高血壓 高尿酸 慢性腎病 胰島素 https://2019medicinenote.blogspot.com/2019/12/blog-post_57.html . 糖尿病相關筆記~目錄 https://2019medicinenote.blogspot.com/2020/01/blog-post_4.html

2024年3月27日 星期三

燒燙傷-沖水

2023-03-28 燒燙傷使用冷水沖洗, 應該用多低溫的水, 要沖多久?
1. 可將組織降溫到大約 12度. 在燒燙傷最初幾小時內將組織溫到降到 12 度C 可緩解疼痛.
2. 各種醫學研究. 沖水時間 15分鐘至三小時
3. 禁止使用冰塊/冰水.


下面是 uptodate 的建議 (下面中文是google的翻譯)

立即燒傷護理和冷卻— 應立即除去任何灼熱或燒傷的衣服、珠寶和明顯的碎片,以防止進一步受傷,並能夠準確評估燒傷程度(護理人員應採取預防措施,避免在以下情況下受傷):移除此類材料。

燒傷部位應立即用冷水或鹽水浸濕的紗布冷卻。對於中小型燒傷,冷卻可以最大程度地減少受傷區域。多項研究調查了最佳燒傷冷卻時間,持續時間從 15 分鐘到 3 小時不等 [ 52-54 ]。我們一般用生理食鹽水浸濕的紗布,在12℃左右的溫度下敷15到30分鐘。在受傷後的最初幾個小時內將組織冷卻至 12°C (54°F) 左右可有效減輕燒傷疼痛;應避免冰敷和冷凍,以防止凍傷、全身溫過低和燒傷損傷擴大。

持續監測核心體溫,同時進行冷卻以幫助防止體溫過低,特別是在處理超過 10% TBSA 的燒傷時;應避免體溫低於 35°C (95°F) [ 55,56 ]。溫熱的靜脈輸液可用於維持核心體溫。

備註. 
計算傷燙傷面積, 以二度或以上的(更嚴重)才列入計算
二度燒燙傷會起水泡. 

Immediate burn care and cooling — Any hot or burned clothing, jewelry, and obvious debris should immediately be removed to prevent further injury and to enable accurate assessment of the extent of burns (caretakers should take precautions to avoid injuring themselves when removing such material).

Burned areas should be cooled immediately using cool water or saline soaked gauze. For small and moderate sized burns, cooling can minimize the zone of injury. Multiple studies have investigated optimal burn cooling, with durations from 15 minutes to three hours [52-54]. We generally apply saline-soaked gauzes, at a temperature of approximately 12°C, for 15 to 30 minutes. Cooling tissue to around 12°C (54°F) during the first several hours after injury effectively decreases pain from burns; ice and freezing should be avoided to prevent frostbite, systemic hypothermia, and extension of burn injury.

Core body temperature is continuously monitored while cooling is performed to help prevent hypothermia, especially when dealing with burns greater than 10 percent TBSA; body temperature below 35°C (95°F) should be avoided [55,56]. Warmed IV fluids can be used to maintain core body temperature.

秒懂家醫科-血糖血脂(膽固醇)

2025-07-02 11:48AM 【門診醫學】 2024年美國糖尿病學會指引 【門診醫學】高膽固醇血症的治療建議 【預防醫學:什麼食物會升高膽固醇?】