Burn Flashcards
What are the qualifications to transfer to a burn center?
->10% TBSA partial thickness burns
-partial thickness burns or deeper to the face, hands, feet, genitalia, perineum, and joints
-third degree burns
-burns in patients w/significant comorbidities
-pts when advanced rehab needs
-burns in children
airway damage from burn exposure is caused by?
inhaled toxins
is singed facial hair have high sensitivity to predict inhalation injury
no
what quantifies mild hypothermia?
90-94 degrees F
shivering and mild mental changes
maybe some tachycardia to increase cardiac output
what quantifies moderate hypothermia?
94-89 degrees F or 28.9-31.7 C
agitated or combative
muscle spasticity, dilated pupils, slowing of respirations, afib, hypotension, decreased vascular resistance
what quantifies severe hypothermia?
70-84 F or 21.1 - 28.9 C
EKG changes (prolonged QRS or Osborn waves), flaccid/comatose, ventricular fibrillation, death
what is profound hypothermia?
<70F or <21.1 C
loss of vital signs, cardiac activity, and EEG tracings
what is the first treatment for hydrofluoric acid burn?
2.5% calcium gluconate gel to burned areas, if burn persists can use 5% calcium gluconate can be injected intradermally around The affected areas
what does hydrofluoric acid burn cause?
life threatening hypocalcemia because the HF acid binds calcium and can lead to cardiac arrest
what is characteristic of a full thickness burn?
non blanching white, leathery, painless
what is a fourth degree burn?
extends through entire skin into the underlying fat, muscle, and bone
looks dry, black, charred, with eschar
what is a deep second degree burn
Depth to the reticular dermis
Dry, yellow or white, less blanching, insensate, may be slightly painful
what is a superficial second degree burn
depth to the papillary dermis
moist, redness with clear blisters, blanches with pressure, painful
what is a first degree burn
depth to epidermis
dry, red, without blisters, painful
what is a side effect of bacitracin?
nephrotoxicity and anaphylaxis
which topicals can penetrate eschar?
Mafenide acetate and silver nitrate
which topical to use with exposed cartilage?
Mafenide acetate
what topical should you used for superficial MRSA
Mupirocin
which topical can cause methemoglobinuria?
silver nitrate
which topical is painful?
mafenide acetate
does silver sulfadiazine penetrate eschar?
no
when doing an escharotomy, do you incise the muscle fascia?
no - that would be a fasciotomy
what does frost nip look like
ice crystal formation on surface of the skin, no tissue damage
treat with rewarming, no long term sequelae
what does a first degree frost bite look like?
injury limited to the epidermis, edema, white plaque formation
treat with rewarming, +/- topical ointment
sensory loss may take time to recover, no permanent tissue loss
what does second degree frost bite look like?
injury extends to the dermis, clear blisters
rewarm and wound care +/- skin grafting
blister may form an esher that eventually sloughs off
no permanent tissue loss
what does a third degree frost bite look like?
injury extends to subcutaneous tissue, hemorrhagic blisters, black eschar
rewarming, intensive wound care, permanent tissue loss is possible, skin or tissue grafting is necessary, may need amputation
what does a fourth degree frost bite look like?
extends to muscle, bone
complete necrosis, mummification
Rewarming and intensive wound care
Will need amputation
what is the Parkland formula?
4 ml x weight (kg) x TSBA (%)
first half of volume given over first 8 hours then second half over next 16 hrs
