Anoxia Health Dictionary

Burns are injuries caused by dry heat, scalds by moist heat, but the two are similar in symptoms and treatment. Severe burns are also caused by contact with electric wires, and by the action of acids and other chemicals. The burn caused by chemicals di?ers from a burn by ?re only in the fact that the outcome is more favourable, because the chemical destroys the bacteria on the affected part(s) so that less suppuration follows.

Severe and extensive burns are most frequently produced by the clothes – for example, of a child – catching ?re. This applies especially to cotton garments, which blaze up quickly. It should be remembered that such a ?ame can immediately be extinguished by making the individual lie on the ?oor so that the ?ames are uppermost, and wrapping him or her in a rug, mat or blanket. As prevention is always better than cure, particular care should always be exercised with electric ?res and kettles or pots of boiling water in houses where there are young children or old people. Children’s clothes, and especially night-clothes, should be made of non-in?ammable material: pyjamas are also much safer than nightdresses.

Severe scalds are usually produced by escape of steam in boiler explosions. Cigarettes are a common cause of ?res and therefore of burns; people who have fallen asleep in bed or in a chair while smoking may set ?re to the bed or chair. Discarded, unextinguished cigarettes are another cause.

Degrees of burns Burns are referred to as either super?cial (or partial-thickness) burns, when there is su?cient skin tissue left to ensure regrowth of skin over the burned site; and deep (or full-thickness) burns, when the skin is totally destroyed and grafting will be necessary.

Symptoms Whilst many domestic burns are minor and insigni?cant, more severe burns and scalds can prove to be very dangerous to life. The main danger is due to SHOCK, which arises as a result of loss of ?uid from the circulating blood at the site of a serious burn. This loss of ?uid leads to a fall in the volume of the circulating blood. As the maintenance of an adequate blood volume is essential to life, the body attempts to compensate for this loss by withdrawing ?uid from the uninjured areas of the body into the circulation. If carried too far, however, this in turn begins to affect the viability of the body cells. As a sequel, essential body cells, such as those of the liver and kidneys, begin to suffer, and the liver and kidneys cease to function properly. This will show itself by the development of JAUNDICE and the appearance of albumin in the urine (see PROTEINURIA). In addition, the circulation begins to fail with a resultant lack of oxygen (see ANOXIA) in the tissues, and the victim becomes cyanosed (see CYANOSIS), restless and collapsed: in some cases, death ensues. In addition, there is a strong risk of infection occurring. This is the case with severe burns in particular, which leave a large raw surface exposed and very vulnerable to any micro-organisms. The combination of shock and infection can all too often be life-threatening unless expert treatment is immediately available.

The immediate outcome of a burn is largely determined by its extent. This is of more signi?cance than the depth of the burn. To assess the extent of a burn in relation to the surface of the body, what is known as the Rule of Nine has been evolved. The head and each arm cover 9 per cent of the body surface, whilst the front of the body, the back of the body, and each leg each cover 18 per cent, with the perineum (or crutch) accounting for the remaining 1 per cent. The greater the extent of the burn, the more seriously ill will the victim become from loss of ?uid from his or her circulation, and therefore the more prompt should be his or her removal to hospital for expert treatment. The depth of the burn, unless this is very great, is mainly of import when the question arises as to how much surgical treatment, including skin grafting, will be required.

Treatment This depends upon the severity of the burn. In the case of quite minor burns or scalds, all that may be necessary if they are seen immediately is to hold the part under cold running water until the pain is relieved. Cooling is one of the most e?ective ways of relieving the pain of a burn. If the burn involves the distal part of a limb – for example, the hand and forearm – one of the most e?ective ways of relieving pain is to immerse the burned part in lukewarm water and add cold water until the pain disappears. As the water warms and pain returns, more cold water is added. After some three to four hours, pain will not reappear on warming, and the burn may be dressed in the usual way. Thereafter a simple dressing (e.g. a piece of sterile gauze covered by cotton-wool, and on top of this a bandage or adhesive dressing) should be applied. The part should be kept at rest and the dressing kept quite dry until healing takes place. Blisters should be pierced with a sterile needle, but the skin should not be cut away. No ointment or oil should be applied, and an antiseptic is not usually necessary.

In slightly more severe burns or scalds, it is probably advisable to use some antiseptic dressing. These are the cases which should be taken to a doctor – whether a general practitioner, a factory doctor, or to a hospital Accident & Emergency department. There is still no general consensus of expert opinion as to the best ‘antiseptic’ to use. Among those recommended are CHLORHEXIDINE, and antibiotics such as BACITRACIN, NEOMYCIN and polymixin. An alternative is to use a Tulle Gras dressing which has been impregnated with a suitable antibiotic.

In the case of severe burns and scalds, the only sound rule is immediate removal to hospital. Unless there is any need for immediate resuscitation, such as arti?cial respiration, or attention to other injuries there may be, such as fractures or haemorrhage, nothing should be done on the spot to the patient except to make sure that s/he is as comfortable as possible and to keep them warm, and to cover the burn with a sterile (or clean) cloth such as a sheet, pillowcases, or towels wrung out in cold water. If pain is severe, morphine should be given – usually intravenously. Once the victim is in hospital, the primary decision is as to the extent of the burn, and whether or not a transfusion is necessary. If the burn is more than 9 per cent of the body surface in extent, a transfusion is called for. The precise treatment of the burn varies, but the essential is to prevent infection if this has not already occurred, or, if it has, to bring it under control as quickly as possible. The treatment of severe burns has made great advances, with quick transport to specialised burns units, modern resuscitative measures, the use of skin grafting and other arti?cial covering techniques and active rehabilitation programmes, o?ering victims a good chance of returning to normal life.

CHEMICAL BURNS Phenol or lysol can be washed o? promptly before they do much damage. Acid or alkali burns should be neutralised by washing them repeatedly with sodium bicarbonate or 1 per cent acetic acid, respectively. Alternatively, the following bu?er solution may be used for either acid or alkali burns: monobasic potassium phosphate (70 grams), dibasic sodium phosphate (70 grams) in 850 millilitres of water. (See also PHOSPHORUS BURNS.)... burns and scalds

Inhalation of regurgitated stomach contents, usually as a complication of general ANAESTHESIA. It may cause death from ANOXIA or result in extensive lung damage.... mendelson syndrome

Perinatal mortality consists of deaths of the FETUS after the 28th week of pregnancy and deaths of the newborn child during the ?rst week of life. Today, more individuals die within a few hours of birth than during the following 40 years. It is therefore not surprising that the perinatal mortality rate, which is the number of such deaths per 1,000 total births, is a valuable indicator of the quality of care provided for the mother and her newborn baby. In 2002, the perinatal mortality rate was 7.87 in the United Kingdom compared with 11.4 in 1982 – and over 30 in the early 1960s.

The causes of perinatal mortality include extreme prematurity, intrapartum anoxia (that is, di?culty in the birth of the baby, resulting in lack of oxygen), congenital abnormalities of the baby, and antepartum anoxia (that is, conditions in the terminal stages of pregnancy preventing the fetus from getting su?cient oxygen).

The most common cause of perinatal death is some complication of placenta, cord or membranes. The next most common is congenital abnormality. Intrauterine hypoxia and birth asphyxia comprise the third most common cause.... perinatal mortality

The BRAIN is the organ of the mind. Normal conscious alertness depends upon its continuous adequate supply with oxygen and glucose, both of which are essential for the brain cells to function normally. If either or both of these are interrupted, altered consciousness results. Interruption may be caused by three broad types of process affecting the brain stem: the reticular formation (a network of nerve pathways and nuclei-connecting sensory and motor nerves to and from the cerebrum, cerebellum, SPINAL CORD and cranial nerves) and the cerebral cortex. The three types are di?use brain dysfunction – for example, generalised metabolic disorders such as URAEMIA or toxic disorders such as SEPTICAEMIA; direct effects on the brain stem as a result of infective, cancerous or traumatic lesions; and indirect effects on the brain stem such as a tumour or OEDEMA in the cerebrum creating pressure within the skull. Within these three divisions are a large number of speci?c causes of unconsciousness.

Unconsciousness may be temporary, prolonged or inde?nite (see PERSISTENT VEGETATIVE STATE (PVS)), depending upon the severity of the initiating incident. The patient’s recovery depends upon the cause and success of treatment, where given. MEMORY may be affected, as may motor and sensory functions; but short periods of unconsciousness as a result, say, of trauma have little obvious e?ect on brain function. Repeated bouts of unconsciousness (which can happen in boxing) may, however, have a cumulatively damaging e?ect, as can be seen on CT (COMPUTED TOMOGRAPHY) scans of the brain.

POISONS such as CARBON MONOXIDE (CO), drug overdose, a fall in the oxygen content of blood (HYPOXIA) in lung or heart disease, or liver or kidney failure harm the normal chemical working or metabolism of nerve cells. Severe blood loss will cause ANOXIA of the brain. Any of these can result in altered brain function in which impairment of consciousness is a vital sign.

Sudden altered consciousness will also result from fainting attacks (syncope) in which the blood pressure falls and the circulation of oxygen is thereby reduced. Similarly an epileptic ?t causes partial or complete loss of consciousness by causing an abrupt but temporary disruption of the electrical activity in the nerve cells in the brain (see EPILEPSY).

In these events, as the brain’s function progressively fails, drowsiness, stupor and ?nally COMA ensue. If the cause is removed (or when the patient spontaneously recovers from a ?t or faint), normal consciousness is usually quickly regained. Strokes (see STROKE) are sometimes accompanied by a loss of consciousness; this may be immediate or come on slowly, depending upon the cause or site of the strokes.

Comatose patients are graded according to agreed test scales – for example, the GLASGOW COMA SCALE – in which the patient’s response to a series of tests indicate numerically the level of coma.

Treatment of unconscious patients depends upon the cause, and range from ?rst-aid care for someone who has fainted to hospital intensive-care treatment for a victim of a severe head injury or massive stroke.... unconsciousness

Whooping-cough, or pertussis, is a respiratory-tract infection caused by Bordetella pertussis and spread by droplets. It may occur at all ages, but around 90 per cent of cases are children aged under ?ve. Most common during the winter months, it tends to occur in epidemics (see EPIDEMIC), with periods of increased prevalence occurring every three to four years. It is a noti?able disease (see NOTIFIABLE DISEASES). The routine vaccination of infants with TRIPLE VACCINE (see also VACCINE; IMMUNISATION), which includes the vaccine against whooping-cough, has drastically reduced the incidence of this potentially dangerous infection. In the 1990s over 90 per cent of children in England had been vaccinated against whooping-cough by their second birthday. In an epidemic of whooping-cough, which extended from the last quarter of 1977 to mid-1979, 102,500 cases of whooping-cough were noti?ed in the United Kingdom, with 36 deaths. This was the biggest outbreak since 1957 and its size was partly attributed to the fall in vaccination acceptance rates because of media reports suggesting that pertussis vaccination was potentially dangerous and ine?ective. In 2002, 105 cases were noti?ed in England.

Symptoms The ?rst, or catarrhal, stage is characterised by mild, but non-speci?c, symptoms of sneezing, conjunctivitis (see under EYE, DISORDERS OF), sore throat, mild fever and cough. Lasting 10–14 days, this stage is the most infectious; unfortunately it is almost impossible to make a de?nite clinical diagnosis, although analysis of a nasal swab may con?rm a suspected case. This is followed by the second, or paroxysmal, stage with irregular bouts of coughing, often prolonged, and typically more severe at night. Each paroxysm consists of a succession of short sharp coughs, increasing in speed and duration, and ending in a deep, crowing inspiration, often with a characteristic ‘whoop’. Vomiting is common after the last paroxysm of a series. Lasting 2–4 weeks, this stage is the most dangerous, with the greatest risk of complications. These may include PNEUMONIA and partial collapse of the lungs, and ?ts may be induced by cerebral ANOXIA. Less severe complications caused by the stress of coughing include minor bleeding around the eyes, ulceration under the tongue, HERNIA and PROLAPSE of the rectum. Mortality is greatest in the ?rst year of life, particularly among neonates – infants up to four weeks old. Nearly all patients with whooping-cough recover after a few weeks, with a lasting IMMUNITY. Very severe cases may leave structural changes in the lungs, such as EMPHYSEMA, with a permanent shortness of breath or liability to ASTHMA.

Treatment Antibiotics, such as ERYTHROMYCIN or TETRACYCLINES, may be helpful if given during the catarrhal stage – largely in preventing spread to brothers and sisters – but are of no use during the paroxysmal stage. Cough suppressants are not always helpful unless given in high (and therefore potentially narcotic) doses, and skilled nursing may be required to maintain nutrition, particularly if the disease is prolonged, with frequent vomiting.... whooping-cough

Usually associated with some loss of sensation and power in another part of the body. Taste, smell, hearing, sight and movement may be affected. The following are some of the disorders that may affect the brain. Each has a separate entry in this book.

Abscess, Alzheimer’s Disease, anoxia (oxygen starvation), coma, concussion, haemorrhage, Down’s syndrome, epilepsy, tumour, hydrocephalus (water on the brain), meningitis, multiple sclerosis, stroke (rupture of blood vessel), spina bifida, syphilis (general paralysis of the insane), sleepy sickness.

Poor circulation through the brain due to hardening of the arteries: Ginkgo, Ginseng. Ginseng stimulates the hypothalmic/pituitary axis of the brain and favourably influences its relationship with the adrenal glands.

Congestion of the brain – Cowslip (Boerwicke). Irritability of brain and spine – Hops. Oats. Inflammation of the brain (encephalitis) as in viral infection, poliomyelitis, rabies, sleepy sickness, etc: Echinacea, Passion flower, Skullcap and Lobelia. Gelsemium acts as a powerful relaxant in the hands of a practitioner: Tincture BPC (1973): dose 0.3ml.

Brain storm from hysteria, locomotor ataxia, etc – Liquid Extract Lobelia: 5ml teaspoon in water when necessary (Dr Jentzsch, 1915, Ellingwood) Supplement with Zinc, Vitamins C and E.

Blood clot, thrombosis: Yarrow. Neurasthenia: Oats, Basil, Hops.

Brain fag and jet-lag: Chamomile, Skullcap, Oats, Ginseng, Ginkgo.

Tumour may be present years before manifesting: Goldenseal.

Mental state: depression, anxiety, schizophrenia.

Tea. Formula. Skullcap, Gotu Kola and German Chamomile; equal parts. 1 heaped teaspoon to each cup water gently simmered 10 minutes. Strain. 1 cup thrice daily.

Unspecified tensive state. Formula. Tinctures. Hops 1; Passion flower 2; Valerian 2. Dose: 2 teaspoons thrice daily until diagnosis is concluded.

Unspecified torpor. Formula. Tinctures. Ginseng 1; Kola 1; Capsicum quarter. 2 teaspoons in water thrice daily until diagnosis is concluded.

Brain weakness in the elderly: Ginkgo. See: ALZHEIMER’S DISEASE.

Fluid on the brain: see HYDROCEPHALUS.

Abscess of the brain: see ABSCESS.

Brain restoratives. Black Haw, True Unicorn root, Galangal, Oats, Oatstraw, False Unicorn root, Kola, Hops. Vitamin B6. Magnesium.

Cerebral thrombosis. See entry.

Note: Cold water may help victims to survive: rapid loss of body heat protects the brain. (Child Health Department, University of Wales)

Treatment by or in liaison with general medical practitioner or hospital specialist. ... brain disorders

Sudden cessation of breathing, resulting from any process that severely depresses the function of the respiratory centre in the brain. Causes include prolonged seizures, an overdose of opioid drugs, cardiac arrest, electrical injury, serious head injury, stroke, or respiratory failure. Respiratory arrest leads to anoxia and, if untreated, cardiac arrest, brain damage, coma, and death.... respiratory arrest

n. a syndrome of anxiety, agitation, and insomnia found in pilots flying unpressurized aircraft and attributed to *anoxia.... aeroneurosis

n. a condition in which there is less than the normal concentration of oxygen in the blood. See also anoxia; hypoxaemia.... anoxaemia

n. a deficiency of oxygen in the tissues. See also anoxia; hypoxaemia.... hypoxia

inhalation of regurgitated stomach contents by an anaesthetized patient, which may result in death from anoxia or cause extensive lung damage or pulmonary *oedema with severe *bronchospasm. It is a well-recognized hazard of general anaesthesia in obstetrics and may be prevented by giving gastric-acid inhibitors (e.g. *cimetidine or *ranitidine) or sodium citrate before inducing anaesthesia. [C. L. Mendelson (1913–2002), US obstetrician]... mendelson’s syndrome

a form of *derealization in which there is a sensation of leaving one’s body, sometimes accompanied by visions of travel. It typically occurs after anaesthesia or severe illness and is often attributed to *anoxia of the brain.... out-of-body experience

n. 1. the passage of air into and out of the respiratory tract. The air that reaches only as far as the conducting airways cannot take part in gas exchange and is known as dead space ventilation – this may be reduced by performing a *tracheostomy. In the air sacs of the lungs (alveoli) gas exchange is most efficient when matched by adequate blood flow (*perfusion). Ventilation/perfusion imbalance (ventilation of underperfused alveoli or perfusion of underventilated alveoli) is an important cause of *anoxia and *cyanosis. 2. the use of a *ventilator to maintain or support the breathing movements of patients. Invasive ventilation involves the insertion of an endotracheal tube (see intubation), through which air is blown into the lungs; patients need to be paralysed and anaesthetized. This need can be eliminated by using techniques of *noninvasive ventilation.... ventilation