Exhaustion Burn

**Exhaustion** is a syndrome characterized by a drop in body weight or moderate malnutrition (including loss of up to 15-20% of body weight) over several weeks due to the long-term existence of the body’s hidden resources due to a lack of organic functions due to shock and concomitant infection , bleeding or vascular insufficiency, etc.

The reason for the development of exhaustion is a violation of the mechanisms of breakdown and mobilization of energy substrates (especially glycogen). As well as a decrease in the supply and use of nutrients by cells, which leads to a decrease in oxidative phosphorylation and ATP synthesis. Wasting is characterized by intense bone resorption due to osteolysis and is accompanied by high levels of hormonal secretion (appetite-regulating neuropeptides, thyroid hormones, gonadotropins, ACTH, insulin), which makes it clinically similar to hypothyroidism, thyrotoxicosis and diabetes mellitus. The earliest signs of exhaustion are weight loss, lethargy, apathy, weakness, and fatigue. Low-grade fever that persists despite drainage of the septic focus, signs of anemia, and oliguria appear later. With severe exhaustion, shock with arterial hypotension develops, and heart rhythm disturbances are possible. The most unfavorable sign of exhaustion is a loss of body weight of 20% or more. The general condition of the patients progressively worsens. They are indifferent to their surroundings, do not respond to simple questions, and lose their individual behavioral characteristics. The smell of acetone is felt from the mouth. Meningeal symptoms are mild. Reflexes decrease.

The topic of the article is “Traumatic (burn) exhaustion.”

Part 1. Description of injury. The age studied in this case was the age of the affected children from 1 to 5 years old who were admitted to the surgical department of children's hospital No. 1 of the State Budgetary Healthcare Institution. At 13:04, patient B.V., a girl born in 2019, was admitted to the department with a ride, accompanied by her parents. with a diagnosis of thermal injury to both upper extremities and the lower third of the right leg. Received 28.5% of the area of ​​body burns. An ambulance team delivered her to the address where she lived. The child was not examined by a pediatrician upon admission. Before admission, she was observed regularly by a pediatrician; three weeks ago, on the direction of a local doctor, she was hospitalized in the hospital, where the next day she spontaneously escaped from the hospital and was discharged with a diagnosis of ARVI. The girl was repeatedly hit by a car, but first aid was not provided in connection with the accident. We contacted the emergency department by phone, the call was received on May 7, 2023 at 08:17 min. The dispatcher's reception was carried out correctly, in detail, and the information was transferred to the manager in full. Parents about hospitalization