INTERNATIONAL WEBINAR BURN AND TRAUMATIC WOUND SEPTEMBER 12, 2026

Main Ideas & Lessons From the Video

1) Webinar Housekeeping: Zoom/Webinar Participation Rules (International “Rules of Procedure/Order”)

Speakers/committee set expectations for how participants must join and participate:

• Use your full name when joining Zoom so the committee can identify you easily.
• Turn on your camera and dress appropriately during the webinar.
• Presentation audio policy
  • During presentations, participants’ voices are muted/off.
  • Participants can ask questions via a question link shared by the committee.
• Attendance & evaluation
  • Participants must take attendance.
  • Participants must complete a learning outcome evaluation/test at the end of the activities.
  • Continuing participation depends on being marked as having passed (implying progression/unlocking after passing).
• Virtual background
  • Participants are required to use the provided virtual background.
• Complete the series
  • Participants must attend all sessions from start to finish.

2) Pre-Webinar Safety & Health Guidance (Online Webinar Ergonomics and Well-Being)

Before attending, the host briefs participants on physical and mental health:

• Ergonomic sitting
  • Sit with back straight and lean appropriately.
  • Keep the screen parallel to eye level to prevent neck pain.
  • Keep feet and elbows on the floor at about 90° angles.
  • Use a comfortable chair with a backrest.
• Eye health (20-20 rule)
  • Every 20 minutes, look away at an object about 20 feet (~6 meters) away.
  • For 20 seconds, reduce screen brightness if needed.
  • Avoid environments that are too dim or too bright.
• Stretching/mobilization
  • Do light stretching about every 60 seconds (subtitles also suggest frequent movement intervals).
  • Stretch shoulders, neck, wrists to reduce stiffness.
  • If possible, stand briefly to improve blood circulation.
• Healthy environment
  • Ensure good ventilation.
  • Sit in a comfortable place with minimal interference.
  • Keep the table and work area clean and organized.
• Mental health
  • Focus on the material; avoid excessive multitasking.
  • If tired/uncomfortable, take a break.
  • Follow activities calmly while maintaining self-balance.

3) Opening Ceremony & Presenters (Ceremonial Flow + Music/National Anthem/Documentation)

The MC/host:

• Opens with religious salutations and multilingual greetings (e.g., Islamic, Balinese Om swastiastu, Buddhist Namo buddhaya, etc.).
• Welcomes:
  • CEO leadership from the host organization
  • International speakers (Indonesia and Malaysia)
  • Committee members and all participants
• Conducts:
  • Basmalah / opening invocation
  • The national anthem “Indonesia Raya”
  • Group documentation: participants are asked to turn on camera, smile, and follow photo timing instructions

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Educational Content Presented

Material 1: Burn Wound Management (Assessment, Initial Stabilization, Dressing Care)

Core message: Burn care must be systematic and life-saving first, because burns can cause major systemic (hemodynamic) changes—not only skin injury.

A) Burn Management Priorities (Life-Saving Approach)

A repeatedly emphasized framework:

1. First aid / emergency first aid
2. Primary survey + secondary survey
3. Burn wound management (dressing/care) as part of the overall priority sequence

Why priority matters: Burns—especially larger burns—can lead to systemic instability (e.g., fluid/electrolyte, cardiovascular, immune, endocrine, GI changes).

B) Burn Categories: “Minor/Non-Complex” vs “Complex”

From the subtitles:

• Non-complex / minor
  • Adults: ≤ 15% TBSA
  • Children: < 10% TBSA
  • Children under 1 year: < 5% TBSA
• Complex
  • Adults: > 15% TBSA
  • Children/elderly: > 10%, with thresholds such as <1 year > 5%

Burns are also treated as complex even with “smaller” TBSA if they involve high-risk locations:

• Hands, feet, face, perineal/genital area
• Joints
• Circular areas

C) Causes & Epidemiology Context (Burn Incident Discussion)

• Fire reported as a major cause, followed by hot water, chemicals, and electricity.
• Discussion includes regional patterns (Southeast Asia higher incident rates) and likely household cooking practices.

D) First Aid / Emergency Burn First Aid Steps (Stop the Burning Process)

Stepwise practical approach:

• Stop the burning process
  • Cool with running tap water (avoid ice)
  • Cool for about 20 minutes
  • Goal: prevent deeper tissue damage by bringing skin temperature back toward safe levels
• Alternatives/support
  • Hydrogel (modern dressing option)
  • If hydrogel isn’t available: aloe vera (mentioned as a cooling/reducing option)
• During cooling
  • Remove jewelry/clothes that retain heat
  • Avoid actions that increase skin damage risk
• Pain control
  • Provide analgesics
• Tetanus status
  • Check whether tetanus injection is needed
• Urgent assessment triggers
  • Consider additional risks such as inhalation injury (especially with larger burns or face/neck burns)

E) Assessment & Stabilization (Assessment and Stabilization Overlap)

Emphasis that assessment and initial stabilization occur simultaneously:

• Measure TBSA (extent)
• Assess burn depth/stage
• Decide whether patient needs:
  • Outpatient care vs hospital vs ICU
• Possible procedures mentioned: IV access/fluid resuscitation, ETT/tracheostomy, escharotomy

F) Primary Survey Adapted to Burn Risk (ABCDE)

Burn-specific risks are mapped into a primary survey structure:

• Airway risks / inhalation injury
  • Face/neck burns may require airway management even if TBSA is “small”
  • Fire-related burns increase concern for inhalation injury and CO/airway damage
  • Signs may include oxygenation/GCS changes and burn signs around nose/airway
  • Possible actions: intubation or tracheostomy, supportive oxygenation
• Breathing risks
  • Circumferential chest burns can impair lung expansion
  • Possible emergency action noted: escharotomy
• Circulation risks
  • Burns >20% increase risk of hypovolemic shock; consider fluid resuscitation
  • Escharotomy may be relevant in deeper burns (e.g., deep thickness/third degree)
• Disability & exposure
  • Assess neuro status and fully expose for exam while preventing hypothermia
  • Reassess TBSA and burn depth

G) Fluid Resuscitation (Formula-Based Guidance)

A fluid resuscitation plan includes:

• Use IV access
• Formula mentioned: “modified Parkland formula”
• Dosing schedule:
  • Half of the calculated fluid in the first 8 hours
  • Other half over the next 16 hours (total 24 hours)

H) Determining Burn Depth/Stage (1st–4th Degree) + Clinical Indicators

Depth grading described:

• 1st degree (epidermal): red, epidermis intact; often like sunburn
• 2nd degree (superficial/deep): skin changes, blisters; altered pain pattern
• 3rd degree: deeper damage (described with paler/white/blackish progression)
• 4th degree: eschar formation

Indicators emphasized:

• Color
• Capillary refill
• Pain pattern (deeper burns may be less painful due to nerve damage)
• Eschar concept: tissue death related to protein denaturation

I) Burn Wound Dressing & Technique Options (Aspiration, Deroofing, Autolysis)

Multiple approaches were compared:

1) Aspiration

• Advantages: lower infection risk; potentially safer for the patient
• Disadvantage: fluid may re-accumulate, requiring repeat visits/dressings

2) Deroofing

• Advantages: faster recovery
• Disadvantages: painful; higher infection risk (as described)

3) Autolysis

• Emphasized as:
  • More comfortable
  • Can reduce pain
  • Helps necrotic tissue lift naturally
• Requires appropriate moisture/agents (e.g., ointments/hydrogel/hydrocolloid mentioned)

J) Dressing Goals & Principles (Including Moisture Balance)

Repeated theme: dressings should:

• Maintain moisture
• Reduce pain
• Prevent infection

Choice depends on:

• Burn depth/stage
• Amount of exudate
• Infection risk

Antimicrobials/antiseptic dressings were mentioned for infection-prone wounds.

K) Debridement for Deeper Wounds (Escharotomy & Biofilm Concepts)

• Escharotomy referenced when eschar is present (especially deeper burns)
• Autolysis may precede or complement eschar management
• Mechanical debridement and biofilm concepts mentioned in chronic/infected wound context

L) Pressure Garment & Scar Prevention (Keloids)

For scar management, the talk mentioned:

• Pressure garment therapy / compression garments
• Presented as a method to help prevent keloids and manage hypertrophic scarring risk

Q&A From Material 1 (Summarized)

• Child with hot water burns; limited dressing options locally
  • Emphasis: maintain moist wound healing if modern dressings aren’t available
  • Example temporary approach: petroleum jelly/vaseline smeared on gauze
  • If using alternatives (e.g., honey/aloe), dressing change frequency may need adjustment to avoid sticky/irritating issues
• Electric shock burns with necrosis, smell, pain, fever
  • Treat systemic infection first when fever suggests systemic involvement
  • Then focus on wound care: washing/antiseptics and antimicrobial dressings
  • Reassess dressing frequency (about every 2 days suggested)
• Blistering burns with significant fluid and pain during dressing changes
  • Focus on pain assessment (pain characteristics)
  • Use moist dressings to reduce friction and pain during dressing removal
  • Recognize deeper burns (3rd/4th) may be less painful due to nerve damage

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Material 2: Traumatic Wound Management (Hemorrhage Control, Assessment, Emergency Care)

Core message: treat traumatic limb/soft tissue wounds using a structured approach:

1. Prevent catastrophic bleeding first
2. Rapid ABC-style primary survey
3. Assess neurovascular status and wound details
4. Irrigate/manage contamination
5. Decide closure strategy & provide comfort

A) Traumatic Wound “Paradigm” (Who You Treat)

• A traumatic wound is only part of the patient
• Management depends on:
  • Life-threatening factors
  • Neurovascular status
  • Wound/tissue involvement and contamination

B) Initial Impression & Primary Survey Order (Life First)

Sequence meaning remains consistent:

• Address life-threatening issues first, especially:
  • Uncontrolled bleeding
  • Airway/respiratory compromise
  • Shock
• Then proceed with:
  • Neuro status/disability
  • Exposure/environment precautions (including preventing hypothermia)

C) Hemorrhage Control Escalation Steps

Explicit steps provided:

1. Step 1: Direct pressure
   • Apply firm, continuous pressure
   • Do not repeatedly lift to “check”
2. Step 2: Wound packing
   • For deep cavity/junctional bleeding
   • Pack firmly into the wound and maintain sustained pressure
3. Step 3: Tourniquet
   • For life-threatening hemorrhage when direct pressure/packing isn’t sufficient
   • Apply above the wound
     • For lower limb segments: place proximal (above)
   • Tighten until bleeding stops
   • Time tracking: record exact start time and monitor effectiveness

Common errors noted:

• Tourniquet placed too loosely
• Releasing periodically
• Placement near/over a joint instead of proximal to the wound
• Delaying tourniquet application
• Failing to monitor afterward

D) Penetrating Objects: Do Not Remove

• If knives/penetrating objects are involved:
  • Do not remove
  • Stabilize the object in place
  • Control bleeding around it
  • Arrange definitive management after stabilization

E) Systemic Traumatic Wound Assessment Framework (What to Evaluate)

Document/assess:

• Mechanism of injury (blunt/penetrating/crush/high-energy; animal bites, etc.)
• Location/anatomical site (near joints, bony prominences, junctional areas, perineum/groin)
• Size/description (length/width/depth; undermining/shape)
• Tissue involvement (skin/fat/fascia/muscle/nerves/bone)
• Contamination/foreign body (possible material embedded)
• Wound age/time since injury and environmental context (water/rot exposure)
• Neurovascular status (perfusion + sensation + motor)
  • Include capillary refill and compare affected vs unaffected limb

F) Red Flag Escalation (Stop & Refer/Escalate)

Immediate escalation triggers include:

• Uncontrolled hemorrhage
• Signs of shock
• Diminished/absent pulse
• Sudden neuro deficits or GCS drop
• Exposed bone/tendon
• Suspected vascular injury (internal bleeding)
• Open fracture or deep penetrating wound
• Concern for compartment syndrome
• Major contamination

G) Wound Irrigation + Principles (On-Scene Phases)

Arrival goals:

• Irrigation goals
  • Remove dirt/foreign material
  • Reduce infection risk
  • Improve visualization
  • Protect viable tissue and support definitive management
• Irrigation principles
  • Do not scrub aggressively (avoid extra tissue injury)
  • Explain procedure and gain cooperation
  • Provide pain control if possible (IM/IV)
  • Remove loose debris; avoid unnecessary manipulation

H) Closure Decision Principles (Primary vs Delayed vs Secondary Intention)

Options described:

• Immediate primary closure
  • After adequate cleaning/treatment when conditions allow
• Delayed primary closure
  • Leave open initially, close later when infection risk decreases
• Secondary intention
  • Leave wound open to heal via granulation and contraction

Wounds that should generally not be immediately sutured:

• Established infection
• Crush injuries, puncture wounds
• High contamination
• High-risk patients (e.g., diabetic, immunocompromised)
• When there is significant tissue destruction risk

I) Emergency Care Considerations (Pain, Function, Reassessment)

• Provide pain management and comfort measures
• Assess:
  • Pain character/severity
  • Functional impact
  • Response to intervention
• Reassess after initial management
• Avoid:
  • Covering too quickly without evaluation
  • Routine antibiotics without indication
  • Masking problems with pain meds alone without reassessment

J) Special Notes: Open Fractures

• Do not press exposed bone
• Prioritize bleeding control, cover, and immobilize
• Assess for compartment syndrome

Q&A From Material 2 (Summarized)

• Tourniquet timing question
  • Answer: tourniquet use is time-limited and setting-dependent
  • “Around 2 hours” was mentioned as a common approximate approach
  • If bleeding doesn’t stop, it suggests improper placement or injury severity—requires reassessment and continued hemorrhage control

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Event Wrap-Up & Engagement

Quiz Session and Prizes

• Participants answered quiz questions, including multiple-choice and a “Who am I?” prompt.
• Winners received webinar vouchers.
• Additional voucher winners were selected via “spin the wheel.”
• Participants were reminded to:
  • Complete attendance and learning evaluation after the webinar
  • Complete learning modules via an online portal to obtain certificates/SKPs

Announcements for Future Events

The committee announced upcoming learning/webinar activities, including:

• September 13, 2026: another session (chronic wound care / diabetes / pressure injury)
• September 19, 2026: national webinars
• September 20, 2026: activity (casualty incident/triage response preparedness)

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Speakers / Sources Featured (As Stated in the Subtitles)

1. Putri Andini — MC/Moderator (also referred to as “Putri Andi” in some places)
2. Nurse Irma Puspita Arisanti (Indonesia) — burn wound management specialist
3. Muhammad Afiq bin Moh Azlin (Malaysia) — traumatic wound management speaker
4. PT Pondok Sehat Indonesia — hosting organization (referenced repeatedly)
5. Mr. Bhandwi Ananda — named as CEO (Indonesian Healthy Cottage / related wording in subtitles)