Burns | Medical Science Optional Notes for UPSC PDF Download

Burns-Pugilistic Attitude

Boxing, fencing or defence attitude:

• The body posture following exposure to intense heat is frequently distinctive.
• This involves flexed legs at the hips and knees, arms flexed at the elbows and wrists, extended in front of the body, a slightly extended head, and all fingers forming claw-like hooks.
• Contraction of the paraspinal muscles often leads to pronounced opisthotonus, resembling the posture commonly adopted by boxers.

Reason

This rigidity results from the coagulation of muscle proteins and dehydration, leading to contraction. The bulkier flexor muscles contract more than extensors, causing the joints in all limbs to flex.

Note: This phenomenon transpires regardless of whether the individual was alive or deceased during the burning. It does not serve as a distinguishing factor in determining whether the burns are ante-mortem or post-mortem.

Antemortem vs Postmortem Burns

The carboxyhemoglobin level proves valuable in differentiating between postmortem and antemortem burns. A level exceeding 10% suggests that the individual inhaled smoke and was alive during the fire.

TBSA-Burns

Fluid Resuscitation
Safety Measures
Techniques

• Hand Rule
• Nine Rule
• Lund and Browder Chart

Rule of Nine

The Lund and Browder Chart

In contrast to the Wallace Rule of Nines, the Lund and Browder chart factors in the individual's age. As the child grows older, it adjusts the percentage of body surface area (BSA), reducing it for the head and increasing it for the legs. This feature enhances its utility in assessing burns in pediatric cases.

Burns-Repeats

1. How do you determine the-extent of burn? What is the difference between ante mortem and postmortem burns (2006)? 
2. A married woman was found dead with 100% bums on the body in her house. How will you establish on post-mortem examination that whether burns are ante-mortem or post-mortem in nature? (2011) 
3. Discuss briefly the formula used for calculating the Total Body Surface Area' involved in burns in an adult and a child. (2018)