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.
Question for BurnsTry yourself: What is the characteristic body posture following exposure to intense heat burns?View Solution
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.
Question for BurnsTry yourself: What does a carboxyhemoglobin level exceeding 10% indicate?View Solution
Burns-Repeats
- How do you determine the-extent of burn? What is the difference between ante mortem and postmortem burns (2006)?
- 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)
- Discuss briefly the formula used for calculating the Total Body Surface Area' involved in burns in an adult and a child. (2018)
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FAQs on Burns - Medical Science Optional Notes for UPSC
| 1. What is the meaning of the term "pugilistic attitude" in the context of burns? |  |
Ans. In the context of burns, a pugilistic attitude refers to a body posture where the arms and legs are flexed and the individual assumes a defensive position. This posture is often seen in severe burns where the skin shrinks and tightens, causing the limbs to bend and the fingers to curl towards the palm.
| 2. How does a pugilistic attitude occur in burn patients? | |
Ans. A pugilistic attitude occurs in burn patients due to the contraction of the burned skin. When the skin is damaged by burns, it undergoes a healing process called wound contraction. During this process, the skin tightens and shrinks, leading to the characteristic flexed position of the limbs and fingers.
| 3. What are the implications of a pugilistic attitude in burn patients? | |
Ans. The pugilistic attitude in burn patients can have several implications. Firstly, it can restrict the range of motion and mobility of the affected limbs, making it difficult for the patient to perform daily activities. Secondly, it can increase the risk of contractures, where the joints become permanently stiff and lose their normal range of motion. Lastly, the pugilistic attitude can affect the overall appearance and psychological well-being of the patient.
| 4. How can a pugilistic attitude be managed in burn patients? | |
Ans. Managing a pugilistic attitude in burn patients involves a multidisciplinary approach. Physical therapy and occupational therapy are essential components of treatment. These therapies focus on stretching exercises, splinting, and positioning techniques to prevent contractures and improve range of motion. In some cases, surgical intervention may be required to release contracted tissues or perform skin grafts. Pain management, psychological support, and counseling are also important in addressing the emotional and psychological impact of a pugilistic attitude.
| 5. Can a pugilistic attitude be prevented in burn patients? | |
Ans. While it may not be possible to completely prevent a pugilistic attitude in burn patients, early and appropriate management can help minimize its severity and impact. Prompt and adequate wound care, including the use of dressings, topical treatments, and skin grafts, can promote effective healing and reduce the extent of wound contraction. Regular physical therapy and occupational therapy interventions can also play a significant role in preventing or minimizing the development of contractures and maintaining optimal range of motion.
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Oct 31, 2024 Last updated |
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