Thermal opyk of the back according to ICD 10. Coded thermal opik in ICD

Termichny opik (code for MKKh-10) - the price of the shkirne ushkodzhennya, which is developed for the international classification of ailments. The system was given from 1998 until the end of the day. The statti has a variety of steps in terms of term descriptions and methods of improving the first medical aid.

Vipaluvannya epіthelіyu or large large balls of shkіri, such as wine, when in contact with an open fire, heated objects are called thermoburn. Vrakhovuєtsya inlet, so go out of solid, rare and gas-like streams, which may cause high temperature.

Otrimanі uhkodzhennya is not safe, and can witness death. Sered termicheskikh opikiv, code for MKH-10 T20-30 - tse scalded, hit blisk, radioactivity, rubbing, electrostrum and heating attach. In the case of the classification, ailments, ultraviolet vipromynuvans, eritemi do not turn on.

Reasons for confusion:

into the fire;
okrіp for steam;
dottik before baking items.

It is a matter of great importance to the type of training, to diagnose the severity of the patient's camp. At neglected stages similar to the kind of injuries є causes of a lethal result.

Lіkuvannya folding, trivial, overheating of the shkіrny curvature supervolujutsya ruinuvannya bіlkіv, so take a part in the woven innovation and clerical life.

Features of the opikiv on the new parts of the file according to the ICD

Razrіznyayut zonі urazhnya on tіlі people:

Head і shia.
Tulub.
Shoulder girdle and upper designs.
Hands, wrists.
Hip area, hips, legs.
Gomіlkovostopni slopes and feet.

Until the head and the head are damaged, the integrity of the hair, the eyes, the hairy part is rendered. Okremo pezglyadyayutsya wounds, surrounded by the zone of the eyes, the company and the pharynx. Nebezpeka - closeness to mucous nose and eyes.

As soon as it is simple or straight lines of the abdomen, back, chest, groin, body parts, then they are classified for ICD-10 T21. With vines є wounds to the scapula i groin zones, Viewed in T22.

If the wound is divided between zones or it is unwise because of the severity of the injury, it should be reported to an unspecified localization.

The heat flow on the shoulders, in front of the hand and arm, is classified up to T22.

Vipalyuvannya shkіri wrist, brushes, including nіgtі, dolonі - okremiy point. Up to T24 according to ICD-10, thermal opic of stegna, traumas of kintzivoks is applied. Possibility of a foot and a homie - at point T25.

Stages of term descriptions and inheritances

People can get injured when high-temperature regimes are injected. Yaksho poured in half the mind, at the first blast of the wound, it was important to see the surplus of burnt ointment. Nadal undercooked become the reason for the information.

Garyacha ridina, she had a meal on epidermis, to bring it up until the wound was confirmed. When opik not glib, ale is often hostile to the spirits. When torquing with baked objects, the wound is clearly corrugated, glibka, and when it is visible in the flow, it is most often seen before it comes out. Razr_znyayut decilka steps of thermal action according to ICD-10:

ailment to the diet;
forming bulbs;
vipalyuvannya klitkovini;
fabric bend, carbonized meat and cyst components.

At the first step, the turgor begins to appear, and there is a poignant, swollen feeling. Two or three days later, mіsce, yake became aware of a thermal burn, start to burn. Pislya the end of the dermis desquamation, so they know. Thermal ophthalmology of the foot or fingers according to ICD-10 at another stage є it is not safe, it is not easy to reveal that breasts. When vipalyuvannі to the parostochny ball, it becomes plump, reminiscent of sіrkoy. Regeneration of the inheritance is more and more important.

On the third step, the epithelium, the dermis, suffers. The wound is a scab of black, brown color, painful sensitivity is lower. When outside infectious acceleration and second-hand gagging, curling independently, renewed by stretching out the pivot. When the fabrics are reduced, they diagnose a quarter of the steps.

terminova help

Chi does not get stashed in oil ointments and fat. The trick is to ruin the camp, and then you will see a puddle of butter, so that the patient will feel like it. It is not correct to apply a bandage to ruin the camp of a sick person, leading to an embarrassment and a diagnosis of suppuration.

There is a bit of a hostile factor, and the chilling zone is burnt under the flowing water, as the integrity of the epidermis is not damaged.

Vikoristannya jgut without consuming turn into a second picture. Naybіlsh correct solutions when discarding opiqueness є corruption to a medicinal mortgage, destroying zenoluvannya і obrob.

Testimonials є To give a frequent view of traumatism to small people, who were assigned a number of ailments in the documents of the international classification of ailments 10 to a glance. Also, according to ICD 10, there is a term code, which is based on the scale and the time of the development of the urazhenoi shkiri.

Classification

term the cipher in the range T20-T25... Characteristics of the ear for multiple forms and unspecified localization are coded as T29-T30, in the fallowness of the wideness of the rate. The code T31-T32 will increase the level of performance up to the headings T20-T29 according to the scale of the performance of the school on the basis of the percentage of the population. For example, thermal opic 70-79% of the surface of the entire body is given the code T31.7, which can be further characterized by any code from the headings T20-T29.

In the opioid centers, such data on nosology provide a tremendous amount of help at the designated stages of diagnostics, clinical visits, as well as predictions.

Fakhіvtsі high qualifications in a stretch of baguch rockіv it was time to stay on the practical local protocol to provide the first help and to guide the children with regard to the problems of the school children.

pathology

At MKB 10, the thermal opyk is approved for pouring on the pins on the hot ridin, steam, half or a strong stream of baked liquor. Chimіchny opіk to go out in case of hitting on the school of aggressive razchinіv chemistry warehouse, For example, acids and meadows. The stench of goodness in a short period of time provoke necrosis of the tissue.

The optical surface is expanded and qualified behind the step of widening and striking of small and child fabrics with an offensive rank:

pochervoninnya and prejudice for dilyanka shkiri (1 step);
confirmation of chubby (2 steps);
necrosis of the upper spheres of the shkiri (3 steps);
outside the necrotic epidermis and dermis (4 steps);
training, when you move all the balls of the shkiri and start to the necrotic process of fostering tissue (5 steps).

Thermal code for the foot, arm, abdomen, or the back, should be stored according to the scale of the process, according to the recommendations of the local protocols in ICD 10.

The area of the battle is based on the "rule of the nine", so that the skin part of the body is shown to the singing top of all surfaces.

So the head and hand are folded at 9%, the front (live and chest), the back surface of the tulub (back) and the leg are 18% each, 1% is introduced on the crotch and genital. More fahіvtsі can vikoristovuvati valley, the area of which is cleverly expensive is approximately 1% of the area of all tіla people.

For example, the term “opic” of the brush, revealing or the feet becomes less than 2% of the opic surface. When the broadening process is established, the process is liable to break the mind, when there is a tissue injury. Important aspects are involved: the character of the agent, the hour of the flow, the temperature of the middle class and the manifestation of the heavy factors in the viglyad.

When the temperature is poured onto the organ at 55 ° C, or if it’s a chemical spill, a deterioration of tissue, called an opik, is established. A broad inflow of aggressive middle ground to produce global changes in the body and negatively reflect on the integrity of the school's curves, robotic hearts, sudin, immunity.

Stages of opіkіv nіg

When the foot of the first step is small, the guardian is only small in area and the zone. The symptomatology is tied with an insignificant wrinkle of the shkiri and the embryo. The patient does not need to go to the hospital for medical assistance. It is necessary to use it in case of consumption and damage to the point of view.
In case of injury to the foot of another step, people tend to be more susceptible to turning pain syndrome... Shkira on the nosy of a chervon, covered with plump pink-sized plumes and napivprozoroi ridinoy. The patient is guilty of going to a trauma center, as a high-risk person is infected. Until then, the patient does not have the necessary minds to provide adequate first aid.

Be absorbed medically. The destruction of the integrity of the bulb is not possible, but it is impossible to make the risky drink in the middle of the infection.

When the feet of the third step are full, let the nobility have a partial necrosis for the protection of the sprout zones of the shkiri. In important situations, the entire lower part of the leg is affected. People can only get help from the hospitalization term for giving them the first help.
Naivazhcha feet, which are characterized by reversible necrosis of the upper curvatures, as well as by inconsistencies and carbonization of internal tissues (mucous membranes, cysts). If there is any trauma, a potentially fatal result. Lykuvannya po'v'yat z surgical entitlementsі held only in the clinic.

Thermal opyki in the ICD

The international classification of ailments has been broken up to forgive the disease and analysis is called ailment. Vikoristovuyutsya not only in the scientific light, but in the extravagant licensed cards.

Skin ailments and injuries have been assigned a code. Classification warehouse to look at each other for ten years.

For descriptions of the foot and homily, the numbering is designated by the step and character of the step. Opinions:

termichny;
cheery.

For a thermal footprint, the ICD code 10 is repaired from 25.1 and ends on 25.3.

25.0 - an unspecified step of the foot.

The classification for chemical injuries is similarly filed: from 25.4 to 25.7.

T24 є term i chemistry descriptions tazostehnovy hillock і lower kіntsіvka, behind a vignette hіlkovodnogo hillock і foot, unspecified step.

Factor i group riziku

Injuries of this kind in the area of a homogeneous foot-shaped slope and five are very rare: the lower part of the leg is most often seized by the protective material swollen.

Ale inodi likari use the code t25 according to the ICD (the sub-item starts with a step), you see the following:

Termichny opіk region nіg. Possibility of insisting as a result of unprotected heating with be-like dzherel of heat energy: hot objects (fired, batteries, fired as a result of third-party pouring), environment, steam, see half of the mind.
Chemist opik. It is typical to drink on a range of small, frumpy speeches, to quickly or in a step-by-step manner destroy the integrity of the upper curves. Acid and meadows are admitted to the least safe vapors.
Radioactive. To eat when it is optimized. Recognize it in laboratories, at the disposal (especially unauthorized) of such kind, in the zones of advanced radio.
Electric. To go as a result of a stroke of the foot with a strum.

diagnostics

If you have a homolevoid slope and a foot of an unspecified step, you should avoid the nature of the injuries.

For the selection of the correct strategy for the development of the vehicle, I respect:

glybin;
the area of the urazhenoi region.

For all to get stuck:

"Rule of the Valley";
The Rule of Nines.

At the first, the fall of the area is violated, according to the principle: proportionally to the share of a loan of 1% from the outside surface of the curvatures.

The other had 1 homologous foot with global trauma, which was 9% of the total volume.

So, as in children, the proportions of fallowness, for them, the Land and Brower table is stagnant.

At the pharmacy, for the help of the fakhivtsy, they come with a sieve applied to them.

lykuvannya

Because of the strength of the first additional help to the patient with ankle troubles and (or) feet, to lie down further away, there is a quicker and long-range forecast.

To the skin corynsus, get familiar with the awkward order of diy, how to be victorious in the case of opikas:

Z urazhenoi dilyanka see all odyag. So, yak synthetics, you can stick to the shkiri, then you should carefully look with knives.
Apply a sterile bandage.

It is not possible to independently vikoristovuvati niyaki creams, ointments, sticks, compresses. Lykar signifies drug administration.

The patient should be assisted to take the maximum possible position with the injured child.
Odin lyki, yake give to people - sun-sickly.

Opik of the 1st stage is admitted independently. In some cases, a specialist is required.

Come on in, which will be held within the framework of medical mortgage, links from:

repercussions and usunions inflamed;
zagєannam.

Often, they prescribe a course of antibiotics to prevent the development of infections.

Dodatkovі come in:

splitting from the government;
analgesics.

Fakhivtsi respectfully quilted, but did not pretend suppuration.

In special cases, the operation is indicated:

plastic;
transplant shkіri.

Thermal and chemical descriptions of a light step are a frequent byproduct trauma. Important issues related to accidents, for non-security on virobnitsvі. Stagnate sterile materials when they grow up on the steps, the first one grows up to the lykar.

The overrun of the inheritance of opic trauma is abundant in what to lie in due to the freedom of the first medical aid and rational treatment on all the face of ailments. When opikas are more than 10%, and in small children 5% of the surface area, there is a real risk of shock development, so, if given the first additional help, it is necessary to visit to prevent shock and infection in the early. At the same time, inject zest-sickly zasobi (50% of analgin with 1% of diphenhydramine or 2% of razchin of promedol). When sparing epidermis, the surface is covered with a bit of cooling with a jet cold water Anyway, using the most accessible methods, and apply a sterile bandage to the wound. Change in hyperthermia of tissues, ignition reaction, embryo, necrosis, development of toxic speech from burned tissues, intoxication of the organisms in the early (during the first year of injury) rare nitrogen... In case of localization of reports on the pictures with the results of functionally active files, it is necessary to secure transport immobilization. Sufferers evacuate up to the dignity of a surgical profile, a treatment in which it is necessary to include the introduction of a protivopravtsevoy and toilet wounds.
When detecting the first step, the bandage should not be applied; Totally growing from aerosol balloons with lykarsky sums, to avenge corticosteroid hormones.
When detecting the II stage, carry out the toilet of the wound on the aphids of the introduction of noxious diseases (2% of the results of the medol or pantopon). Win polyagaє in cleansed wounds and navkolishniy shkіri warm milky water, 0.25% amyaku, antiseptic breaks (ethacridine lactate, furacilin, chlorate, detergent breakdown), visible aliensі obrivkіv epіdermіsu. If you DO NOT peel the epidermis, then sprinkle the scalded surface with alcohol. Cycles of bulbs pidrizaut or dotted, visible in place. Protected the epidermal wounds of the wound from the first time, the protection against it against the better and less often.
Opinions of the II stage can be carried out in a very sensitive way, as well as the diagnostics of the IIIA stage, in the context of the day-to-day vidokremlyuvanny and the root of optimal minds for reparative processes in the early. For the duration of the minds of abacterial treatment of wounds to the toilet for amelioration of secondary infection and suppuration on the wound, apply bandages with antiseptic lines (rivanol 1: 1000; furatsilin 1: 5000; 0.1-1% rosacea drug) panthenol, vinisol, legrocht, olazol, oxycort). In a cold time of fate, more beautifully close the wound with a bandage with non-greasy creams or ointments (line synthomycin, 0.5% furacilin and 15% propolis ointment, balm line according to A.V. Vishnevsky).
In the minds of the masses, there is a lot of energy consumption in the toilet of an opic wound, to the extent that aerozol is consumed with film-forming polymers (Furoplast, iodinizol, lifuzol, plastubol, akutol, acrilasept i). Perevaga їkh polyaga in a significant change in the triviality of the processing of the burned surface, the economy of the perevyazuvalny material. Plivka seize a wound from an infection, when it is lost through a wound, I will control over the interruption of the wound process (if there is a gap), so it allows, if necessary, to promptly make corrections to the wound. With a smooth interruption of the wound healing process, it is infused firstly with a pile. This allows for the possibility of sympathizing with the problems and the better, without the bandages, taking over the wound from the hardships and information. If necessary, the primary toilet can be made in the early stages. Yogo should not be carried out with the manifestation of shock in sufferers with important descriptions. In such cases, the wound is slightly curled up with a bandage for the ointment, and the toilet will start to stabilize and become ill and will be shocked. So it is the very action with the mass of the necessary ailments.
Firstly, I will put on a bandage, do not change for 6-8 days. Shown before її change in case of opikas II stage є suppuration, just to reduce pain in the early and specific wet dressing. In case of suppurative opioid wounds from the toilet with peroxide peroxide, if an antiseptic is used, apply wet-desiccating dressings, to avenge antiseptics or antibiotics, up to a sensitive microflora of wounds.
Firing up of stage II opikiv is infused for 10-12 days. Oduzhannya ailments with opikas of the I stage are recognized in 3-5 days with injuries.
when opikas III stage The dermal ball of the shkiri is often deceased, which often helps to prevent dermal suppuration, which can lead to the collapse of the shkiri derivatives and the establishment of granular wounds. Mainly, during the process of detecting the steps of the field, the steps of the field in the alternate death. Tsyogo reach the path of a quick vision of the dead tissue and direct struggle against the early infection. For an hour of dressings, when it is done in 1-2 days, one can see a necrotic scab in steps (repaired from the 9-10th day). If the scab is dry, then it’s not a matter of time to see it, so it’s possible to get rid of it.
For dressings in case of stage IIIA opioids, add dressings with antiseptics (ethacridine lactate, furacilin, 0.25% chloroacetate, 0.5% medication nitrate i) or antibiotics. Infrared and ultraviolet diagnostics of wounds allows for the onset of necrosis, changes in vision and increased efficiency.
By world the termination of exudation at the final stage of the treatment of necrotic tissues from the processing of necrotic tissue goes to ointment and oil balm pov '(5-10% liniment synthomycin, 0.5% furatinic 5-10% dihydrogen oxide, 0.1% Levosin, Lvomekol, Olazol i) Masi do not scratch the wound, give a pompous і zealous effect. A change of bandages to shy away from the world soaked with gnarly visions (in 1-2 days).
The treatment of II-III stages can be carried out in local isolators with a regulated middle in a sensitive way, allowing the reduction of the level of bacterial infection of wounds and spontaneous diseases.
Infusion-transfusion therapy of great and great opikiv. Infusion-transfusion therapy in complex treatment ailments with great accounts of loans from one of the provinces. In case of great opyka, values of energetic vitrati are obtained, which can reach 5000-6000 kcal, or 60-70 kcal per 1 kg of mass, and nitrogen inlet from the surface of the wound becomes 20-50% of the back-to-back losses, but to produce a negative balance of negative. Infusion-transfusion therapy is used for the treatment of cym in case of treatment of opioid ailments.
All ailments with high opikas 10-15%, and children - 3-5% of the surface area for 1 year after injuries require intensive infusion-transfusion therapy. When there is a turn of the intoxication of the internal vascular infusion, carry out a daily individual program suspected to be severe thermal injuries.
In case of opioid shots of infusion-transfusion therapy, the transfer of storage in the jury channel to the family of electrolytes, blood cells and erythrocytes, the polishing of the communication processes, the function of disinfection and detoxification.
In ailments with opikas less than 10-15% of the surface of the body, since they do not have a lot of vomit, they can take 5% of the range of glucose with vitamins C and group B, and they can be kept in the middle of 5%. The storage of the bedside liabilities of the vessel bed can be reached behind the additional internal vessel introduction of the bed, as well as the transfer of the deposited blood for active circulation for the auxiliary hemodilution.
Methods of carrying out antishock therapy and detoxification of the organism, vikoristovuyu salt rose (Ringer - Locke, lactasol), plasma and colonic plasma substituting drugs (rheopolyglucin, hemodez, polydez, gelatinol and glucose 5-10%) і groups in a dose of 500-1000 ml in the first addition for injuries in adults. In case of light opioid shots, the therapy should be carried out without blood transfusions. At the development of a severe and extremely important shock, blood transfusions (250-1000 ml) go until the end of 2 times, or for the third time, hematological indicators and functions of nirok. To fight against acidosis in case of vikoristovuyut 4% of sodium bicarbonate, which is prepared before consumption and injecting the deficiency in number.
For a child of a kidnapped and old man, an internal obsyag is not guilty of transferring 3-4 liters, and for children - 2-3 liters for dobu. A lot of infusion-transfusion therapy for opioid shots in children can be based on Wallace's scheme: use the weight of the child (in kilograms) to multiply the opic (in kilograms) on the area. Otrimane tvir - the whole number of birthdays (in millennia), as it is necessary to introduce the child in a stretch for the first 48 years after the opyka. At the same time, the physiological need for water is not included (700-2000 ml for additional in the fallow of the child), yak, it is satisfactory, and it gives 5% glucose.
Spіvіdnoshennya coloide (white and synthetic) and crystal breakdowns due to the beginning of a severe opic shock. Typically, with a light opic shotsi spіvdnoshennya coloide, salt solutions and glucose, buty is 1: 1: 1, with important - 2: 1: 1, and in the most important - 3: 1: 2. -12 Zagalny obsyag vnut_shno vodinno rіdini, scho is introduced on the 2nd after injury to change 2 times.
Pislya zapovnennya ossyagіv in the ship channel, just to reduce the number of indicators in the bcc, stasis osmotic diuretics. Mannitol at 20% viglyad should be injected per 1 g of dry speech per 1 kg of weight of the patient, in total 150 ml with 40-60 drops in khilina. effective diureticє lasix, which priznachayut in a dose of 60-250 mg / day for the reduction of the BCC deficiency.
When carried out infusion therapy Opikovy shoku can vikoristovuvati 20% of the sorbite, which is to introduce 1.5 2.5 g of dry speech per 1 kg of sick fat for dobu. Eversions diuretic effect is infused in 40-60 minutes after the introduction of osmotic diuretics. If necessary, after 3-4 years, the stench can be re-introduced.
Infusion-transfusion therapy in case of opioid shots, stay in the complex with visits, straightened to the disease, prophylaxis, for example, deprivation of acid deficiency, impairment of the function of the heart-vascular disease, dichny systems and other organs. With the help of vikoristovuyut cardiotonic drugs, antihypoxanths, antihistamines drugs. Intra-intravenously inject korglikon, kordiamin, 1-2 ml 2-3 times per dob, priznachayut kissen for inhalation. The dose of heart glucosides can be used with the prescribed cocarboxylase at 50-100 mg 2 times for the addition, which is pleasantly infused into the exchange of carbohydrates. Significant polystyrene blood flow of the heart meat і nirok spriyє euphilin, which is also diuretic, which is administered in viglyadі 2.4% range with 5% range of glucose 5-10 ml up to 4 times for dobu.
Injecting intravenously 1% morphine or 2% promedol with 50% analgin. Zastosuvannya neuroleptic droperidol in viglyadi 0.25%, the difference will be unsettled by the use of psychomotor zbudzhennya.
With an important and extremely important opioid shock, if the infusion-transfusion therapy is insufficiently effective, it normalizes the infusion on the hemodynamics and the function of nadying corticosteroids. The stench puffs up the heart's wicked, blots the blood of the heart's blood, aggravates the spasm of the peripheral sudins, increases the penetration and increases the dyuresis. With the presence of opikiv dikhalnyh nobles smell the change in the bronchial tree. We have to take hydrocortisone internally in a dose of 125 mg in a warehouse of infusions, or prenizalon in a dose of 30-60 mg 3-4 times for 1 dib of protichoke therapy until normalization of hemodynamics and dyuresis.
In connection with the impairment of oxidative-recovery processes in patients with burned and deficiency in the body of vitamins, when infusion-transfusion therapy is used, it is necessary to inject Biitamic acid in doses of 5-10 ml to 5-10 ml of 5% rose. -200 mcg 3 times for doba, nicotinic acid 50 mg each.
Yak antihypoxic substance with the success of storing sodium oxybutyrate (GHB, natrієva sil hydroxybutyric acid). Sodium oxybutyrate reduces the destruction of wastewater treatment plants, reduces the amount of under-oxidized products in the blood, and reduces microcirculation. In case of opioid shots, the drug should be administered internally 2-4 g 3-4 times per dob ( dobova dose 10-15 g).
In order to inhibit proteolysis and enzymes of the callicrein system, it is necessary to inject counterkal 100,000 OD to the infusion center, or 500,000 OD trasylol to add, for normalization of the permeability of the vertebral column.
In ailments with a shock, after 6 years, injuries are seen as more significant in the blood instead of histamine. We use a pathogenetically primed zyme with antihistamines: 1% diphenhydramine, 1 ml 3-4 times for dob, 2.5% for 1 ml, 2.5% for dob.
Infusion-transfusion therapy should be carried out under the control of CVT and arterial vise, heart rate and heart rate, age-related diuresis, hematocrit, hemoglobin concentration in the blood, concentration of calories and sodium in plasma, KOS, blood clots.
An altogether low CVT (less than 70 mm of water.) To indicate the lack of ventilation of the BCC and to serve as a guide for the increase in the amount of money and the rate of introduction of the infusion meanings (as well, there are no problems with development). The visoka of the CVP is a sign of heart failure, in connection with which it is necessary to change the intensity of the infusion therapy, for the time being.
When monitoring the weather-related diuresis, it should be adjusted to a level of 40-70 ml. When carrying out infusion therapy, it is necessary to ensure that the sodium concentration in the plasma is not lower than 130 mmol / l and not in food 145 mmol / l. The concentration of calories in plasma must be adjusted at 4-5 mmol / l. The quick release of the hyponatrium can be reached by an infusion of 50-100 ml of 10% solution to sodium chloride, at the same time it is necessary to assimilate the hypercalcium. Introduced 250 ml of 25% glucose with insulin is shown in the іnshomu vipad.
Transfusion of the middle in case of opioid ailments should be administered by venepuncture or venesection of available pediatric veins. At the same time, it is necessary to strictly follow the principles of asepsis and antiseptics. At the same time, if the provincials have a therapy є to see the catheterization of the clavicular, jugular, abnormal veins, then they see the pass. Catheterization of the central veins will most likely provide for the necessary maintenance of the infusion-transfusion therapy during the last period, as long as the patient is in shock.
When catheterization of the central veins of the thyroid gland, the thromboembolic catheter is removed, injections into the vein, it is necessary to systematically rinse sodium chloride with heparin with a physiological solution (2-3 times per dose). When the infusion is finished, fill the catheter with heparin (2500 OD per 5 ml of isotonic range) and close it with a stopper. When there is a sign of phlebitis, or a perfluency, infusion into a vein is guilty, but inaccurately. In the development of a disease process in opiate wounds, especially in the period of opioid ailments, a catheter from the vena has been seen to be seen, so that he did not appear to be the provider of the infection and the accelerated cause of the disease.
Control of the adequacy of infusion-transfusion therapy in terms of day-to-day results laboratory dosages can you zd_ysnuvati for key signs opic shock. Bleed, cold and dry skin is indicative of impaired peripheral blood circulation, for renewal of which there may be vicoristani rheopolyglyukin, gelatinol, hemodez, polydez. Strong spraga is spared in a sick person when there is a lack of water in the body and development of hypertension. It is necessary to inject 5% of glucose levels into the whole vipad, and for the duration of the boredom and the blues, it is necessary to introduce 5% of the glucose levels in the middle. Reduction of pediatric veins, hypotonia, decreased turgor of the scalp is prevented with sodium deficiency. Infusion of electrolytes (lactasol, Ringer's rose, 10% sodium chloride) strong head b_l, Sudami, pogirshennya zoru, blues, sludge, and to inform about the clitinous hypergidration and water toxicity, serve as indicated until osmotic diuretics are stagnant. The main signs are to indicate about the appearance of scorching from shock, є stabilization of central hemodynamics and renewal of dyuresis, elimination of spasm of peripheral veins, warming of skin diseases of the skin.
During the period of opioid toxemia and infusion-transfusion therapy, the total volume of 2-4 liters is continued, or 30-60 ml per 1 kg of oil. I mark the fight against alkalosis in ailments with important considerations: a supplementary infusion of 20% glucose up to 500-600 ml for supplementing with insulin from a bottle 1 OD for 2-4 g glucose and 0.5% calories chloride up to 500 ml for control with calories and sodium in the blood of the sick.
With the method of disintoxication and prophylaxis of anemia, hypo and dysproteinemia, pre-systematic transfusion of freshly preserved resussocompatible single-group blood or components (erythrocytes, native protein and dry plasma, albumen) 250 ml before the control of hematological indicators (the level of hemoglobin, the number of erythrocytes), which are responsible for the determination of the norm. Particularly, the disintoxication process is used to produce direct blood transfusion, transfusion of freshly hepatic blood or blood and plasmas of convalescents, at the moment when some problems were lost, no more than 1 time passed.
Reduced toxicity is included in the complex of infusion mediators of osmotic diuretics (manitol, lasix, 30% of the severity), infusion of some of the most commonly used intravenous infusions of low molecular weight diseases
With the method of disintoxication in case of diagnostics and hospitality of surgical treatment of hemodialysis, hemosorption, plasma and lymphosorption. One of the mechanisms lіkuvalnoї dії hemosorption є reduction of the level of proteasemia and reduction of the toxicity of plasmas and the rate of metabolic disorders. Sorption permits superbly and efficiently the organisms of the burning of toxic metabolites. However, hemosorption is supervised by the second form of blood elements (thrombocytes, leukocytes, erythrocytes), chills, a change in physical and chemical powers of erythrocytes. The positive effect of hemosorption is saved not more than 2-3 dB. To ensure effective detoxification of the vine, it is necessary to carry out repeated hemosorption at intervals of 24-48. Hypovolemia and instability of hemodynamics, which are spontaneous in case of great diagnoses, є contraindicated to the presence of hemosorption.
In the period of septicotoxemia, intensive infusion-transfusion therapy is especially necessary at preparation before surgical operations and every hour it’s good, if the organism needs more energy to store energy vitrates. At the end of the period of blood transfusion, 250-500 ml 2-3 times per day, which are taken from the transfusion of blood preparations and plasma-mediated detoxification drugs, is the main component of infusion-transfusion therapy.
The procedure for blood transfusion for the replacement of trivial injections of blood, the improvement of the colloidosmotic and transport functions of the blood, but a significant amount of transfusion of dry and native plasma, 250-500 ml, 2 times per week, as a dose If blood transfusions do not give rise to a full range of indicators in the albumin fraction of blood cells, then it is worthwhile to fully consume 5-10% of albumin rashes of 200-250 ml for 3-4 days, especially in an old sick kidnapped patient. The growth of albumin is highly effective in compensating for the loss of post-mortem depletion and loss of hypo and dysproteinemia, normal colloid osmotic clutch of plasmas, and toxic hepatitis in young people. Podtrimka іvnya zagalnogo rylka sirovatki blood і 6.5-7 g% і albumin 3.5-4.0 g% required for protection friendly perebіgu wounding process, successful training before the operative engagement with the renewal of the shkirny cover and the first vikonannya.
High energetic vitrati in the body of the burned ones will not be cared for in the course of ruining life, in carbohydrates and bile. At the same time, syrovatkovy beads and beads of tissue, especially skeletal muscles, are stained. The most frequent changes in the deterioration of the bile exchange are detected with a stretch of the first symptoms of opic ailments in ailments with important indications. Catabolism occurs in the main albumen and if the deyak has a part of coal bulbs, it develops hypo and disproteinemia, a deficiency of internal and lateral blood cells, a high deficiency. Clinically, it is manifested in vapors, atrophies, changes in mass.
For the replenishment of energy vitrates and the reintroduction of the nitrogen balance in the last period of the opiate ailment, the significance of parenteral feeding, Yake, allowing you to take care of the sick, easily adopt live rhymes and compensate for the damage of all types of exchange. For parenteral feeding of vicoric acid, hydrolyzate of a bottle with a dose of 15 ml / kg (in the middle 800 ml), amino acid preparations (10 ml / kg), if to inject not more than 45 drops in fat in fat, and a component of glucose (energy glucose)
In case of important clues, glucose is injected in a viglyad of 10-20% of the ratio with insulin. For the reduction of insulin resistance, it is not easy to develop in ailments with important indications, and the process of utilization of glucose is completely consumed by tocopherol in 10% viglyad, 1 ml 1 time per dose. With the help of parenteral feeding, sorbitol and fatty emulsion can be victorious.
In patients with ailments, parenteral feeding can be successfully replaced by an enteral one - by means of a probe inserted through the nasal tube into the slunker or two to twenty guts... For enteral tube feeding, the amount of sugar is lost, glucose, liquor and fat should be taken in by the drip method (20-30 drops per quill). It is possible to enter only for renewal of the wet and motor function of the intestine.
During the period of the state opioid toxemia and septicotoxemia, the infusion-transfusion therapy should be carried out on the basis of the rational treatment for the high-calorific life, which should contain 120-140 g of alcohol, vitamins and minerals.
Purulent demarcation firing in opikovoy wound to produce before melting and recycling of necrotic tissue. At the same time, it is possible to tolerate the intoxication of the body in the presence of moisture in the products of the melted tissue and microbial toxins. Intoxication of the body can be reduced in terms of the world in the case of early diseases in the minds of the Kerovian abacterial middle because of the congestion of the open method of wound management in the insulators with the information of the bed. Postіyne odnospryamovane ruh pіdіgrіtogo sterile povіtrya in znachnіy mіrі zmenshuє vtrati energії at obpalenih, znizhuє eksudatsіyu i mіkrobnu zabrudnenіst opіkovih wounds peretvoryuє vology necrosis Sukhiy, zavdyaki chomu zmenshuyutsya vtrati bіlka, znizhuєtsya aktivnіst proteolіtichnih fermentіv in ranі, vіdznachaєtsya priskorena epіtelіzatsіya at poverhnevih opіkah, s 'It is possible to see an opiate scab in a larger early term and to prepare a wound before the skin cover is renewed.
The appearance of small fabrics is the main reason for the development of opikovoy ailments, that is, the appearance of necrotic fabrics and the renewal of shkirny coverings is the main reason for the development of illnesses with glibs. All of them come in, which are carried out in the process of a complex outbound and muscular treatment, direct to the preparation for dermatoplastic operations.
surgical treatment... Demonstration, vibration method and terms of testing of plastic plastics. The country’s camp and the patient’s age, the latitude and localization of bad reports, the manifestation of donor resources in the school and the country of the patient’s bed may be of the greatest importance when the terms of carrying out and the vibration method are established prompt engagement, As well as the method for updating the shkirny cover.
In case of intercourse with large opiqies, the most rational method is to increase the hanging of necrotic tissue in the first 2 days after injuries with one-hour application of sutures to the wound, as it is possible to allow the growth of ailing tissue from the point of view. If you can’t imagine yourself close to the edge of the wound, then you’ll be the first to get it, or to combine it (as a result of the new and worldly plastic) plastic plastic.
Early hanging can be deprived with the presence of dry scab. It is especially necessary for the localization of intermittent large opikiv in the area of loam, brush and fingers. At the connection with the high functional activity of the hand and fingers, the folding of the functions, it is possible to carry out the hanging of the necrotic scab and in the quiet vines, if the derivatives of the school have been taken care of (indications of the 3rd step), and it is possible to cut
In case of detections that osteonecrosis is observed in functionally active areas, it is necessary to carry out an early hanging of non-published copies of the case, not spontaneous sequestration, in one hour to replace a defect in the tissue of a combined dosage school. With a tsom kistkovu fabric To close the rotary valve of the shkiri from the pediatric fatty cells, or to the valve to the lower vitality, and once again, having made a defect, you will learn about the additional healthy shkirnoy plastics.
At the same time, they showed our experimental and clinical care, when detecting in the area of the crypt of the skull from the small boxes of small boxes, you can easily choose from the savings of the undeveloped files of the box. At the time of the day, the suppuration in the early days is seen by the undead m'yak_ fabric, Vibrate ultrasound cavitation and multiple craniotomy of the end and swelling cutter to bleed the ball of the cyst and cause osteonecrosis. In such cases, osteonecrotic data are not sequestered and the resorption of unpublished elements of the list is not seen in the new solutions.
Early necrectomy, viroblen in the first 4-10 days with injuries in the minds of abacterial ailments, is the most optimal method of surgery. Until the end of an hour, I will become ailing with great battles, and will become an ill person with great battles. The blame to become ailments, in those who have circular illnesses of tuluba, if there is a threat of severe damage due to health breast cancer for the same pictures, when the bloodstending breaks down distalі deep-lying tissues In such cases, a non-adherent multiple decompressive necrotomy is shown, or a part of necrotomy, as it allows the patient to suspend and wickle.
Tactics and technology of non-correctness. In case of early non-correctness, there is a loosening of the hanging opiate scab behind an additional electrodermatoma until the surface of the wound appears to bleed. Such hanging of the opiate scab in the big world allows you to save the life of the printed fabric, significantly change the triviality of the most traumatic stage of the operation and to open the surface of the wound, which helps to prevent the grafting of the tissue.
Hemostasis from the hour of the operation is reached by the way of applying gauze servet with a solution to peroxide with water or aminocaproic acid. Great bloody judges ligate. In the case of difficult problems, such as diagnosing with bleeding, in some cases, the operation is victorious in two stages. At the other stage, it’s okay to get there in 2-3 days after it’s not correct, and the plastic surgery is done earlier than the prepared bed. Until the end of the hour, there is a strong hemostasis when a tight aseptic dressing is applied, and also some necrotized tissue appears, which did not appear on the first stage. Dodatkov's vision of non-published fabrics with a greater successful result of the operation with transplantation of shkiri. In aseptic early, when the early hanging of necrotic tissue is established, the optimal drainage is developed for the engraftment of small grafts.
The first and the earliest plastic surgery in the time of success allowed for the progression of intoxication in the meantime, the development of infection in wounds and given development opikovoy ailments, scho to produce up to the primary suppression of opikovy wounds in the best terms. The early renovation of the skinny cover should be brought up to a decrease in the triviality of the style and without providing more friendly functional and cosmetic results of the great plasticity.
Great necroctomy with one-hour shkіrnoy plastic - a traumatic operation, as it is supervised by significant blood loss. After the operation, I will die of a sick person, as long as there is no additional replacement of wounds with shkіrny autografts, or general engraftment. Victory with a carbon dioxide laser for visualization of an opioid scab allows you to reduce blood loss, even more difficult, when you are diagnosed with a glibine, a tissue loss, and the traumatic nature of the operation is streaming and anxiety. In the case of cymosis, early necroctomy is generally violated when opiqn is not more than 10-12% of the surface.
Great non-correctness and plastic surgery in the early term may be less effective in special medical descriptions of surgery, which may lead to an awareness of plastic surgery, for the reason of adequate surgery for blood management.
Shown to the secondary school plastics. In case of severe illness of a sick person and severe opiqueness of more than 10-15% of the surface of the body, it is shown before the secondary plastic surgery is applied to the granular surface of the tissue. For the visualization of the tsikh fabrics docilely vikoristovuvati stage bezkrovnu necrostomy in the world of їkh intentional marketing. Tsymu spriy zasosuvannya enzymatic and chemical necrolysis. The visualization of opiate scab behind the addition of 40% salicylic ointment, benzoic acid and ointment, which should replace 24% salicylic and 12% lactic acid, allows for 5-7 days to change the triviality of preoperative preparation. The general administration of necrotic tissue does not take systematic treatment of hygienic baths, it is more rational zahalne lykuvannya, Directly on the adjustment of the reactivity of the body, the prevention of anemia and important problems in the alcohol exchange. When you go in and the retailer toilet early before the hour of dressing for the removal of opiate scab with the method of reducing the bacterial obstruction, it is possible to stretch for 2.5-3 times due to injuries of children who are ill up to severe plastic surgery.
Timely retinal preparation of wounds relieves the need for granulation in front of plastic plastic, as the stench does not smell of an obviously pathological character and does not prevent the wounding process. V CLINIC PRACTICE all the same it is not easy to come to terms with difficult ones when granular wounds are ready to go through plastic surgery. There is great obstruction of the surface of the wound with pathogenic microflora in weakened ailments. Vіlna shkіrna plastic in cich umov is prototype. In such cases, it is necessary to energize the antibacterial therapy and to carry out antibacterial therapy until a quiet period, until the sick person is gone and the regenerative processes will do their best in the early days.
Spriyatlivy vpliv on perebіg runs Process nadayut zroshennya wounds antiseptichnimi rozchinami, gіgієnіchnі Vanni of detergents mіstseve zastosuvannya magnіtoterapії, ultrasound, laser rozsіyanogo opromіnennya, lіkuvannya on lіzhku fіrmi "Klіnіtron" i vikoristannya naybіlsh affordable method - chastoї zmіni pov'yazok of rozchinami antiseptikіv. In ailments with susceptibility to susceptibility and due to the interruption of the wound process, additional hormonal therapy with glucocorticoids and anabolic steroids for the presence of antibiotics under the control of the sensitivity of the microflora of wounds to them.
The presence of equal, granular, juicy, rather not fluffy and not granulation, how to bleed from other visions and swirling obscenities near the earliest serve as a garnish indicator of adherence to plasticity.
A very friendly spry bed for small grafts є young granulation tissue, rich in blood vessels and a small number of fibrous elements, so you can start sprying from 2.5 to 6 months. The price is the optimal term for the application of high-grade plastic on a granular surface.

Opik - the cost of the loss of tissue integrity to the body as a result of the flow high temperature for chemical reagents. It is due to the ethology of the significant factor, the stench is subdivided into thermal (temperature factor), chemistry (meadows, acids), exchange ( sleepy stroke), Electric (blinking blow). According to the WHO data, the term seizure injuries are close to 6% of all injuries.

Opik according to ICD 10 is classified for impotent criteria (the nature of the problem, the severity of injuries, localization, for the area of the battle) for a reliable way of detecting, predicting the result.

Clinical manifestation of thermal shock is primed on the depth of the slab. At the 1st stage, the opik maє viglyad hyperemic і embryonic dilyanka. Bіl sberіgaєte by stretching three dib. There is a regeneration of the skin cover without visible defects.

Characteristic is the appearance of puffs. Became the middle of the urazhennya shkіri і bulge of the papillary ball of the dermis. The zone of pozhkojennya has strong beat, Omezhene pochervoninnya, pechinnya, swelling right up to the demarcation line.

Bulbashki is easy to inflict during an hour of the wound healing process. Yakshcho not dotrimuvatisya rules of asepsis of possible development of gn_yno-ignition vognischa.

It is characterized by a sharp pain, and a black scab forms on it. Regeneration is seen as a rule, with a scar.

At the 4-th stage, puffiness is characteristic, as well as a dark-red scab.

see

Thermal statements according to ICD-10 (international classification of ailments of the 10th glance) may range from T20 to T-32. The skin type can be found in the ICD 10 code, which should be used in diagnostics in the history of ailments.

T20 - T25 Thermal and chemical descriptions of the new parts of the house, with singing localization. At the same time, the stage of development is meant. Thermal statements according to ICD-10:

T20. Heads і shiї.
T21. Middle part of the building.
T22. Upper beautiful pictures, including the wrists and phalanges of the fingers.
T23. Wrist and hands.
T24. The lower part of the foot, the edge of the ankle and the lower part of the foot.
T25. Areas of homilkofoostny slope and foot.
T26. Surrounded by the periorbital zone.
T27. ...
T28. Everything.
T29. Some areas of tila.
T30. Unassigned localization.

Classifiers with code ciphers from T30 to T32 storage, in the fallow area from the damaged surface of the layer of people. Code op_ku viznachaє class zakvoryuvan.

step

Classification by glybin of tissue production allows for the development of a pathological process and predict other events.

Stage of the battle:

First steps. Winikak as a result of insignificant and short-hour contact with a hot surface, or with a pair. Break the ball off the epidermisu.

Friend. There is a growing layer of epithelial cells. Above the shkіroi, a spherical form is formed, which is used to avenge blood plasma in its own blood, and in the bagatus with leukocytes - mikhur.

Third. Typical necrosis of the shkiri. See two stages:

IIIa - necrosis on the epithelial cells and on the surface of the dermis;
ІІІb - necrosis on the іvnі dermis up to the cystic ball, inclusive, with the ruining of the hair follicles; zaloz shkіri, with a partial transition to the hypodermis.

Falling from the aggregate mill of the agent who has contacted the wet opik and dry. Vinikє with trivial, massive pouring onto the surface of the temperature factor.

Quarter. The new scale of steps. May be fatal. Necrotic zmіn pіddajutsya all 3 balls of shkіri, scho lay out underneath the fabric.

Diagnostics and value of the step

For reliable diagnostics, there is a special algorithm for collecting information.

Carry out an anamnesis at once with the necessary information.

In the history of ailment, it is guilty that:

the hour of rejection;
mісce otrimannya (view / close up);
yak buv otrimaniy;
nіzh bulo otrimano.

On the given stage, the likar z'yasovu the quality of the first inconvenient help, Conduct a medical history. It is necessary for the folding of the scheme of the false lіkuvannya.

Zagalom anamnesis to overhaul:

chronic pathology;
on-the-spot operations;
the appearance of an allergy;
decline in pathology.

At the presentation of the information, the doctor will conduct a survey:

Assess the area of the fallowing area in proportion to the tree;
Stage of the battle (1-4);
There is an area of non-residential dilyanok tila;
Localization of thermal injuries (on lower kintsivkakh in general, diffusely on nose and feet);

Lykar-khirurg viznachaє is shown before the hospitalization, to carry out the necessary medical procedures.