Thermal Burns and Smoke Inhalation Injuries

In this pathophysiology paper, the reader is presented with a profile of an elderly patient who recently suffered thermal burns and smoke inhalation injuries as a result of a nursing home fire. This patient’s severe burns were classified as deep partial-thickness and full-thickness and her total body surface area (TBSA) of burns was over 15%. This paper details the different types of burns, the varying clinical manifestations of thermal burns, smoke inhalation injuries, laboratory values associated with burns, and the multitude of treatment necessary for each stage of burn management. Wound healing is described as well as potential risks and complications associated with burns. Suggestions for nursing care are also given in order to properly care for a patient similar to the one in this profile

Reasoning About the Reliability of Multi-version, Diverse Real-Time Systems

This paper is concerned with the development of reliable real-time systems for use in high integrity applications. It advocates the use of diverse replicated channels, but does not require the dependencies between the channels to be evaluated. Rather it develops and extends the approach of Little wood and Rush by (for general systems) by investigating a two channel system in which one channel, A, is produced to a high level of reliability (i.e. has a very low failure rate), while the other, B, employs various forms of static analysis to sustain an argument that it is perfect (i.e. it will never miss a deadline). The first channel is fully functional, the second contains a more restricted computational model and contains only the critical computations. Potential dependencies between the channels (and their verification) are evaluated in terms of aleatory and epistemic uncertainty. At the aleatory level the events ''A fails" and ''B is imperfect" are independent. Moreover, unlike the general case, independence at the epistemic level is also proposed for common forms of implementation and analysis for real-time systems and their temporal requirements (deadlines). As a result, a systematic approach is advocated that can be applied in a real engineering context to produce highly reliable real-time systems, and to support numerical claims about the level of reliability achieved

PENGARUH KOMBINASI MADU DAN TEH HIJAU TERHADAP (Camellia sinensis) PENYEMBUHAN LUKA BAKAR DERAJAT 2 PADA TIKUS PUTIH (Rattus norvegicus)

Background: Burns are injuries due to heat from fire or other hot objects that cause damage to the skin, the level of tissue damage depends on the type and length of exposure to heat sources. Increased ROS occurs after burns injury begins and can interfere with wound healing if it is too high in number. Definitive management is needed to accelerate the healing of burns. Honey and green tea (Camellia sinensis) are natural ingredients that contain anti -inflammatory and antioxidants that can reduce levels of ROS so that healing can be faster. Purposes: This research was conducted to see the effect of the combination of honey and green tea on healing the second degree of burns in white rats. Method: This type of research is experimental with the Post-test Only Control Design with the calculation of the area of the second degree burns on the 14th day after being given topical therapy combination of honey and green tea extract with a mixture composition (1 ml of honey: 1 ml of green tea extract: 1 ml of honey: 0.5 ml of green tea extract: and 0.5 ml of honey: 1 ml of green tea extract). Results: One way Anova statistical test analysis shows the value of P = 0.593 and Linear Regression analysis revealed a 7.9% effect of the combination of honey and green tea on the healing of second degree burns. Conclusion: The combination of honey and green tea has no significant effect on healing the second degree of burns in white rats

Tommy Burns as a Military Leader: A Case Study using Integrative Complexity

Lieutenant-General E.L.M. Burns is relatively well-known to Canadian military historians and to Canadians generally. A professional soldier born in 1897, Tommy Burns attended the Royal Military College, leaving before graduation to serve with the Canadian Corps in France and Flanders during the Great War. He saw much action, won the Military Cross, and decided to remain in the tiny Canadian Permanent Force after the Armistice. Burns rose with rapidity in the interwar years, his career helped by brilliant performance at the British Army Staff College, Quetta, and selection for the Imperial Defence College, London. He had powerful patrons, senior officers such as Harry Crerar who admired his intelligence and skills as a staff officer, traits that occasionally camouflaged his sarcasm and lack of traditional leadership qualities of the kind that can make men willing to follow an officer into battle. At the same time, Burns’ restless mind was searching for other outlets. He began writing articles in H.L. Mencken’s American Mercury, the magazine of the 1920s. He published a play and a novel, and he wrote sketches for the theatre. And at the same time, the Canadian Defence Quarterly, the military’s one interwar intellectual outlet, featured a stimulating debate on the use of armour between Burns and a young captain, Guy Simonds, who was to develop into the best general Canada was to produce in World War II. Burns, in other words was a man of parts

Identifying patient concerns during consultations in tertiary burns services: development of the Adult Burns Patient Concerns Inventory

ObjectivesIdentifying the issues and concerns that matter most to burns survivors can be challenging. For a number of reasons, but mainly relating to patient empowerment, some of the most pressing concerns patients may have during a clinical encounter may not naturally be the focal point of that encounter. The Patient Concerns Inventory (PCI) is a tried and tested concept initially developed in the field of head and neck cancer that empowers patients during a clinical encounter through provision of a list of prompts that allows patients to self-report concerns prior to consultation. The aim of this study was to develop a PCI for adult burns patients.DesignContent for the PCI was generated from three sources: burns health-related quality of life tools, thematic analysis of one-to-one interviews with 12 adult burns patients and 17 multidisciplinary team (MDT) members. Content was refined using a Delphi consensus technique, with patients and staff members, using SurveyMonkey.SettingWithin outpatient secondary care.ParticipantsTwelve adult burns patients and MDT members from two regional burns centres.ResultsA total of 111 individual items were generated from the three sources. The Delphi process refined the total number of items to 58. The main emergent domains were physical and functional well-being (18 items), psychological, emotional and spiritual well-being (22 items), social care and social well-being (7 items) and treatment-related concerns (11 items).ConclusionsThe Adult Burns Patient Concerns Inventory is a 58-item, holistic prompt list, designed to be used in the outpatient clinic. It offers a new tool in burn care to improve communication between healthcare professionals and patients, empowering them to identify their most pressing concerns and hence deliver a more focused and targeted patient-centred clinical encounter

Not Burns – Dunbar!

No abstract available

‘Epitaph' on Grizzel Grim: a newly-discovered manuscript in the hand of Robert Burns

Describes and reproduces a newly-discovered Burns manuscript, with notes and numerical calculations relating to his work as an Excise Officer, and the four-line 'Epitaph' on Grizzel Grim (Kinsley II:926); discusses its publication history, attribution to Burns, and relation to Burns's ballad of similar title; gives a collation of variant readings; and transcribes related notes about the manuscript from the Craufurdland Castle papers

Care of burns in Scotland: 3-year data from the managed clinical network national registry

Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 onwards, data were prospectively collected for all patients in Scotland with complex burn injury admitted to Scottish burns units. Data collection was initially on a paper pro forma, but subsequently evolved into a web-based audit data capture system to securely link hospital sites involved in the delivery of care of complex burns. Data collected included extent and mechanism of burn, presence of airway burn or smoke inhalational injury, comorbidities, complications, length of stay, interventions and mortality. Quality, completeness and consistency of data collection are audited with feedback to the individual units. Results In a population of approximately 5.3 million, the annual incidence of complex burn injury is 499 to 537 (9 to 10 per 100,000). The incidence of a major burn is 5% of burn admissions. The hospital mortality from a burn is 1 to 2.2%. See Table 1. Table 1. Numbers of complex burns in Scotland 2010 to 2012 Conclusion From these data, Scotland now has comprehensive national figures for complex burn injury. This allows for benchmarking against other international indices, few of which provide comprehensive data. COBIS data can now also be correlated with other mortality data sources. As data quality improves, detailed analysis of mortality data will allow COBIS to identify contributing issues affecting burns patients. Some issues identified already are that patients with burns often die soon after their discharge from hospital of other related and unrelated causes. Subsequent analysis of this will allow COBIS to identify and address issues that may be contributing to these statistics