1.19 Burns 1 Flashcards
criteria to refer to a burn center (10)
- 10% body surface area partial thickness burns
- full thickness burns, any age
- specific areas: hands, feet, face, perineum, genitalia, skin overlaying major joints
- electrical burns
- chemical burns
- inhalation injury
- pre-existing illness that could cause additional problems with a burn
- burn + fx/spinal cord injury/something else
- social/emotional/long term rehab/abuse
- children in hospital setting w/o qualified burn personnel
When in doubt?
SEND TO A BURN CENTER
Why is 10% coverage with partial thickness burns an issue?
problems with autoregulation
full thickness burns: layer, what do you lose the ability to do?
- subcutaneous or deeper
- lose the ability to regrow skin
What can scarring cause with burns (mobility)?
joint contractures due to tightening
Which types of burns cause contractures?
- deep partial thickness (doesn’t have to be full thickness)
What does a chemical burn look like?
basically melts the skin off
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?
- Did they inhale something hot enough to burn the INSIDE?
- inflammation in the lungs, can’t breathe
example of a pre-existing illness that might complicate a burn
diabetes, malnourishment, etc
Priority is survival during this time frame
24 hours
Things to consider in the first 24 hours after a burn
- Can we stabilize them?
- Stabilize temp?
- Can we maintain appropriate BP?
- How much blood vol was lost?
- How much fluid lost?
- Open airway?
- Burns causing pressure?
What does tissue do when it burns?
contracts
types of burns
- electrical
- chemical
- thermal
- radiation
electrical burn: immediate response
- 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)
chemical burn: immediate response
depends on the chemical
- hospitals: everything has MSDS info
- home: most should have labels to tell you what to do
thermal burn: immediate response
- remove clothing
- cool water
Why would you not put cold water on a thermal burn?
could send them into shock
radiation burns: examples
- sun
- nuclear
- cancer treatments
What are the majority of burn types that we treat?
thermal (usu send others elsewhere)
loss in volume (water)
hypovolemia
increase in metabolism caused by inflammatory response
hypermetabolism
hypermetabolism is caused by
inflammatory response
When might inflammation continue for a very long time?
with a bad enough burn
What are the zones of a burn?
- zone of coagulation
- zone of stasis
- zone of hyperemia
