burn rehab

Question 1

superficial 1st degree burn

Answer 1

epidermis

Question 2

partial thickness 2nd degree

Answer 2

epidermis and dermis

Question 3

full thickness 3rd degree

Answer 3

epidermis, dermis, subcutaenous layert

Question 4

superficial thickness

Answer 4

• dry, no blisters, blanches
• red, bright pink
• painful
  -epidermis only
  -3-7 days, may peel

NOT includewd in TBSA %

Question 5

superficial partial thickness

Answer 5

• blistered, weeping
  -bright red
  -very painful
  -epidermis, pap dermis
  -7-21 days, minimal to no scarring, pigment change unlikely

Question 6

deep partial thickness

Answer 6

-pseucochar
-motted white to pink
-blanching indicates healing
-pain= healing, no pain= deep burn
- epidermis, pap and reticular
- 21-35 days, may develop severe hypertrophic scarrin

Question 7

full thickness

Answer 7

-dry, leathery, charred
-mixed white, waxy, pearly, khaki
-no pain, hair pulls out easily
-epidermis, dermis, subcuteanous and beyond
-skin grafting- wont heal on its own

Question 8

Lund and Browder

Answer 8

most accurate method of determining total body surface area (TBSA)
-necessary to calculate fluid resuscitation requirements

-most critical time for injury is first 24-48 hours

Question 9

rule of 9’s

Answer 9

-body divided into 11 segments
9% or multiples of 9 but 1% for perineum

Question 10

thermal burns

Answer 10

scald
flame
friction

Question 11

scald

Answer 11

-hot liquids and grease
-common in kids and older
-patterns

Question 12

flame

Answer 12

may involved inhalation injury

Question 13

friction

Answer 13

road rash usually

Question 14

electrical

Answer 14

-contact points might be small, internal damage more severe
- follows pattern of least resistance
- can see entrance spot but dont always know depth of injury

Question 15

chemical

Answer 15

-treat by massive dilution
-attempts to chemically neutralize the burn can have adverse effect
-

Question 16

radiation

Answer 16

sunburn
-radiation therapy

Question 17

nectrotizing fasctisiis

Answer 17

-bacterial infection : Group A strep
-progresses quickly: red, warm, severe pain, fever
- antibiotics and daily surgical debridement necessary
- complications: sepsis, organ failure, life or limb, scarring

Question 18

SJS and TEN

Answer 18

SJS= <10%, TEN= >30%
-epidermis
-allergic reaction to a drug
-life threatening when it gets to gut

Question 19

frostbite

Answer 19

-hennepin score
-t-PA protocol, bone scan, rewarming
-time is of the esscence

Question 20

renal system

Answer 20

-hypovolemic shock
marked fluid loss in organs increases HR , decreases urine and BP

Question 21

escharotomy

Answer 21

fluid accumulates in extracellular space
-burn/eschar acts as torniquet
-ischmeic, compartment syndromw

Question 22

mesh graft

Answer 22

run graft through a mesher
- interstices allow for wound drainage
-expanded over large area
- less durable than sheet grafts
-waffle like appearne

Question 23

sheet graft

Answer 23

-graft unaltered
-more cosmetic
-requires large donor site
-watch for bleeders

Question 24

cultured epidermal autograft

Answer 24

pts with large TBSA >30%
-skin biopsies taken and grow in the lab