24 - Burns Flashcards
Types of Burns
Thermal
Chemical
Smoke/Inhalation (Metabolic asphyxiation, upper airway, lower airway)
Electrical
thermal burn
contact burn fr flame, flash., scald
chemical burn
fr contact w acid, alkalis, organic compounds
smoke + inhalation injury
fr breathing noxious chem or hot air
>can damage resp tract
>major predictor of mortality
3 types
3 types of smoke/inhalation me
upper airway injury
lower airway injury
metabolic asphyxiation
metab asphyxiation
-fr carbon monoxide _ hydrogen cyanide
-impaired O2 delivery> hypoxia
-deadly if carboxyhemoglobin occurs
carboxyhemoglobin
when Hgb mixes w CO > 20%
-deadly
upper airway
redness, swelling, edema, blistering
-can lead to narrowing of airway
lower airway
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
Rule of 9
for extent of burn
front half:
head, arm: 4.5%
leg: 9%
chest: 18%
groin: 1%
thermal burns less than 10% of body
cover in clean,cool tap water dampened towel until med care: helps minimized depth of injury
burn larger than 10% or electrical or inhalation is suspected
priorities?
circulation (check pulse + elevate birned limbs to prevent swelling
airway: check patency + for soot or singed
breathing: check ventilation
to prevent hypothermia…
cool large burns NO MORE THAN 10 mins
-never cover in ice
-remove as much of adherent clothing + wrap in dry clean sheet/blanket
chem burn priority
remove clothing
flush affected area for 20 min to 2 hr
if CO poisoning is suspected…
treat w 100% humidified O2
3 phases of burn mgmt
1 emergent/resusciative
2 acute/wound healing
3 rehab/restorative
emergent resusc phase
first 72 hr
-concernd are onset of hypovol shock + edema formation
-ends w fluid mobilization _ diuresis
partial thic/1st degree
-blanching w pressure
-min edema
-mod-severe tenderness
-pain
-redness
partial thick/2nd degree
hypersensitive to touch + air
-moist blebs blister
-mottled qhitre, pink to cherry red
partial thick/2nd degree
hypersensitive to touch + air
-moist blebs blister
-mottled white, pink to cherry red
full thick/3rd degree
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
parkland baxter formula
4 ml x kg x %TBSA = 24 hr fluid
-1st half given in first 8 hr
-2nd half given in second 16 hr
UO parameter
0.5-1 ml/kg/hr
or 75-100ml/hr for electrical burn
cardiac parameter
MAP >65
BP > 90
HR <120
