Summary

Summary :
Types of burns :
• Chemical burns
• Electrical burns
• UV light burn
• Radiation injury

Signs and Symptoms :
Burn
• First-degree burns:
red, swollen, and painful. The burned area whitens (blanches) when lightly touched but does not develop blisters.
• Second-degree burns:
pink or red, swollen, and painful, and they develop blisters that may ooze a clear fluid. The burned area may blanch when touched.
• Third-degree burns :
usually are not painful. The skin becomes leathery and may be white, black, or bright red. The burned area does not blanch when touched, and hairs can easily be pulled from their roots.

Infection
• Change in color of the burnt area or surrounding skin
• Purplish discoloration, particularly if swelling is also present
• Change in thickness of the burn (the burn suddenly extends deep into the skin)
• Greenish discharge or pus
• Fever

Severity of Wound
• Depth
• Surface Area (Rule of nine, Rule of palm)
• Body part
• Pre-existing medical problem
• Age

Classification of Wound :
• 1st degree (epidermis)
• 2nd degree (epidermis + part of dermis)
• 3rd degree (epidermis + dermis)

Investigations for wound infection :
Wound culture:
• help determine whether wound infected
• identify bacteria
• prepare sample for susceptibility testing
• steps
o collecting sample
o stimulating growth (media)
o identification (e.g. gram stain)
o antimicrobial susceptibility testing (for treatment)

Complications:
Minor burns :
• usually superficial and do not cause complications.
Severe burns and some moderate burns :
• Dehydration
o Cause shock if dehydration is severe
• Chemical imbalances
• Destruction of muscle tissue (rhabdomyolysis)
• Infection cause severe illness or death.
• Thick, crusty surfaces (eschars)
o cutting off blood supply to healthy tissues or impairing breathing.

Normal process of healing :
Hemostasis
• growth factors are released.
• Constriction of blood vessels
• Adherence of platelets to damaged epithelium
• Discharge of adenosine diphosphate – promote thrombocyte clumping
• Clot forms to close blood vessels
• Cytokines initiate inflammatory phase

Inflammation
• Polymorphonuclear leukocytes released
• Activation of complement
• Macrophage formation

The proliferative phase
-collagen deposits
-angiogenesis
-granulation
-tissue development
- wound contraction

Maturation Phase
-remodelling of the scar
- strength of scar tissue

Treatment and Management :
• Wound Management.
• First Aid
o CPR
o Airway
 Check airways that may cause breathing problems.
o Breathing
o Circulation
 Fluid resuscitation (IV therapy)
• Chemical Burns
• Electrical Burns
• Skin Grafts
o Types – (Pinch Grafts, Split-thickness grafts, Full thickness grafts , Pedicle grafts)
• Skin Treatment Medication
• Follow-Up
o Physiotherapy
o Counseling and Support Groups
o Rehabilitative Care

Complementary medicine :
• Nutrition and diet supplement
• Herbs
• Acupuncture
• Massage therapy
• Physical therapy
• Homeopathy
• Mind-body Medicine
• Therapeutic Touch
• Maggot Therapy

Diseases spread by food handlers:
Agents of Food-borne diseases:
• Microorganisms, including:
o bacteria
o viruses
o parasitic protozoa
o worms
• natural toxins
• chemical residues
• prions.

List of potential diseases:
• Typhoid fever
• Gastroenteritis - norovirus, rotavirus, adenovirus, astrovirus, Helicobactor pylori
• Hepatitis A
• Cholera
• Listeriosis
• Hemolytic uremic syndrome
• hemorrhagic colitis
• Septicaemia
• Bovine Spongiform Encephalopathy (BSE)
• Strep throats
• Foodborne botulism
• Hemorrhagic colitis
• Salmonellosis
• Meningitis

Route of transmission (main diseases only)
Typhoid fever - stool of persons infected with typhoid fever or carriers, water
Gastroenteritis - fecal/oral, oral/oral, or gastric/oral pathways.
Campylobacter - from the consumption of undercooked meat, unpasteurized milk
Shigella - typically spread from person to person
Hepatitis A- by the fecal-oral route of transmission.
Cholera - through contamination of water sources and contamination of food.
Bovine Spongiform Encephalopathy (BSE)
–through an agent related to scrapie in sheep, which contaminated recycled bovine carcasses used to make meat and bone meal additives for cattle feed.
-contaminated bovine-based food products
Listeria - bacteria found in soil and water, raw foods as well as in processed foods and foods made from unpasteurized milk

Prevention of burns
• keep hot liquids away from table & counter edges
• don't hold or pass hot liquids over children
• keep cups & bowls with hot contents out of reach
• keep children out of kitchen while cooking
• keep iron or curling iron cords out of child's reach
• Never leave candles unattended. Blow them out when you leave the room.
• Test the water temperature before you or your children get into the tub or shower.
Preventing Radiation Burns
• Use a sunscreen
• Avoid exposure to UV (ultraviolet) radiation from sunlamps or tanning beds.
Preventing Chemical Burns
• Wear gloves and other protective clothing when you handle chemicals. Store chemicals, including gasoline, out of the reach of children.
• Store Chemicals in Locked Cabinet
• Purchase Potentially Dangerous Chemicals in Safety Containers
• Avoid Prolonged Chemical Exposure
Preventing Electrical Burns
• keep electrical outlets covered from children
• put covers on any electrical outlets that are within children's reach.


Public Health Issue :
General Requirement for food premises
• Location
• General design
• Water supply
• Cleanliness of food premises
• Pest control in food premises
• Disposal of refuse

Specific Requirements for Food premises
• Floor surfaces
• Wall surfaces
• Lighting
• Ventilation
• Ceiling
• Door
• Furniture, fitting and food contact surfaces
• Food storage
• Changing room
• Wash basin
• Toilet room
• Drainage facility

Food Handler
• Food handlers training
• Clothing of food handler
• Medical examination and health condition of food handler
• Personal hygiene of food handler
• Duty to keep food premises clean