBox, set the Filter property to the file types that you want to display. Heres a sample filter:   FilterComboBox1.Filter : All files (*.*)|*.* | Project files (*.dpr)|*.dpr | Pascal units (*.pas)|*.pas; Hints and Tips Setting the DirectoryListBox.Drive property and the FileListBox.Directory property (in the previously written OnChange event handlers) at runtime  can be also be done at design time. You can accomplish this kind of connection at design time by setting the following properties (from the Object Inspector): DriveComboBox1.DirList : DirectoryListBox1DirectoryListBox1.FileList : FileListBox1 Users can select multiple files in a FileListBox if its MultiSelect property is True. The following code shows how to create a list of multiple selections in a FileListBox and show it in a SimpleListBox (some ordinary ListBox control).   var k: integer;...with FileListBox1 doif SelCount 0 thenfor k:0 to Items.Count-1 doif Selected[k] thenSimpleListBox.Items.Add(Items[k]) ; To display full path names that are not shortened with an ellipsis, do not assign a Label object name to the DirLabel property of a DirectoryListBox. Instead, insert a Label into a form and set its caption property in the DirectoryListBoxs OnChange event to the DirectoryListBox.Directory property.