ABSITE Review - Burns Flashcards
What is the burn classification?
1st - Sunburn (epidermis)
2nd
Superficial dermis (papillary) - painful to touch; blisters; blanches
Deep dermis (reticular) - decreased sensation; loss of hair follicles
3rd - leathery feeling; down to SQ fat
4th - down to bone
What is the “Rule of 9s”?
Head = 9, arms = 18, chest = 18, back = 18, legs = 36, perineum = 1
Patient’s plam = 1%
What is the Parkland formula?
For burns >20%, give 4cc/kg x % burn in first 24hrs; give 1/2 in first 8 hrs
What is the best measure of resuscitation?
Urine output
What are the indications for escharotomy?
Circumferential burns
Fasciotomy if compartment syndrome present
Problems ventilating patient with significant chest torso burns
What produce deeper wounds: acid or alkali burns? Why?
Alkali due to the liquefaction necrosis
Acid burns cause coagulation necrosis
What is the treatment for hydrofluoric acid burns?
spread calcium in the wound
What are contrindication for skin graft?
Positive culture for beta-hemolytic strep or bacteria >105
What are the MC reasons for skin graft loss?
seroma or hematoma formation under graft
Which type of skin graft has less wound contraction?
Full thickness skin graft
What is the MC organism in burn wound infection?
Pseudomonas followed by Staph, Ecoli and Enterobacter
What are the side effects of silvadene?
Neutropenia, thrombocytopenia
Contraindicated in pts with sulfa allergy, G6PD deficiency
Limited eschar penetration. Ineffective against pseudomonas.
What are the side effects of silver nitrate?
Can cause electrolyte imbalances –> hypoNa, hypoCl, hypoCa, hypoK
Limited eschar penetration. Ineffective against pseudomonas.
What are the side effects of sulfamylon?
Metabolic acidosis
Good eschar penetration; good for burns overlying cartilage
Broadest spectrum against Pseudomonas and GNRs
What is the MC viral infection in burn wounds?
HSV
