tailieunhanh - Critical Care Obstetrics part 53

Critical Care Obstetrics part 53 provides expert clinical guidance throughout on how you can maximize the chances of your patient and her baby surviving trauma. In this stimulating text, internationally recognized experts guide you through the most challenging situations you as an obstetrician are likely to face, enabling you to skillfully:Recognize conditions early-on which might prove life threatening, Implement immediate life-saving treatments in emergency situations, Maximize the survival prospects of both the mother and her fetus | Thermal and Electrical Injury Figure Maternal and perinatal morbidity and mortality increase as the total body surface area burned increases 7 . Table The rule of nines. Anatomic area Percentage of body surface area Head 9 Upper extremities 9 each Lower extremities 9 each Anterior trunk 18 Posterior trunk 18 Neck 1 extremely difficult to assess. Electrical current may be delivered as a wave or alternating pattern called alternating current AC or as direct current DC . Current is created when the flow of electricity measured by voltage meets resistance. When this flow encounters resistance it generates current measured by amperage. The higher the current the more severe is the injury. Alternating current is more dangerous than direct current as it can cause tonic muscle contractions and the victim may be unable to release the source of electrical energy. Since different parts of the body provide varying degrees of resistance the damage caused by electricity can vary. As the same current can generate varying amounts of heat damage is based on the resistance it encounters 3 . Electrical injury can occur through four mechanisms. Direct contact with the electrical source results in injury to the skin in contact with the source and the surrounding subcutaneous tissues. Arcing of electricity usually occurs across joint areas as electrical charge is transferred. This results in cutaneous burns in areas not involved with entry or the exit site. Conduction burns occur when the current is conducted through another medium such as water to another body area. Secondary ignition burns occur when the electrical source ignites a flammable material. The most common causes of electrical burns include occupational hazards household appliances and lightning. There is scarce information regarding fetal outcome after accidental electric shock in pregnancy. A prospective cohort study noted that in most cases accidental electric shock occurring during day-to-day life during .