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Principles2 > Burn > Flashcards

Burn Flashcards

1
Q

what are the 4 functions of the skin? (S, PI, F/E B, TR)

A

sensation, prevents infection, fluid/electrolyte balance, thermal regulation

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2
Q

why is the Lund & Browder burn chart preferred over Rule of Nines?

A

because it takes into account the proportional difference in adults and children

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3
Q

what enzyme does cyanide inhibit?

A

cytochrome oxidase

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4
Q

cyanide concentration of > 100 ppm causes what 3 s/s? (L, S, RF)

A

lethargy, seizures, resp failure

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5
Q

for cyanide toxicity, what 2 meds do you give?

A

sodium nitrate, sodium thiosulfate

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6
Q

how many mg of sodium nitrate do you give?

A

300 mg

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7
Q

how many grams of sodium thiosulfate do you give?

A

12.5 grams

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8
Q

repeat what percent of the sodium nitrate and sodium thiosulfate doses if s/s reoccur within 2 hours?

A

50%

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9
Q

what carbon monoxide s/s are seen at these % levels?

  1. 15-20% (H,T,C)
  2. 20-40% (N,F,D)
  3. 40-60% (H,C,CI)
  4. > 60% (D)
A
  1. HA, tinnitus, confusion
  2. nausea, fatigue, disorientation
  3. hallucination, combativeness, C/V instability
  4. death
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10
Q

immediately after a major burn, are these increased or decreased:

  1. CO and arterial BP
  2. SVR and PVR
  3. contractility
  4. capillary permeability
  5. response to catecholamines
A
  1. decreased
  2. increased
  3. decreased
  4. increased
  5. decreased
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11
Q

what factors cause decrease contractility and increase capillary permeability? (HMF)

A

humor mediated factors

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12
Q

2-5 days after a burn, O2 consumption and cardiac output are increased how many times for weeks to months? (range)

A

2-3 times

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13
Q

what are 3 vascular s/s the first 24 hours after injury? (V,H,H)

A

vasoconstricted, hypercoagulable, hemoconcentrated

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14
Q

what is a potential SE of silver nitrate 0.5%? (M)

A

methemoglobinemia

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15
Q

what are the 2 fluid resuscitation formulas? (PMH, BAH)

A

parkland memorial hospital, brooke army hospital

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16
Q

what is the formula for first 24 hours?

A

4mL x kg x % burn

4 x 100kg x 80% = 32,000 mL

17
Q

what % of fluid do you give in the first 8 hours?

A

50%

18
Q

what % of fluid do you give in the next 16 hours?

A

50%

19
Q

after first 24 hours, maintenance rate of D5W with colloids is what? (mL/kg/%TBSA)

A

0.5 mL/kg/%TBSA

20
Q

what is the drug of choice for burn procedures?

A

ketamine

21
Q

what degree range do you keep the OR?

A

98-100 degrees

22
Q

initial burns are considered what and require what?

A

full stomachs, RSI

23
Q

Succs may be used up to how many hours?

A

24 hours

24
Q

burn pts may require how many times more non-depolarizing muscle relaxants d/t increased Vd and plasma protein binding? (range)

A

2-3 times

25
Q

are narcotic requirements increased or decreased in burns?

A

increased

26
Q

what is max epi dose with these agents? (mcg/kg)

  1. sevoflurane
  2. isoflurane
  3. desflurane
A
  1. 5 mcg/kg
  2. 6.7 mcg/kg
  3. 7 mcg/kg
27
Q

Criteria for adequate fluid resuscitation:

  1. UO how many ml/kg/hr? (range)
  2. blood lactate less than how many mmol/L
  3. base deficit less than what?
  4. gastric intramucosal pH greater than what?
  5. cardiac index of what? (L/min/m^2)
  6. oxygen delivery index (mL/min/m^2)
A
  1. 1-2 mL/kg/hr
  2. 2 mmol/L
  3. -5
  4. 7.32
  5. 4.5 L/min/m^2
  6. 600 mL/min/m^2
28
Q

do burn pts require more or less NMBs?

A

more

29
Q

what is the major cause of inhalation injury in burn pts?

A

carbon monoxide

30
Q

what type of metabolic state are burn pts in:

  1. first 24 hours post burn
  2. 2-5 days post burn
A
  1. hypodynamic

2. hyperdynamic

31
Q

cyanide concentration > how many ppm cause seizures, lethargy and respiratory failure?

A

> 100 ppm

32
Q

are induction agents (ketamine, propofol, etomidate) stand doses for burns?

A

yes

33
Q

during debridement, pts may lose what range of mLs per 1% TBSA excised?

A

200-400 mL

34
Q

after ABCs, what is the #1 priority?

A

temperature

35
Q

for burns, maintain UO greater than what mL?kg/hr?

A

> 0.5 mL/kg/hr

36
Q

reasons why burn pts need more NDMRs:

  1. reason related to Vd
  2. reason related to plasma protein
  3. what are the 2 reasons related to NMJ receptors?
A
  1. increased Vd
  2. increased plasma protein
  3. increased # of NMJ receptors and decreased affinity
37
Q

avoid what two muscle relaxants in burn pts? (T, A)

A

tubocurarine (DTC), atracurium

38
Q

why avoid tubocurarine (DTC) and atracurium in burn pts? (HR)

A

histamine release

Principles2 (21 decks)

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