5) Burns Flashcards
(duration to burn a child) A.120 degrees
B.125 degrees 2 minutes
C.140 degrees 6 seconds
D.150 degrees 2 seconds
A.10 minutes
B.2 minutes
C.6 seconds
D.2 seconds
4 dif/ burns:
thermal, electrical, chem, radiation,
skin tolerates up to ? degrees
111F
Heat gradient
H → L heat will go
Extent of burn injury related to amount of
heat energy transferred to skin (Heat gradient)
Factors of burn severity:
Duration, Exposure, temp, surface
agent’s temperature relation to potential damage.
greater the agent’s temp, the greater its potential to cause damage.
Jacksons Theory of Thermal Burns 3 burn zones:
1st Zone of Coagulation 2nd Zone of Stasis 3rd Zone of Hyperemia
(Jacksons Theory) Zone of Coagulation:
Area of burn nearest to the heat source (most damage & tissue necrosis)Most damaged area
Zone of Hyperemia:
surrounding Area of erythema, damage with more RBC coming to area b/c/& cap/s more permeable (increased blood supply) trying to get phagocytes to inside for healing process
Sig burns have sig swelling from shift of fluid
Zone of Stasis / “Ischemia”:
Less damaged area adjacent to the Zone of Coagulation (treatable & posible reversible damage)
Thermal burn phases:
Emergent, Fluid-shift, Hypermetabolic, & Resolution phase
(Thermal burn phases) Emergent phase:
Vtach, cells anaerobic Body’s initial reaction to burn; pain response (afferent nerves damage> Nor/Epi release > tachycardia ; unless on beta blockers
(Thermal burn phases) Fluid-shift phase:
2nd phase; can last up to 24 hours; larger than 15 to 20%(BSA) of total body surface area
vasodilates & capillaries more permeable for phagocytosis
(Thermal burn phases) Hypermetabolic phase:
3rd phase Days or weeks depending on burn severity; increase in body’s demands for nutrients; begins process of repairing damaged tissue (needs Glucose, amino acids, carbohydrates, O2 to support damage)
(Thermal burn phases) Resolution phase:
4th phase Scar tissue laid down and remodeled; rehabilitate and return to normal function (weeks to months) new collagen & usually doesnt remodel to original state & makes escar (burn keloid) bc overgrowth
“pressure” of electric flow
Voltage
“energy” or amount of flow in given time
Current; measured in amperes
Ohm’s law:
relationship between current (I), resistance (R), voltage (V)
Electricity follows path of
least resistance w/ entry & exit wound: Nerves & blood vessels
Lightning can still strike you if proximity up to:
up to 50yrds can strike you
Chemical burns:
biochemical makeup of cell membranes; destroy cells
Direct current (DC):
Alternating current (AC):
= electrons flow in one direction > grab on can’t let go
= reverses flow in short intervals (60 cycles change electrons’’ flow) can let go
Lightning shock pathway to heart can & b/c:
= PSNS & SNS attach heart “defib w/o defibrillator” put in dysrhythmia or arrest
Denature:
take away natural state (from chem burns)
Alkalotic vs acidotic burns severity
Alkalotic burns > Acidotic burns
Lightning strikes frequency & strike proximity
~100times a sec around world & up to 50yrds can strike you
Chemical burns effect:
Denature biochemical makeup of cell membranes; destroy cells
best way to wash eyes
Morgan lens ((hard lens/contacts hooked up to water)
Radiation burns:
Factors:
= from nuclear sources Damages cells mischapping them & replicating thus cancer
= duration, Distance, shielding
(Rad) S/S of Exposure:
First sign:
Lethal Dose Exposure:
Organ shutdown:
= SLUDGEM PSNS S/S
= slight nausea & fatigue
= Emesis & malaise, Epistaxis, mouth, gums, & rectum (Vomiting usually lethal exposure
= Death
Geiger Counter:
Dosimeter:
= Radiation emission measured w/ Dosimeter
= Cumulative exposure recorded
1 Types of Radiation:
2 Radioactive Particles:
3 Alpha:
4 Beta:
5 Ionizing Rays:
6 Gamma:
7 X-Rays:
8 Atomic:
1= Radioactive Particles & Ionizing Rays
2= Alpha &Beta:
3= least worry & deflected w/ newspaper
4= flys further w/o skin penetration
5= Gamma & X-Rays
6= worst, several ft of concrete & lead
7= penetrates skin
8= nuclear reactor
(Radiation) Duration:
Distance:
Shielding:
= Radiation exposure accumulative danger
= Rad/ strength lessens quickly as distance from source increases
= More material between you & rad/ source, < exposure experienced
Light Burns:
Inhalation Burns:
Toxic inhalation:
Cyanide & carbon monoxide are released via:
= Intense light from arc welder, industrial laser (Ultraviolet keratitis)
= Inhaled gases, heated air, flames, steam; airway & resp/ injury
= Synthetic resins & plastics release toxic gases as they burn
= fake wood & such burning thus Toxic inhalation
Stridor w/ inhalation burns:
Bad Airway burns might might need:
= AKA “crowing” larynx last defense against heat then swells 2/3s so intubate asap bc only worsens (Press chest & follow bubbles)
= Might need to nasal endotracheal intubation w/ BAAM & Endotrol tube (ET w/ trigger) BAAM> High=inhale &Low=exhale
1 (Burn depth) 3rd degree:
2 feeling & appearance:
1= full thickness burn down to SCT may involve M. bone & organs
2= leather, looks Charred, dark brown or white, hard to touch “painless”
(Burn depth) Degrees:
= 1st/Superficial, 2nd/partial, 3rd/full/complete
(Burn depth) 1st degree:
= Epidermis only, red skin, pain & tender, NO blister(can lose temp/reg)
(Moderate criteria) Superficial:
Partial thickness burns:
Full thickness burns:
= BSA >50%
= BSA <30%
= BSA <10%