Nosocomial infection also known as Hospital acquired infection (HAI) is an infection that the patient acquires when he/she is admitted to a hospital or a health care facility for any reason other than that infection. The infection should have not been present or incubating prior to the patient’s being admitted to the hospital.
Certain factors may affect the susceptibility of the patient to get nosocomial:
Nosocomial infection also known as Hospital acquired infection (HAI) is an infection that the patient acquires when he/she is admitted to a hospital or a health care facility for any reason other than that infection. The infection should have not been present or incubating prior to the patient’s being admitted to the hospital.
Origin of Nosocomial infection:
Nasocomial infection can be external (from out side the body) or internal (from the inside of the body).
Nosocomial infection also known as Hospital acquired infection (HAI) is an infection that the patient acquires when he/she is admitted to a hospital or a health care facility for any reason other than that infection. The infection should have not been present or incubating prior to the patient’s being admitted to the hospital.
Sites of Nosocomial infections:
Diabetes mellitus is a chronic disease that has many complications, among which is the effect of diabetes on the blood vessels leading to damage, narrowing and may lead to blockage of the blood vessels, leading to alteration of blood perfusion and subsequent reduction in the oxygen and nutritional delivery to the tissues which will affect wound healing. Diabetes can affect the nerves leading to nerve damage (diabetic neuropathy); nerves affected are responsible for temperature, pressure, texture and pain sensation. The nerves of the lower legs and feet when affected can lead to insensitivity to temperature and pain in the lower legs and feet and patients may experience numbness and tingling sensation in these areas.
Diabetic patients with neuropathy have an increased risk of burn injuries. These burns may happen from soaking the feet in hot water, heating pads, walking on hot surface, and contact with a warming device such as heaters. Because of the impaired sensation of the feet in these patients, they may sustain a burn injury without being aware of it. These patients have poor wound healing due to the effect of diabetes on the nerves and blood vessels and the increased risk of wound infection in diabetic patients.
Burns in diabetic patients even when they are minor may lead to ulceration of the wound, serious infection and even amputation of the limb. Therefore preventing and early recognition of burns in diabetic patients is very important.
Flash burns to the eye:
A flash burn to the eye occurs when the person is exposed to a bright ultraviolet light. Causes of flash burn to the eye may include:
Burns to the eyes can be caused by many different things such as chemicals, hot air, steam, sunlight, welding equipments etc.
Chemical burns:
They can be caused by solid chemicals, liquid chemicals, chemical fumes or powdered material. Damage to the eyes may be minimized if they are washed quickly. The most dangerous chemical burns involve strong acids or alkali (base) substances.
When the skin is burned and depending on the severity of the burn, tissue will die, this dead tissue is called an eschar which is inelastic and can’t expand.
When the burn is a circumferential (burned all the way around) second and third degree burn, eschar will form and with the edema (fluid leak from injured vessels) formed; the pressure will increase in the burned area. If this happens in arms and legs, this will lead to compression of the underlying veins arteries and nerves acting like a tourniquet. If the circumferential burn happens in the neck or chest, the pressure will prevent chest expansion leading to breathing problems. In these situations escharatomy is often needed.
Escharotomy is a surgical procedure done by making an incision through the eschar to relieve the underlying pressure, measuring the pressure in the compartment (closed space of nerves, muscle tissue and blood vessels) distal (furthest) to the affected area is one of the parameters used to determine the timing of escharatomy. Another way to determine the timing of the escharotomy is clinically by assessing the perfusion (the flow of blood) distal to the area affected.
Also known as Adult Respiratory Distress Syndrome is a life threatening lung condition in which fluid accumulates in the lung leading to low levels of oxygen in the blood.
When a healthy person breathes, air will enter the nose and mouth passing through the trachea (windpipe) to reach the alveoli (air sacs) of the lungs. Oxygen will pass from the alveoli to small blood vessels surrounding the alveoli called the capillaries and from the capillaries to the bloodstream where it will be carried to different parts of the body. When the lung is injured from many causes including severe burns fluid and blood will leak from the capillaries into the alveoli, this will prevent air from entering the alveoli leading to decreased oxygen in the bloodstream and in turn decrease the oxygen supply to different organs which will affect their function. The lungs become inflamed, the inflammation will lead to scaring and fibrosis of the lungs causing the lungs to become stiff. This stiffness of the lung with fluid will make breathing very difficult for the patient.
Causes may include:
Treatment:
Acute compartment syndrome is considered a medical emergency that requires immediate surgical treatment. The surgical procedure is called a fasciotomy which is simply done by making a long incision in the fascia to release the pressure building inside.
Subacute compartment syndrome is treated surgically by urgent fasciotomy.
A compartment is defined as a closed space of nerves, muscle tissue and blood vessels. This space is surrounded by fascia (thick layer of tissue) that doesn’t stretch. When the pressure inside the compartment increases from any cause and if the pressure increases substantially, this may lead to the compression of the nerves, blood vessels and muscles inside the compartment. The result may be impaired blood flow and reduced oxygenation that may result in muscle and nerve damage. Compartment syndrome most commonly involves the forearm and lower leg although it can occur in other places. Compartment syndrome can be acute, subacute or chronic (see below).
Causes:
An injury that leads to an increase in the pressure inside the compartment may cause compartment syndrome, these may include:
Burn Injury Resource Center