Burn Treatment

Question 1

Fluid replacement

One of the most important aspects of burn management is _____

Answer 1

What time burn occurred

Question 2

Fluid replacement

Why is it important to know what time the burned occurred?

Answer 2

Fluid therapy for first 24 hours is based on time of injury…not when tx started

So if patient comes in at 2 pm with burn and the burn was actually at Noon, then 24 hr fluid replacement is based off the noon time, not 2 pm time!

Question 3

Fluid replacement

What is parkland formula?

Answer 3

Calculate what you need in first 24 hours and give 1/2 in first 8 hrs

Question 4

Fluid replacement

What is consensus formula?

Answer 4

4 mL of LR x body weight in kg x % of TBSA burned

1st 8hr: 1/2 of total volume
2nd 8hr: 1/4 of total volume
3rd 8hr: 1/4 of total volume

Question 5

Fluid replacement

If the client is restless, it could suggest 3 problems. What are those problems?

Answer 5

Inadequate fluid replacement
Pain
Hypoxia – priority!!!

Question 6

Fluid replacement

What is used to determine if clients fluid volume is adequate?

Answer 6

UO!!!

*normally daily weight is answer, but with burns UO is better to monitor fluid volume

Question 7

Emergency management

What can be used to stop the burning process?

Answer 7

Blankets

Cool H20

Question 8

Emergency management

How does blanket help

Answer 8

Holds in body heat

Keep out germs/bacteria

Question 9

Emergency management

Why do we remove jewerly?

Answer 9

Swelling can occur

Metal gets hot and continues to burn

Question 10

Emergency management

Clothing

Answer 10

Remove non-adherent clothing and cover burns with clean, dry cloth

Question 11

Emergency management

Signs of airway injury

Answer 11

Singed nose and facial hair
Soot
Coughing up black specks/secretions
Blisters on MM

Question 12

More death with upper or lower body burns?

Answer 12

Upper

Question 13

Emergency management

If clients respirations are shallow. What are they retaining? What acid base-imbalance?

Answer 13

Retaining Co2

Acid base balance: Resp. acidosis

Question 14

Medication management-Albumin

What does albumin do?

Answer 14

Hypertonic fluid (filled with particles) that holds fluid in the vascular space

Question 15

Medication management-Albumin

Albumin what all increases/improves?

Answer 15

Vasc. volume increases
Kidney perfusion improves
BP and CO increase

This helps correct volume deficit!! Fluid is going INTO vas. space!

Question 16

Medication management-Albumin

When you start giving a client albumin, you know vascular volume will ___

Answer 16

Increase…so this increase workload of heart (can stress heart out!)

Question 17

Medication management-Albumin

If you stress heart out too much, then what happens?

Answer 17

Can be thrown into fluid volume excess. CO will decrease. Lungs will be wet/crackle

Question 18

Medication management-Albumin

What measurement can be taking to make sure that you’re not overloading the heart and giving the fluids too rapidly

Answer 18

CVP (direct measurement of R. atrium pressure)

Normal: 2-6

Question 19

Medication management-Pain

What are IV pain meds preferred over IM with burns?

Answer 19

IV meds act quickly and fast

Question 20

Medication management-Pain

If an IM injection is going to work, you must have what?

Answer 20

Adequate perfusion to muscle

Question 21

Medication management-Immunization

Tetanis toxoid is for active or passive immunity?

Answer 21

ACTIVE–takes 2-4 weeks to develop own immunity

Question 22

Medication management-Immunization

Immune globiin is for active or passive immunity?

Answer 22

Passive; think IMMEDIATE protection!

Question 23

Medication management-Immunization

What if client doesnt know status of their last tetanus shot–what is better tetanus toxoid or immune globulin

Answer 23

Immune globulin