Burn/Wound/PRS Flashcards
Most commonly used burn drug?
Silver sulfadiazine
Which burn drug causes transient leukopenia?
Silver sulfadiazine
Burn drug that’s an anhydrase inhibitor. Side effect?
Mafenide acetate
Side effect metabolic acidosis
Which burn drug cause hyponatremia?
Silver nitrate
Which burn drug causes methemoglobinemia?
Silver nitrate
treatment for methhemoglobinemia: methylene blue
treatment for cyanide toxicity: sodium nitrite, sodium thiosulfate
Which stage of frostbite has numbness and edema?
Superficial stage. Stage I
Which stage of frostbite has milky white blisters?
Hemorrhagic blisters?
What do you do about these blisters?
Stage 2. Partial thickness. Drain the milky white blusters
Hemorrhagic blisters: stage 3. You leave these alone
Car mechanic found down under a car, no evidence of trauma. Treatment?
Hyperbaric oxygen chamber. Carbon monoxide poisoning.
Hypothermia is body temp under what?
How is hypothermia classified?
35C, 95F
Mild hypo: 90-94F (32-34) - shiver, mental status, tachy
Moderate hypo: 84-89F (29-32) - agitated, combative, slowed respirations
Severe: 70-84 (<29) - prolonged qt, Osborn waves
CPR and active rewarming in hypothermic asystole pt should be continued until what?
Until T is 90F and K > 12 mmol/L
Meshed split thickness vs. full thickness skin graft
Which one has better cosmetic results?
What does meshing do?
Which one gets worse pigmentation?
Which one has higher rate of engraftment?
Full thickness has better cosmetic results
Meshing reduceds seroma/hematoma formation. doesn’t improve imbibition
Split thickness gets worse pigmentation
Split thickness higher rate of engraftment because they have less dermis and require lower metabolism
Which burn drug can cause methemoglobinemia?
Silver nitrate
What’s primary contraction vs. secondary contraction?
Split thickness graft has more or less primary/secondary contraction?
Primary contraction: how much it contracts after harvesting and before grafting
Secondary contraction: how much it contracts after grafting
Split thickness - less primary contraction, more secondary contraction
Full thickness - more primary contraction, less secondary contraction
Predominant cells in 24-48hr after surgery
Neutrophils
What timeframe do macrophages show up in the wound after surgery?
48-96hr after surgery
When do lymphocytes show up to wound after surgery?
3 day Mark
When do fibroblasts show up at the wound after surgery?
Within 24hrs then predominate @ ~10 days
Wound healing. When is there maximum amount of collagen accumulation?
On what day do the fibroblasts dominate?
21 days
Fibroblasts dominate at 10 days. Collagen is maxed at 21 days
Mafenide acetate is used for what degree burns? Why?
Full thickness
Excellent eschar penetration
Which topical hurts when you apply?
Mafenide acetate
AKA
Sulfamylon
What is the other name for silver sulfadiazine?
what is its side effect?
Silvadene
leukopenia
Most commonly used burn drug for partial thickness burn?
Silver sulfadiazine/silvadene
Singed hair has high or low sensitivity to predict inhalation injury?
Airway damage from inhalation damage is primarily from the heat?
Singed hair is not that sensitive
No the heat of inhalation injury mostly dissipates in the upper airway. Damage is mostly from INHALED TOXINS
For burn pts, urinary output of how much is appropriate for adults and children?
Adults: 0.5 - 1 cc/kg
Children: 1 - 1.5 cc/kg
