1. What is the tissue structure of human skin?
Skin is one of the largest and most important organs in human body. Whole body skin accounts for 4%-6% of human body weight, and subcutaneous tissue accounts for 15%- 17% of human body weight? . According to the anatomical structure of skin, skin consists of epidermis, dermis and skin accessories. Epidermis: consists of stratum corneum, transparent layer, granular layer, spinous cell layer and basal cell layer. Dermal: divided into shallow layer and deep layer.
Accessories include sweat glands, sebaceous glands, hair follicles, etc. The appendix is of great significance in the regeneration of superficial skin defects.
2. What are the functions of human skin?
Skin covers the surface of human body and is in direct contact with the outside world. It has the following functions:
(1) Protective and defensive function: Skin is an important natural barrier of human body, which is flexible and has certain protective effect on slight external friction, impact and traction. There is a lipid film on the skin surface, which can protect and prevent the evaporation of water in the body to keep the skin soft. At the same time, intact skin can prevent the invasion of bacteria.
(2) Respiratory function: The human body can metabolize gas through the skin, and its function depends on the secretion of sweat glands. The more sweat glands secrete, the faster gas metabolism.
(3) regulating body temperature: the skin has a large number of cold, heat, pain, tactile and other receptors, rich vascular network and sweat glands. Skin regulates body temperature balance by contracting blood vessels and subcutaneous fat, reducing heat radiation and evaporation, and sweat secretion and heat dissipation.
3. What's the difference between skin in different parts of human body?
(1) The skin thickness of different parts of the same individual is different. Generally, the skin on the soles of feet, shoulders, palms and toes is thicker, while the skin on the inner side of body, back of hand, behind ears, eyebrows and eyelids is thinner, so the burn depth caused by injuries in different parts and under the same conditions is different.
(2) Skin thickness is related to age, sex, occupation and other factors. Generally, children and the elderly have thinner skin, women have thinner skin than men, and mental workers have thinner skin than manual workers. Thick skin has strong healing ability after burn.
4. What are the causes and types of burns?
The cause of burns is the damage to skin or other tissues caused by heat, certain chemicals, current and radiation. According to different injury factors, the types of burns include the following:
Thermal burns: more common in daily life and accidents.
Chemical burns: more common in accidents caused by chemical substances (acid, alkali, phosphorus, etc.). ).
Electrical burn: an accident that often occurs due to violation of operating rules or lack of knowledge of electricity use. According to the injury, it can be divided into: ① electrical contact burn: after a certain part of the human body is electrocuted, the current passes through the human body to cause damage, and the burned part has entrance injury and exit injury; (2) Arc burn: When the human body is close to high-voltage electricity, the instantaneous arc will burn after contacting with clothes;
Radiation burns: During wartime, due to the use of atomic bombs, hydrogen bombs and nuclear explosions, the falling dust polluted the skin, which was caused by incomplete and untimely cleaning. Usually due to improper operation, careless protection or accidents, it will cause radioactive damage, such as X-ray, 60 cobalt, accelerator and so on.
5. What are the common thermal burns?
The most common thermal burns are flame burns, hot water burns and hydrothermal burns. For example: fire, fire or explosion of flammable substances (gasoline, alcohol, etc.). ), high temperature metals (steel, iron, etc. ), boiling water, boiling oil, hot steam, hot porridge, etc. Strictly speaking, the damage caused by any hydrothermal solution (water, soup porridge, etc.). ) it's called a burn.
6. How high is the temperature that can cause thermal burns?
When the thermal temperature reaches 47℃, human skin will feel pain; If it exceeds 55℃, the skin tissue has been damaged. The temperature of flame combustion is usually 200-600℃, which is above 1000℃ in case of fire, while the combustible weapons used in wartime can reach 1000 ~ 3000℃.
7. What are the common chemical burns?
Chemical burns are mostly caused by strong acids and alkalis. Common strong acids are sulfuric acid, nitric acid, hydrochloric acid, hydrofluoric acid, trichloroacetic acid, hydrocyanic acid and formic acid. Strong acid can cause denaturation, solidification and precipitation of protein, which has a strong corrosive effect. Alkaline substance burns commonly include potassium hydroxide, sodium hydroxide, calcium hydroxide, ammonia water, lime and so on.
8. How is the burn depth divided?
The appearance of burn wounds at different depths presents different manifestations, but the depth should be based on the pathological concept. The three-degree quartering method is international, and it is more practical because it is closely related to treatment.
(1) First-degree burn: The superficial epidermis, including stratum corneum, transparent layer, granular layer and sometimes spinous cell layer, is damaged, but the mucous layer is energetic and active in regeneration.
(2) Shallow second degree burn: deep epidermis and dermal papilla were damaged. It can be repaired quickly by relying on the remaining mucous layer cells and skin appendages.
(3) Deep second-degree burn: the dermis is injured, reaching deep level. Epithelial islands were formed by residual skin appendages and gradually epithelized, resulting in many scars of different degrees.
(4) Third-degree burns: the whole skin is injured, even touching subcutaneous fat, muscles, bones and internal organs. Because the skin and its attachments were completely destroyed, the wound surface lost the source of epithelial cells for self-repair. No matter what treatment is used, scars will be left after healing.
9. What are the clinical manifestations of different deep burns?
Three-degree quartering is commonly used in burn clinical work, and the specific manifestations are as follows:
(1)I degree burn: also known as erythema burn. Local skin redness, mild swelling and burning pain. After 3-5 days, the epidermis wrinkles and falls off, and the new epithelium is bright, red and tender after healing.
(2) Second degree burn: also known as blister burn.
① Shallow second-degree burn: local redness and swelling with blisters of different sizes after burn, and the blister fluid is clear and transparent, light yellow or colloidal. Breaking the blister can present a rosy and moist bottom of the wound, and the pain is obvious.
② Deep second-degree burn: local swelling, white or brown epithelium, scattered in small blisters, wet at the bottom of the broken blisters, red, white or reddish in white, with many red spots or small blood vessel branches formed by dilated capillaries. Deep second-degree burns are characterized by embolic and coagulated vascular network, which is insensitive and painless.
(3) Third degree burn: also known as eschar burn. Local wax white or brown, carbon black, heavy carbonizable, hard and tough as leather. Local dryness without blisters, thick and solidified vascular network can be seen through the eschar, and there is no pain.
10. What is the principle of first aid for burns?
Timely treatment of burns can reduce the depth of burns, reduce complications and reduce mortality. The principle of first aid:
(1) The key is to leave the site quickly and move to a safe place;
(2) Before sending the patient to the hospital, we should accurately judge whether the patient has life-threatening combined injuries, such as asphyxia, massive hemorrhage, fracture, craniocerebral trauma, etc., and give necessary first aid treatment quickly;
(3) establish respiratory and venous channels as soon as possible, and make proper rehydration, but avoid drinking too much water to avoid vomiting. Drinking a lot of tap water may also lead to water poisoning. Oral light salt water or burn drink should be taken properly;
(4) The wound can be simply debrided without special treatment for the time being, so as not to aggravate the injury and stimulate the patient. Avoid applying colored external medicine to the wound.
1 1. How to save yourself from fire?
Flame burns are often caused by accidents. People are unprepared for this sudden blow and appear panicked or helpless in the face of the raging fire, so the injury is more serious. Therefore, it is necessary to master certain self-help methods.
(1) Leave the scene of injury quickly. When the flame burns, leave the fire source quickly and take off the burning clothes as soon as possible, especially the chemical fiber cloth, which is not only flammable, but also sticks to the skin, making the burn worse and deeper;
(2) put out the fire with water, or jump into a nearby pool or river ditch to put out the fire;
(3) Lie down quickly and roll slowly on the ground, which has crushed the flame;
(4) Using local materials, it is best to cover the fire with quilts and blankets. It is readily available after soaking;
(5) Don't run, shout, shout or beat the flame with your hands, because when you run, shout, shout or beat the flame with your hands, the flame will become more vigorous with the increase of wind power, resulting in severe burns and inhalation injuries to your head, face and hands;
(6) After the fire is put out, if conditions permit, the burned area can be washed or soaked in cold water for 1-2 hours, so as to continuously reduce the local temperature and reduce the pain and burn depth.
12. How to save yourself after scalding?
The common causes of clinical burns are porridge, boiling soup, boiling water, molten steel and molten iron. Self-help method:
(1) Take off clothes soaked in hydrothermal solution as soon as possible, and keep in thermal contact for a long time to deepen the wound. When you take off your clothes, take off your coat and then your underwear. In order to protect the injured part and avoid damaging the wound surface when undressing, the underwear should be cut open with scissors when it is close to the injured part.
(2) Find the cold water source on the spot and wash it with tap water, well water and mineral water. According to the specific situation, the washing time in winter and summer should be different, that is, to achieve the purpose of washing and keep warm. The ultimate goal is to reduce the temperature of the wound, accelerate heat dissipation, prevent the wound from deepening, reduce the degree of injury, and create conditions for subsequent treatment.
13. How to save yourself after electric injury?
The first aid treatment of arc burn is basically the same as that of flame burn. Electrical contact burns are not only deep and heavy, but also often endanger life safety because current passes through human body.
(1) immediately cut off the power supply and use non-conductive objects (wooden sticks, bamboo poles, etc.) to interrupt the wires. ) make the injured leave the power supply quickly. Remember not to touch the injured or electrical appliances with your hands.
(2) After the person who gets an electric shock is out of the power supply, lie flat on the spot, keep the respiratory tract unobstructed, don't walk around, and carefully observe the injured; Call and pat the injured person to judge whether he is unconscious, but it is forbidden to shake his head. For the injured who have stopped breathing and heartbeat, they should immediately lie flat on their heads and lean back with hard objects on their backs for effective cardiopulmonary resuscitation. The ratio of cardiac compression to artificial respiration is that a single person carries out artificial respiration twice, pressing 15 times; Two people, artificial respiration 1 time, press 5 times until the heartbeat and breathing recover.
14. How to save yourself from chemical burns?
(1) First, take off the wet clothes immediately;
(2) Rinse quickly with plenty of clean water for a long time (0.5- 1 hour) to dilute and remove the residual chemicals on the wound. Avoid looking for neutralizer but rescue opportunity;
(3) If the eyes are burned, rinse them thoroughly with clear water, and do not rub them with hands or handkerchiefs. However, for those who are burnt by quicklime, it is necessary to wipe off the quicklime with a dry cloth first, and then rinse it with clear water, so as to prevent the quicklime from being heated when it meets water and aggravate the degree of scald;
(4) In case of phosphorus burn, put out the flame immediately, take off the contaminated clothes, rinse the wound with plenty of water, and it is best to immerse the affected area in flowing water to wash off the phosphorus. If there is a temporary shortage of water, you can cover the wound with multiple layers of wet cloth to isolate the phosphorus in the air and prevent it from continuing to burn. It is forbidden to wrap the wound with any grease coating, so as not to increase the dissolution and absorption of phosphorus and cause more serious phosphorus poisoning.
15. Why should I wash with cold water immediately after burns? Which patients are suitable for cold water irrigation?
Cold water washing is actually the cold therapy in burn treatment, that is, washing, soaking or cold compress the wound with cold water in the early stage of burn to achieve the following purposes:
(1) Quickly reduce the surface temperature of burned skin, and prevent heat from further damaging deep skin, thus reducing the burn depth;
(2) Relieve pain. The analgesic effect may be that cold water quickly lowers the skin temperature below the pain threshold of 43℃, or blocks the epidermal nerve conduction, making it feel no pain;
(3) Reducing exudation and edema is related to the improvement of capillary permeability after cold therapy;
(4) To achieve the effect of cleaning the wound, cold water mechanical washing can make the wound clean and reduce pollution.
(5) Cold water irrigation is suitable for small area burns, especially burns on limbs, head and face.
16. What should I pay attention to when cleaning with cold water after scalding?
(1) should be performed within 6 hours after injury, and the earlier the time, the better;
(2) It can't be used for patients with extensive burns, because extensive cold therapy will lower the central body temperature and easily cause shock. Generally, people with burn area greater than 20% are not easy to cold therapy;
(3) The time should not be too long. The duration of cold water irrigation is better if the wound is painless or there is slight pain after stopping the drug, which should generally be between 0.5- 1 hour. If the water temperature is low and the wounded feel too cold, you can pause for a few minutes before continuing;
(4) The appropriate temperature is 5-20℃, and tap water or clean water can be used.
17. Can burn wounds be painted with mercuric chloride or methyl violet?
It is not suitable to apply mercuric chloride, methyl violet and other colored external drugs to the wound surface after burn. Because the application of colored topical drugs such as mercuric chloride and methyl violet will affect the early judgment of wound depth, increase the difficulty of debridement and increase the difficulty of future treatment. At the same time, the wound is coated with mercuric chloride in a large area, which can be absorbed by the wound, leading to mercury poisoning; The exposed area is small, and the face is coated with colored external medicine, which will cause the phenomenon of aggravated pigment after cure and affect the appearance.
18. Can patients drink water when they are thirsty after burns?
After burn, the patient's mouth is dry, which is usually a sign of insufficient blood volume. The larger the burn area, the more serious exudation and thirst. At this time, drinking water alone can not alleviate thirst, but drinking a lot of water will increase the burden on the gastrointestinal tract, causing acute gastric dilatation or water poisoning. Because the exudate of burn patients is not only water, but also contains electrolytes, plasma and other components. Oral liquid commonly used in clinic is rehydration salt or burn and scald beverage. The specific preparation method of the beverage for burns and scalds is to add 0.3g of salt, 0.5g of baking soda (sodium bicarbonate), 5mg of phenobarbital and a proper amount of sugar into 100ml of cold boiled water. In principle, oral rehydration should be carried out many times, and it should be increased or decreased as appropriate, and patients' thirst should not be satisfied at will. For patients with severe burns, besides oral rehydration, the main rehydration method should be intravenous.
19. Can patients eat after burns? What should burn patients pay attention to in their diet?
In addition to oral mucosa and esophageal burns, patients can eat after burns. The increase of metabolism and the continuous consumption of tissue are the characteristics of severe burn reaction. Generally speaking, the more serious the burn, the greater the possibility of nutritional disorders. Malnutrition can delay wound healing, reduce immune function, further weaken anti-infection and tissue repair ability, and seriously affect prognosis. Therefore, for severe burn patients, adequate and reasonable nutritional support is an important treatment measure to improve the cure rate of burn patients, reduce complications and shorten the course of disease.
Oral nutritional supplements are not only economical and convenient, but also complete in nutrients, which can stimulate appetite and promote gastrointestinal peristalsis. For patients without other conditions and contraindications for treatment, oral administration should be encouraged as much as possible, and the following points should be noted:
① For severely burned patients, the diet should start with a small amount of trial meals and gradually increase to avoid acute bloating and diarrhea.
② Patients with food residue in the stomach before burn should not eat for the time being, and eat 40-80 ml 3-4 times a day on the 2nd-3rd day after burn, and then gradually increase.
③ Early burn patients should be light and have a digestive diet. Patients with advanced burn should eat more foods with high calorie, high protein, high quality, small size and easy digestion and absorption, and increase the intake of eggs, fish, meat and other foods.
20. Do burn patients need tetanus antitoxin injections? How to inject?
Whether burn patients need tetanus antitoxin injection depends on the situation. Whether a burn patient is complicated with tetanus does not depend on the size of the burn area, but on the depth and injury of the burn. Anyone with deep burns or serious pollution must take measures to prevent tetanus when injured. The preventive method is intramuscular injection of tetanus antitoxin serum (TAT)1500-3000 U. Before injecting this serum, tetanus skin test should be done. Patients with negative skin test should be injected with tetanus antitoxin serum 1500-3000 U at one time, and patients with positive skin test should be desensitized. Close observation should be made during desensitization injection. If the patient is found to have shortness of breath, cyanosis, rash and other reactions, he should immediately stop the injection and give symptomatic treatment. After the symptoms get better, slowly inject the rest for the patient as appropriate.
2 1. Which burn patients need hospitalization?
Third-degree burns and burns for special reasons (chemical, electrical, etc.) require surgical treatment. ), special parts (face, hands, perineum, etc.) burns. ), children burn, elderly burn or deep second degree burn more than 5% should be hospitalized. Shallow second-degree burns with burn area less than 5% can be simply debrided and changed in outpatient department.
22. What should I pay attention to in the family care of patients who change medicine in outpatient department after burn?
(1) Nursing care of burn site. In addition to dressing regularly according to the doctor's requirements in the hospital, pay attention to your body position at home, raise your limbs and maintain your functional position; Facial burns should be taken in a semi-supine position to reduce swelling and keep the respiratory tract unobstructed; Observe the tightness of the bandage and whether there is exudate on the external dressing, keep the local clean and prevent the wound from being polluted; When the wound heals, you can start to move, prevent dysfunction, such as hand movement, and do some housework as much as possible.
(2) Keep the indoor air fresh and the humidity and temperature suitable. Room temperature is generally maintained at 26-30℃ and humidity is 50%-60%, which is beneficial to the cultivation of burn patients and also has an auxiliary effect on wound healing.
(3) the deployment of nutrition. In principle, a diet with high protein, high calories, high vitamins and moderate fat is better. We should arouse the patient's appetite and ensure adequate nutrition intake.
23. What are the advantages of hammocks?
Suspended bed is the compressed air generated by blower entering the middle of ceramic sand particles through diffuser. When the airflow speed reaches 60cm/s, each ceramic sand particle can be suspended in the air, and the airflow is always circulating and the temperature can be adjusted. The outstanding advantages are as follows:
(1) The floating bed has the feeling of floating, and all parts of the body are stressed evenly, so there is no need to turn over to stimulate the patient and avoid local tissue compression and bedsore;
(2) Hot air can promote wound drying;
(3) The bed temperature can adjust the constant ideal environment, which is beneficial to reduce the hypermetabolic reaction of burn patients;
(4) Due to the airflow, the wound remains dry, which is not conducive to the growth of bacteria and has obvious bacteriostatic effect.
24. Which patients need hammock treatment after burns? What should we pay attention to in treatment?
The hammock is suitable for all kinds of burn patients, especially for coma patients, large area burn patients, back, lower limbs and hip burn patients. In order to ensure the performance of the suspended bed in operation, the following points should be noted:
(1) Bed dressing has moderate thickness. Generally, it is enough to spread sheets and sterile gauze pads, which are too thick, affecting the passage of hot air and delaying the drying of wounds; Too thin, the patient's wound exudate, urine, etc. It will penetrate into the ceramic sand particles in the bed to cause agglomeration and affect the normal suspension.
(2) Control the indoor temperature between 28-32℃ and humidity between 40%-50%. If the room temperature is too high, the thermal system of the suspended bed will be disordered; When the humidity is too high, the small particles in the suspended bed will deliquesce into pieces and lose their suspension function.
(3) Keep the suspended bed clean. Change sheets and gauze pads frequently to avoid contamination by exudate or urine. Patients who stay in bed for a long time should be cleaned in time during surgery or examination.
(4) Terminal processing after use. After use, each patient should take out the filter screen in time, filter the ceramic sand and clean the filter bedspread to maintain the normal function of the suspended bed.
25. Which patients need skin grafting?
(1) Patients with third-degree burn wounds that can't heal themselves. Skin grafting can improve the survival rate of patients, reduce complications and shorten the course of treatment.
(2) Patients with deep second-degree burns in functional areas. For example, hands and feet, although deep second-degree wounds can heal themselves, the course of disease is long, leaving scars after healing, which seriously affects the function. Therefore, early escharectomy and skin grafting are advocated.
26. Why is scalp a good source of skin supply?
The skin available for skin grafting in patients with extensive burns is limited, and it takes 2 weeks for the skin outside the scalp to heal, which limits its use. Scalp is a good skin donor for burn patients because it has the following characteristics:
(1) Scalp hair follicles are numerous and dense, with deep hair balls, rich sweat glands, sebaceous glands and blood vessels, and strong growth ability. It can heal in 5-7 days after peeling, without affecting hair growth, scar hyperplasia and less skin itching.
(2) It can be reused. When the skin is taken, the skin flap is very thin, which does not damage the hair roots and heals quickly. Therefore, the skin can be taken repeatedly, usually a dozen times or dozens of times;
27. What are the characteristics of electric burns?
Electrical burns include arc burns and electrical contact burns (electrical injuries). The former is skin burn caused by electric spark, and its characteristics are basically the same as those of thermal burn. The latter is the injury of muscles, nerves, blood vessels, organs and bones caused by the direct contact of human body with high-voltage power supply and the transformation of electric energy into heat energy in the body. Clinically, electric burn refers to electric injury, and its characteristics mainly include the following points:
(1) The injured body surface generally has an entrance and an exit. The entrance is often in direct contact with high pressure, such as hands, feet or head, and the injury is often more serious than the exit. The skin at the entrance is carbonized, the central depression is tough, the local dehydration is dry, the feeling is numb and the temperature is low. There is no strict insulation relationship between human tissues, and they are mixed in series and parallel. It is difficult to determine the path of current through the human body, so the outlet and inlet are often mixed alternately.
(2) The local tissue is seriously damaged, and it is deeper and deeper from the entrance. Its remarkable feature is that the mouth is small and the bottom is big, which is inverted cone-shaped and the mouth is outward. The electric injury is mainly due to the arc discharge when the current is close to the body surface. The arc center temperature can reach 2500-5000℃, and the arc burn is mainly ⅲ degree. Electrical contact burn refers to the severe burns of deep tendons, nerves, blood vessels, organs and bones and joints caused by the current entering the human body after the human body is in contact with the current, which can lead to complete burns of the skin at the entrance and exit. When the entrance and exit are in areas with rich soft tissues, the phenomenon of small mouth and large bottom is obvious, and muscle necrosis is common. When limbs are electrically injured, the resistance of blood vessels and nerves in human tissues is the smallest, which leads to serious damage to blood vessels and nerves themselves, especially when nerves and main blood vessels are injured, which often leads to limb function loss or necrosis.
(3) The symptoms are obvious after severe click injury. After electric injury, the patient may be in a coma, and his heartbeat and breathing will stop due to the passage of current. Severe craniocerebral injury caused by electric current can cause changes in the central nervous system; When current passes through the chest and abdomen, it can cause heart and abdominal organ damage;
(4) Electrical injury is often accompanied by craniocerebral injury and fracture. Most of them are caused by electric shock at high places;
There are also many complications after electric injury.
28. How to classify the severity of burns in children?
(1) Mild burn: the total burn area is less than 5%;
(2) Moderate burn: the total burn area is 5%- 15%, or the third-degree burn area is less than 5%;
(3) The total burned area 15%-25%, or the third-degree burned area is between 5%- 10%. In addition, although the total burn area is less than 25%, it also belongs to severe burn complicated with inhalation injury, chemical poisoning and shock.
(4) Extremely severe burn: the total burn area is more than 25%, or the third-degree burn area is more than 10%.
29. How to prevent children from scalding?
Children's burns are mostly caused by poor nursing or negligence, and life burns account for the majority. Therefore, we should strengthen health publicity and education, popularize burn prevention knowledge and formulate necessary preventive measures according to different ages, living habits and illnesses.
(1) Educate parents, preschool teachers and preschool children on preventing burns;
(2) Items that are easy to cause burns and scalds at home should be properly placed, such as thermos, soup pot, stove, thermos, charcoal pot, electric stove, etc. And children's access to these items should be strictly restricted. Don't put the child next to these items alone to prevent the child from being injured by pulling over;
(3) When children take a bath, they should first pour cold water into the basin, and then add hot water to stir;
(4) When heating with a hot water bottle in winter, be careful that the water temperature is not too high, wrap it with clothes or cloth, and don't stick it directly on children's skin to avoid burns;
(5) Educate children not to play with fire or explosives, and don't tamper with various electrical switches to prevent electric shock accidents. It is necessary to strengthen the custody of gasoline, lighters, matches and chemical inflammables, and put them in safe places where children can't climb to avoid burns;
(6) Strengthen fire education. If you are unfortunately burned, put out the fire as soon as possible and take first-aid measures to alleviate the injury.
30. What are the characteristics of burn in the elderly?
The characteristics of burn in the elderly mainly include the following five points:
(1) is prone to complications. The physical function of the elderly is declining, and many people suffer from chronic diseases such as heart disease, lung disease, kidney disease and endocrine disease. They have poor compensatory ability and poor tolerance to fluid replacement, and are prone to shock and multiple organ failure.
(2) The wound healing speed is slow. Old people's body tissues decline and their growth ability weakens. If you have diabetes, the wound will heal slowly.
③ Susceptible to infection. The elderly have low immune function and poor anti-infection ability;
(4) The wound is deep. Old people feel dull, their skin shrinks, and there is little subcutaneous fat. Burns usually spread to deep tissues, even muscles and bones.
3 1. How do the elderly prevent burns?
(1) Strengthen the care for the life of the elderly. We should help the elderly to take a bath and wash their feet, help adjust the water temperature and strengthen observation;
(2) The temperature of heating materials used by the elderly should be lower. The temperature of hot water, hot water bag and electric blanket used shall not exceed 50℃;
(3) Use the health care therapeutic instrument safely, give professional guidance and read the instructions in detail before use;