24 - Burns

Question 1

Types of Burns

Answer 1

Thermal
Chemical
Smoke/Inhalation (Metabolic asphyxiation, upper airway, lower airway)
Electrical

Question 2

thermal burn

Answer 2

contact burn fr flame, flash., scald

Question 3

chemical burn

Answer 3

fr contact w acid, alkalis, organic compounds

Question 4

smoke + inhalation injury

Answer 4

fr breathing noxious chem or hot air
>can damage resp tract
>major predictor of mortality
3 types

Question 5

3 types of smoke/inhalation me

Answer 5

upper airway injury
lower airway injury
metabolic asphyxiation

Question 6

metab asphyxiation

Answer 6

-fr carbon monoxide _ hydrogen cyanide
-impaired O2 delivery> hypoxia
-deadly if carboxyhemoglobin occurs

Question 7

carboxyhemoglobin

Answer 7

when Hgb mixes w CO > 20%
-deadly

Question 8

upper airway

Answer 8

redness, swelling, edema, blistering
-can lead to narrowing of airway

Question 8

lower airway

Answer 8

damage is r/t duration of exposure to fumes/smoke
-singed nasal hair, facial burns
-hoarseness
-painful swallowing
-dark oral/nasal membranes
-pulmo edema>ARDS

Question 9

Rule of 9

Answer 9

for extent of burn
front half:
head, arm: 4.5%
leg: 9%
chest: 18%
groin: 1%

Question 10

thermal burns less than 10% of body

Answer 10

cover in clean,cool tap water dampened towel until med care: helps minimized depth of injury

Question 11

burn larger than 10% or electrical or inhalation is suspected
priorities?

Answer 11

circulation (check pulse + elevate birned limbs to prevent swelling
airway: check patency + for soot or singed
breathing: check ventilation

Question 12

to prevent hypothermia…

Answer 12

cool large burns NO MORE THAN 10 mins
-never cover in ice
-remove as much of adherent clothing + wrap in dry clean sheet/blanket

Question 13

chem burn priority

Answer 13

remove clothing
flush affected area for 20 min to 2 hr

Question 14

if CO poisoning is suspected…

Answer 14

treat w 100% humidified O2

Question 15

3 phases of burn mgmt

Answer 15

1 emergent/resusciative
2 acute/wound healing
3 rehab/restorative

Question 16

emergent resusc phase

Answer 16

first 72 hr
-concernd are onset of hypovol shock + edema formation
-ends w fluid mobilization _ diuresis

Question 17

partial thic/1st degree

Answer 17

-blanching w pressure
-min edema
-mod-severe tenderness
-pain
-redness

Question 18

partial thick/2nd degree

Answer 18

hypersensitive to touch + air
-moist blebs blister
-mottled qhitre, pink to cherry red

Question 19

partial thick/2nd degree

Answer 19

hypersensitive to touch + air
-moist blebs blister
-mottled white, pink to cherry red

Question 20

full thick/3rd degree

Answer 20

absence of pain at site but severe pain AROUND
-dry, leathery eschar
-impaired sensation when touched
-lack of blanching
-strong odor burn
0waxy white dark brown or charred

Question 21

parkland baxter formula

Answer 21

4 ml x kg x %TBSA = 24 hr fluid
-1st half given in first 8 hr
-2nd half given in second 16 hr

Question 22

UO parameter

Answer 22

0.5-1 ml/kg/hr

or 75-100ml/hr for electrical burn

Question 23

cardiac parameter

Answer 23

MAP >65
BP > 90
HR <120

Question 24

indwelling catheter

Answer 24

to prevent infection inperineal area

Question 25

IM injections?

Answer 25

no, bc not absorbed well

Question 26

shots?

Answer 26

tetanus

Question 27

nutrition?

Answer 27

early + aggresive nutrition support within first few hours
-enteral feeding