{"id":647,"date":"2022-03-16T11:12:12","date_gmt":"2022-03-16T11:12:12","guid":{"rendered":"https:\/\/langs.physio-pedia.com\/case-study-electrical-burn-in-disasters-and-conflicts-fr\/"},"modified":"2022-05-02T02:21:35","modified_gmt":"2022-05-02T02:21:35","slug":"case-study-electrical-burn-in-disasters-and-conflicts-fr","status":"publish","type":"page","link":"https:\/\/langs.physio-pedia.com\/fr\/case-study-electrical-burn-in-disasters-and-conflicts-fr\/","title":{"rendered":"\u00c9tude de cas &#8211; Br\u00fblure \u00e9lectrique en situation de catastrophe ou de conflit"},"content":{"rendered":"<div class=\"mw-parser-output\">\n<div class=\"editorbox\">\n<p><b>R\u00e9dacteurs originaux <\/b> &#8211; <a href=\"\/index.php?title=User:Naomi_O_Reilly&amp;action=edit&amp;redlink=1\" class=\"new\" title=\"User:Naomi O Reilly (page does not exist)\">Naomi O Reilly<\/a>\n<\/p>\n<p><b>Principaux contributeurs<\/b> &#8211; <a href=\"\/User:Naomi_O%27Reilly\" class=\"mw-userlink\" title=\"User:Naomi O'Reilly\"><bdi>Naomi O&rsquo;Reilly<\/bdi><\/a>&nbsp; &nbsp;&nbsp; &nbsp;\n<\/p>\n<\/div>\n<div id=\"toc\" class=\"toc\" role=\"navigation\" aria-labelledby=\"mw-toc-heading\"><input type=\"checkbox\" role=\"button\" id=\"toctogglecheckbox\" class=\"toctogglecheckbox\" style=\"display:none\"><\/p>\n<div class=\"toctitle\" lang=\"en\" dir=\"ltr\">\n<h2 id=\"mw-toc-heading\">Contenu<\/h2>\n<p><span class=\"toctogglespan\"><label class=\"toctogglelabel\" for=\"toctogglecheckbox\"><\/label><\/span><\/div>\n<ul>\n<li class=\"toclevel-1 tocsection-1\"><a href=\"#Title\"><span class=\"tocnumber\">1<\/span> <span class=\"toctext\">Titre<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-2\"><a href=\"#Abstract\"><span class=\"tocnumber\">2<\/span> <span class=\"toctext\">R\u00e9sum\u00e9<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-3\"><a href=\"#Key_Words\"><span class=\"tocnumber\">3<\/span> <span class=\"toctext\">Mots cl\u00e9s&nbsp;<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-4\"><a href=\"#Patient_Characteristics\"><span class=\"tocnumber\">4<\/span> <span class=\"toctext\">Caract\u00e9ristiques des patients<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-5\"><a href=\"#Background\"><span class=\"tocnumber\">4.1<\/span> <span class=\"toctext\">Contexte<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-6\"><a href=\"#Examination_Findings\"><span class=\"tocnumber\">5<\/span> <span class=\"toctext\">R\u00e9sultats d&rsquo;examen<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-7\"><a href=\"#A:_Airway_and_C-spine_Control\"><span class=\"tocnumber\">5.1<\/span> <span class=\"toctext\">A : Contr\u00f4le des voies respiratoires et de la colonne vert\u00e9brale<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-8\"><a href=\"#B:_Breathing\"><span class=\"tocnumber\">5.2<\/span> <span class=\"toctext\">B: Respiration<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-9\"><a href=\"#C:_Circulation\"><span class=\"tocnumber\">5.3<\/span> <span class=\"toctext\">C: Circulation<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-10\"><a href=\"#D:_Disability\"><span class=\"tocnumber\">5.4<\/span> <span class=\"toctext\">D: Handicap<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-11\"><a href=\"#E:_Exposure\"><span class=\"tocnumber\">5.5<\/span> <span class=\"toctext\">E: Exposition<\/span><\/a><\/li>\n<li class=\"toclevel-2 tocsection-12\"><a href=\"#F:_Fluid_Resuscitation\"><span class=\"tocnumber\">5.6<\/span> <span class=\"toctext\">F: R\u00e9animation par administration de fluides<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-13\"><a href=\"#Pain_Management\"><span class=\"tocnumber\">6<\/span> <span class=\"toctext\">Gestion de la douleur<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-14\"><a href=\"#Wound_Care\"><span class=\"tocnumber\">7<\/span> <span class=\"toctext\">Soins des plaies<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-15\"><a href=\"#Rehabilitation\"><span class=\"tocnumber\">8<\/span> <span class=\"toctext\">R\u00e9adaptation<\/span><\/a>\n<ul>\n<li class=\"toclevel-2 tocsection-16\"><a href=\"#Treatment\"><span class=\"tocnumber\">8.1<\/span> <span class=\"toctext\">Traitement<\/span><\/a>\n<ul>\n<li class=\"toclevel-3 tocsection-17\"><a href=\"#Goals\"><span class=\"tocnumber\">8.1.1<\/span> <span class=\"toctext\">Objectifs<\/span><\/a>\n<ul>\n<li class=\"toclevel-4 tocsection-18\"><a href=\"#Short-term\"><span class=\"tocnumber\">8.1.1.1<\/span> <span class=\"toctext\">\u00c0 court terme<\/span><\/a><\/li>\n<li class=\"toclevel-4 tocsection-19\"><a href=\"#Long-term\"><span class=\"tocnumber\">8.1.1.2<\/span> <span class=\"toctext\">\u00c0 long terme<\/span><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n<li class=\"toclevel-1 tocsection-20\"><a href=\"#Expected_Outcomes\"><span class=\"tocnumber\">9<\/span> <span class=\"toctext\">R\u00e9sultats escompt\u00e9s<\/span><\/a><\/li>\n<li class=\"toclevel-1 tocsection-21\"><a href=\"#References\"><span class=\"tocnumber\">10<\/span> <span class=\"toctext\">R\u00e9f\u00e9rences&nbsp;<\/span><\/a><\/li>\n<\/ul>\n<\/div>\n<h2><span class=\"mw-headline\" id=\"Title\">Titre<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=1\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Title\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=1\" title=\"Edit section: Title\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Br\u00fblures \u00e0 la main droite et aux deux pieds suite \u00e0 une blessure \u00e9lectrique \u00e0 haute tension. <sup id=\"cite_ref-1\" class=\"reference\"><a href=\"#cite_note-1\">[1]<\/a><\/sup>\n<\/p>\n<p>Merci \u00e0 Humanit\u00e9 et Inclusion pour cette<a rel=\"nofollow\" class=\"external text\" href=\"https:\/\/resources.relabhs.org\/resource\/early-rehabilitation-in-conflicts-and-disasters\/\">\u00e9tude de cas tir\u00e9e de R\u00e9adaptation pr\u00e9coce en situations de conflit et de catastrophe &#8211; Manuel clinique<\/a>\n<\/p>\n<h2><span class=\"mw-headline\" id=\"Abstract\">R\u00e9sum\u00e9<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=2\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Abstract\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=2\" title=\"Edit section: Abstract\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>M. K est un homme de 23 ans qui s&rsquo;est pr\u00e9sent\u00e9 aux services de sant\u00e9 deux jours apr\u00e8s avoir subi une blessure \u00e9lectrique \u00e0 haute tension qui lui a caus\u00e9 des br\u00fblures \u00e0 la main droite et aux deux pieds, alors qu&rsquo;il essayait d&rsquo;obtenir de l&rsquo;\u00e9lectricit\u00e9. M. K respirait spontan\u00e9ment, ne pr\u00e9sentait pas de br\u00fblures au niveau de la poitrine ou de l&rsquo;abdomen et aucune autre blessure thoracique \u00e9vidente mettant sa vie en danger, ni troubles du syst\u00e8me nerveux central.\n<\/p>\n<h2><span class=\"mw-headline\" id=\"Key_Words\">Mots cl\u00e9s&nbsp;<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=3\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Key Words\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=3\" title=\"Edit section: Key Words\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Br\u00fblures, \u00e9lectrique, haute tension\n<\/p>\n<h2><span class=\"mw-headline\" id=\"Patient_Characteristics\">Caract\u00e9ristiques des patients<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=4\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Patient Characteristics\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=4\" title=\"Edit section: Patient Characteristics\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Background\">contexte<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=5\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Background\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=5\" title=\"Edit section: Background\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<p>M. K est un homme de 23 ans qui a subi une blessure \u00e9lectrique \u00e0 haute tension en essayant d&rsquo;obtenir de l&rsquo;\u00e9lectricit\u00e9 et qui s&rsquo;est pr\u00e9sent\u00e9 deux jours plus tard avec des br\u00fblures \u00e0 la main droite et aux deux pieds.\n<\/p>\n<h2><span class=\"mw-headline\" id=\"Examination_Findings\">R\u00e9sultats de l&rsquo;examen<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=6\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Examination Findings\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=6\" title=\"Edit section: Examination Findings\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"A:_Airway_and_C-spine_Control\">A : Contr\u00f4le des voies respiratoires et de la colonne vert\u00e9brale<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=7\" class=\"mw-editsection-visualeditor\" title=\"Edit section: A: Airway and C-spine Control\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=7\" title=\"Edit section: A: Airway and C-spine Control\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>Aucun ant\u00e9c\u00e9dent de traumatisme associ\u00e9 et aucune l\u00e9sion de la colonne vert\u00e9brale suspect\u00e9e.<\/li>\n<li>Il a peut-\u00eatre cess\u00e9 de respirer sur les lieux, personne n&rsquo;en est s\u00fbr : il est maintenant \u00e9veill\u00e9 mais confus.<\/li>\n<li>Aucune gestion de la colonne vert\u00e9brale n&rsquo;est requise.<\/li>\n<li>Donner de l&rsquo;oxyg\u00e8ne au patient et le surveiller de pr\u00e8s<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"B:_Breathing\">B: Respiration<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=8\" class=\"mw-editsection-visualeditor\" title=\"Edit section: B: Breathing\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=8\" title=\"Edit section: B: Breathing\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>Respiration spontan\u00e9e et bruits respiratoires normaux tout au long de la journ\u00e9e.<\/li>\n<li>RR de 22 BPM<\/li>\n<li>Il n&rsquo;y a pas de br\u00fblures \u00e0 la poitrine ou \u00e0 l&rsquo;abdomen<\/li>\n<li>Aucune autre blessure thoracique \u00e9vidente mettant la vie en danger<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"C:_Circulation\">C: Circulation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=9\" class=\"mw-editsection-visualeditor\" title=\"Edit section: C: Circulation\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=9\" title=\"Edit section: C: Circulation\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>Aucune blessure de ses blessures ne saigne.<\/li>\n<li>Le pouls est de 130 mais semble irr\u00e9gulier.<\/li>\n<li>La tension art\u00e9rielle est de 100\/70<\/li>\n<li>Il pr\u00e9sente des br\u00fblures profondes sur la face palmaire de son avant-bras et de son poignet droits, avec un certain gonflement mais un bon remplissage capillaire.<\/li>\n<li>Il doit \u00eatre surveill\u00e9 de pr\u00e8s, car, ayant subi une blessure \u00e0 haute tension, qui entra\u00eene des dommages musculaires importants, il pourrait n\u00e9cessiter une fasciotomie :<\/li>\n<li>Assurer la liaison avec l&rsquo;\u00e9quipe m\u00e9dicale pour ins\u00e9rer des canules et commencer une th\u00e9rapie des fluides et mettre en place un moniteur ECG pour surveiller la fr\u00e9quence cardiaque.<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"D:_Disability\">D: Handicap<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=10\" class=\"mw-editsection-visualeditor\" title=\"Edit section: D: Disability\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=10\" title=\"Edit section: D: Disability\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>M. K est conscient et r\u00e9pond lorsqu&rsquo;on lui parle (V sur l&rsquo;\u00e9chelle AVPU).<\/li>\n<li>Il ne semble pas y avoir de probl\u00e8mes au niveau neurologique central.<\/li>\n<li>En raison de la zone de la blessure, il y aura cependant probablement des dommages aux nerfs p\u00e9riph\u00e9riques.\n<ul>\n<li>Nerf m\u00e9dian du membre sup\u00e9rieur<\/li>\n<li>Nerf p\u00e9ronier des membres inf\u00e9rieurs<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"E:_Exposure\">E: Exposition<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=11\" class=\"mw-editsection-visualeditor\" title=\"Edit section: E: Exposure\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=11\" title=\"Edit section: E: Exposure\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>Le patient est capable de s&rsquo;asseoir de mani\u00e8re autonome<\/li>\n<li>Brul\u00fbres \u00e9videntes sur le bras droit et les deux pieds.\n<ul>\n<li>La br\u00fblure sur la jambe gauche ne s&rsquo;\u00e9tend pas tr\u00e8s loin mais elle est circonf\u00e9rentielle et le pied est gonfl\u00e9, tout comme le poignet droit (une escarotomie peut \u00eatre n\u00e9cessaire dans les deux r\u00e9gions avec ou sans fasciotomie).<\/li>\n<\/ul>\n<\/li>\n<li>Pas d&rsquo;autres blessures \u00e9videntes.<\/li>\n<li>Veiller \u00e0 ce que le patient soit maintenu au chaud<\/li>\n<\/ul>\n<h3><span class=\"mw-headline\" id=\"F:_Fluid_Resuscitation\">F: R\u00e9animation par adminitration de fluides<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=12\" class=\"mw-editsection-visualeditor\" title=\"Edit section: F: Fluid Resuscitation\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=12\" title=\"Edit section: F: Fluid Resuscitation\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>En termes de surface corporelle brul\u00e9e (Total Body Surface Area &#8211; TBSA), 7 % n&rsquo;est pas une \u00ab\u00a0br\u00fblure \u00e0 r\u00e9animation\u00a0\u00bb, mais nous craignons des l\u00e9sions tissulaires plus profondes, c&rsquo;est pourquoi l&rsquo;\u00e9quipe m\u00e9dicale doit prendre l&rsquo;initiative dans ce cas.<\/li>\n<li>La liaison avec l&rsquo;\u00e9quipe m\u00e9dicale est vitale, car apr\u00e8s 48 heures de la blessure initiale, si M. K avait besoin d&rsquo;une escarotomie\/fasciotomie, il pourrait \u00eatre trop tard : Le patient aurait alors un risque \u00e9lev\u00e9 de devoir \u00eatre amput\u00e9.\n<ul>\n<li>Il est important de surveiller ensuite le d\u00e9bit urinaire, le pouls, la tension art\u00e9rielle et le remplissage capillaire, et de continuer \u00e0 \u00e9valuer la fr\u00e9quence cardiaque \u00e0 l&rsquo;aide d&rsquo;un ECG.<\/li>\n<li>Continuer \u00e0 surveiller l&rsquo;apparition de nouveaux gonflements ou de signes de syndrome des loges dans le bras droit et les deux jambes.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Pain_Management\">Gestion de la douleur<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=13\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Pain Management\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=13\" title=\"Edit section: Pain Management\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<ul>\n<li>Assurer la liaison avec l&rsquo;\u00e9quipe m\u00e9dicale<\/li>\n<li>S&rsquo;assurer que la gestion de la douleur est couverte, y compris avant le changement des pansements et l&rsquo;analg\u00e9sie th\u00e9rapeutique.<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Wound_Care\">Soins des plaies<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=14\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Wound Care\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=14\" title=\"Edit section: Wound Care\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<ul>\n<li>Discuter avec l&rsquo;\u00e9quipe m\u00e9dicale du plan de soins des plaies de M. K\n<ul>\n<li>Il aura probablement besoin d&rsquo;une escarotomie et toutes les plaies devront \u00eatre nettoy\u00e9es et pans\u00e9es.<\/li>\n<li>La th\u00e9rapie doit \u00eatre li\u00e9e au changement de pansement et permettre de v\u00e9rifier la cicatrisation des plaies et d&rsquo;\u00e9valuer les complications<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Rehabilitation\">R\u00e9adaptation<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=15\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Rehabilitation\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=15\" title=\"Edit section: Rehabilitation\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<h3><span class=\"mw-headline\" id=\"Treatment\">Traitement<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=16\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Treatment\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=16\" title=\"Edit section: Treatment\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h3>\n<ul>\n<li>Actuellement, il n&rsquo;y a aucune indication de la n\u00e9cessit\u00e9 d&rsquo;une physioth\u00e9rapie respiratoire.\n<ul>\n<li>Cependant, il faut continuer \u00e0 surveiller la respiration\/toux, etc.<\/li>\n<\/ul>\n<\/li>\n<li>\u00c9lever doucement les bras, notamment la main et le poignet, et les maintenir en abduction et en extension. Continuer \u00e0 surveiller les doigts pour v\u00e9rifier la circulation.<\/li>\n<li>Sur\u00e9lever les pieds et les maintenir en position de fonction (attelle plantigrade).\n<ul>\n<li>NB, il est fort probable qu&rsquo;il devra subir une amputation bilat\u00e9rale ; cependant, il est vital de maintenir une position correcte, m\u00eame si la d\u00e9cision d&rsquo;amputer est prise ult\u00e9rieurement<\/li>\n<\/ul>\n<\/li>\n<li>Attelle avant-bras\/poignet droit.\n<ul>\n<li>Faire en sorte que le patient continue \u00e0 bouger les doigts<\/li>\n<li>Utiliser de la mousse localement pour encourager les contours palmaires et cr\u00e9er des espaces web (surtout entre les doigts deux et trois).<\/li>\n<li>Viser \u00e0 maintenir les articulations interphalangiennes en extension et les articulations m\u00e9tacarpiennes en position neutre.<\/li>\n<\/ul>\n<\/li>\n<li>Continuer \u00e0 surveiller les signes cardiaques de dysrythmie et d&rsquo;enflure.<\/li>\n<li>Enseigner des exercices appropri\u00e9s de mobilit\u00e9 active et passive et d&rsquo;\u00e9tirement.<\/li>\n<li>\u00c9valuer et conseiller sur la mobilisation<\/li>\n<li>S&rsquo;assurer que le patient s&rsquo;alimente bien et qu&rsquo;il b\u00e9n\u00e9ficie d&rsquo;une analg\u00e9sie suffisante<\/li>\n<li>Tout documenter clairement et tout COMMUNIQUER clairement au patient et \u00e0 sa famille<\/li>\n<\/ul>\n<h4><span class=\"mw-headline\" id=\"Goals\">Objectifs<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=17\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Goals\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=17\" title=\"Edit section: Goals\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h4>\n<h5><span class=\"mw-headline\" id=\"Short-term\">\u00c0 court terme<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=18\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Short-term\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=18\" title=\"Edit section: Short-term\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h5>\n<ul>\n<li>Les br\u00fblures sont tr\u00e8s profondes et n\u00e9cessiteront un d\u00e9bridement et une greffe et\/ou une amputation.<\/li>\n<li>Exploration des nerfs et des tendons par un chirurgien plasticien :\n<ul>\n<li>Il faudra envisager de v\u00e9rifier si ces tissus sont endommag\u00e9s<\/li>\n<li>Le patient est consid\u00e9r\u00e9 comme un patient compliqu\u00e9 et doit \u00eatre pris en charge dans un \u00e9tablissement de pointe.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h5><span class=\"mw-headline\" id=\"Long-term\">\u00c0 long terme<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=19\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Long-term\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=19\" title=\"Edit section: Long-term\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h5>\n<ul>\n<li>\u00c9valuer le stade de maturation de la cicatrice et l&rsquo;acceptation par le patient d&rsquo;une image et d&rsquo;une fonction corporelles modifi\u00e9es\u00c9valuer le stade de maturation de la cicatrice et l&rsquo;acceptation par le patient d&rsquo;une alt\u00e9ration de l&rsquo;image et de la fonction corporelles\n<ul>\n<li>NB, les patients qui se pr\u00e9sentent t\u00f4t \u00e0 la suite d&rsquo;une blessure NON li\u00e9e \u00e0 la guerre ne devraient PAS avoir besoin d&rsquo;antibiotiques prophylactiques.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"Expected_Outcomes\">R\u00e9sultats escompt\u00e9s<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=20\" class=\"mw-editsection-visualeditor\" title=\"Edit section: Expected Outcomes\">edit<\/a> <span class=\"mw-editsection-divider\"> | <\/span> <a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=20\" title=\"Edit section: Expected Outcomes\">edit source<\/a> <span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<p>Le r\u00e9sultat id\u00e9al est que la cicatrisation des plaies et des tissus mous soit compl\u00e8te et que le ROM maximal soit atteint. De plus, assurer un retour \u00e0 la fonction ant\u00e9rieure, l&rsquo;endurance cardiovasculaire, la d\u00e9ambulation autonome et les activit\u00e9s ind\u00e9pendantes de la vie quotidienne est cl\u00e9 pour une r\u00e9cup\u00e9ration optimale. \u00c0 plus long terme, un accent devrait \u00e9galement \u00eatre mis sur la gestion des cicatrices et la motivation psychologique.\n<\/p>\n<ul>\n<li>Poursuivre la pr\u00e9vention et le traitement des contractures et des d\u00e9formations articulaires<\/li>\n<li>Gestion continue de la cicatrisation (hypertrophique)<\/li>\n<li>N\u00e9cessit\u00e9 \u00e9ventuelle d&rsquo;une intervention chirurgicale ou d&rsquo;une intervention suppl\u00e9mentaire pour les plaies \u00e0 cicatrisation retard\u00e9e et\/ou les contractures.<\/li>\n<li>Gestion de la douleur<\/li>\n<li>Gestion de l&rsquo;hypersensibilit\u00e9 des cicatrices et du prurit (d\u00e9mangeaisons)<\/li>\n<li>Neuropathie<\/li>\n<li>Th\u00e9rapeutique pharmacologique et non-pharmacologique<\/li>\n<li>Reconditionnement aux activit\u00e9s et participation \u00e0 une activit\u00e9 fonctionnelle<\/li>\n<li>Consid\u00e9rations psychologiques &#8211; On sait que les br\u00fblures ont un impact psychosocial sur les patients, que ce soit en phase aigu\u00eb ou en phase de r\u00e9adaptation plus longue :\n<ul>\n<li>D\u00e9pression et\/ou PTSD (syndrome de stress post-traumatique)<\/li>\n<li>Impact sur les relations<\/li>\n<li>N\u00e9cessite un soutien \u00e0 l&rsquo;int\u00e9gration communautaire<\/li>\n<\/ul>\n<\/li>\n<li>Insatisfaction de l&rsquo;image corporelle (la culture peut influencer de plus en plus cet aspect)\n<ul>\n<li>Consid\u00e9rer en particulier l&rsquo;impact cosm\u00e9tique et psychologique plus important pour le visage<\/li>\n<\/ul>\n<\/li>\n<li>Enfants &#8211; consid\u00e9rations relatives \u00e0 la croissance<\/li>\n<li>Maintenir un bon apport nutritionnel et hydrique<\/li>\n<li>Rechercher une protection solaire (pour les cicatrices)<\/li>\n<li>Rembourrage pour r\u00e9duire le cisaillement sur les cicatrices<\/li>\n<li>Port de gants de protection pour les mains<\/li>\n<\/ul>\n<h2><span class=\"mw-headline\" id=\"References\">R\u00e9f\u00e9rences&nbsp;<\/span><span class=\"mw-editsection\"><span class=\"mw-editsection-bracket\">[<\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;veaction=edit&amp;section=21\" class=\"mw-editsection-visualeditor\" title=\"Edit section: References\">edit<\/a><span class=\"mw-editsection-divider\"> | <\/span><a href=\"\/index.php?title=Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts&amp;action=edit&amp;section=21\" title=\"Edit section: References\">edit source<\/a><span class=\"mw-editsection-bracket\">]<\/span><\/span><\/h2>\n<div class=\"mw-references-wrap\">\n<ol class=\"references\">\n<li id=\"cite_note-1\"><span class=\"mw-cite-backlink\"><a href=\"#cite_ref-1\">\u2191<\/a><\/span> <span class=\"reference-text\">Lathia C, Skelton P, Clift Z. Early Rehabilitation in Conflicts and Disasters. Handicap International: London, UK. 2020.<\/span>\n<\/li>\n<\/ol>\n<\/div>\n<p>&nbsp;<\/p>\n<p><!-- NewPP limit report Cached time: 20220308130900 Cache expiry: 0 Dynamic content: true Complications: [] CPU time usage: 0.042 seconds Real time usage: 0.046 seconds Preprocessor visited node count: 88\/1000000 Post\u2010expand include size: 81\/2097152 bytes Template argument size: 0\/2097152 bytes Highest expansion depth: 3\/40 Expensive parser function count: 0\/100 Unstrip recursion depth: 0\/20 Unstrip post\u2010expand size: 517\/5000000 bytes --><br \/>\n<!-- Transclusion expansion time report (%,ms,calls,template) 100.00% 10.103 1 Special:Contributors\/Case_Study_-_Electrical_Burn_in_Disasters_and_Conflicts 100.00% 10.103 1 -total -->\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>R\u00e9dacteurs originaux &#8211; Naomi O Reilly Principaux contributeurs &#8211; Naomi O&rsquo;Reilly&nbsp; &nbsp;&nbsp; &nbsp; Contenu 1 Titre 2 R\u00e9sum\u00e9 3 Mots cl\u00e9s&nbsp; 4 Caract\u00e9ristiques des patients 4.1 Contexte 5 R\u00e9sultats d&rsquo;examen 5.1 A : Contr\u00f4le des voies respiratoires et de la colonne vert\u00e9brale 5.2 B: Respiration 5.3 C: Circulation 5.4 D: Handicap 5.5 E: Exposition 5.6 [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-647","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/647","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/comments?post=647"}],"version-history":[{"count":1,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/647\/revisions"}],"predecessor-version":[{"id":816,"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/pages\/647\/revisions\/816"}],"wp:attachment":[{"href":"https:\/\/langs.physio-pedia.com\/fr\/wp-json\/wp\/v2\/media?parent=647"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}