1.19 Burns 1

Question 1

criteria to refer to a burn center (10)

Answer 1

1. 10% body surface area partial thickness burns
2. full thickness burns, any age
3. specific areas: hands, feet, face, perineum, genitalia, skin overlaying major joints
4. electrical burns
5. chemical burns
6. inhalation injury
7. pre-existing illness that could cause additional problems with a burn
8. burn + fx/spinal cord injury/something else
9. social/emotional/long term rehab/abuse
10. children in hospital setting w/o qualified burn personnel

Question 2

When in doubt?

Answer 2

SEND TO A BURN CENTER

Question 3

Why is 10% coverage with partial thickness burns an issue?

Answer 3

problems with autoregulation

Question 4

full thickness burns: layer, what do you lose the ability to do?

Answer 4

• subcutaneous or deeper

- lose the ability to regrow skin

Question 5

What can scarring cause with burns (mobility)?

Answer 5

joint contractures due to tightening

Question 6

Which types of burns cause contractures?

Answer 6

• deep partial thickness (doesn’t have to be full thickness)

Question 7

What does a chemical burn look like?

Answer 7

basically melts the skin off

Question 8

What what we ask ourselves when dealing with a burn around the neck or face and we know it’s from a fire or chemical?

Answer 8

• Did they inhale something hot enough to burn the INSIDE?

- inflammation in the lungs, can’t breathe

Question 9

example of a pre-existing illness that might complicate a burn

Answer 9

diabetes, malnourishment, etc

Question 10

Priority is survival during this time frame

Answer 10

24 hours

Question 11

Things to consider in the first 24 hours after a burn

Answer 11

1. Can we stabilize them?
2. Stabilize temp?
3. Can we maintain appropriate BP?
4. How much blood vol was lost?
5. How much fluid lost?
6. Open airway?
7. Burns causing pressure?

Question 12

What does tissue do when it burns?

Answer 12

contracts

Question 13

types of burns

Answer 13

• electrical
• chemical
• thermal
• radiation

Question 14

electrical burn: immediate response

Answer 14

• safely remove electricity
• if they shocked themselves, use something wood or rubberized to move them away (if they’re still in the process of getting shocked)

Question 15

chemical burn: immediate response

Answer 15

depends on the chemical

• hospitals: everything has MSDS info
• home: most should have labels to tell you what to do

Question 16

thermal burn: immediate response

Answer 16

• remove clothing

- cool water

Question 17

Why would you not put cold water on a thermal burn?

Answer 17

could send them into shock

Question 18

radiation burns: examples

Answer 18

• sun
• nuclear
• cancer treatments

Question 19

What are the majority of burn types that we treat?

Answer 19

thermal (usu send others elsewhere)

Question 20

loss in volume (water)

Answer 20

hypovolemia

Question 21

increase in metabolism caused by inflammatory response

Answer 21

hypermetabolism

Question 22

hypermetabolism is caused by

Answer 22

inflammatory response

Question 23

When might inflammation continue for a very long time?

Answer 23

with a bad enough burn

Question 24

What are the zones of a burn?

Answer 24

• zone of coagulation
• zone of stasis
• zone of hyperemia

Question 25

zone of coagulation aka

Answer 25

necrosis

Question 26

zone of stasis aka

Answer 26

ischemia

Question 27

zone of hyperemia aka

Answer 27

inflammation

Question 28

Which zone is the epicenter of the burn?

Answer 28

zone of coagulation (necrosis)

Question 29

zone of coagulation: what happens and can we change it?

Answer 29

• tissue death

- we can’t change this

Question 30

What is significant about the zone of stasis?

Answer 30

• not as much blood flow as periphery
• teeters in the balance of either dying or healing
• we can affect change to create healing in the area

Question 31

What is the zone of hyperemia?

Answer 31

characterized by redness on the outskirts of the wound