Burns 1 Flashcards
burns cause what
physiologic, metabolic and psychological changes with loss of tissue integrity
tissue destruction by burn injuries leads to ______
fluid and electrolyte imbalance
what are the priorities of care when dealing with burns
prevention of infection and closure of burn wound
what is a major cause for disability and death among burn pts
lack of or delay in wound healing which causes systemic problems
these include sweat and oil glands and hair follicles
dermal appendages
what is the severity of the burn determined by
by how much body surface area is involved and the depth of the burn
what is the largest organ in the body
skin
when burns occur, skin can regrow as long as what
as long as parts of the dermis are present
if the dermis is totally burned (including dermal appendages), skin cannot restore itself
what does it mean for the subcutaneous level to be burned
means the layer below dermal is burned/damaged and bones, muscle, or tendons are likely exposed
when tissue integrity is intact what is the function of the skin
to act as a protective barrier against injury and microbe invasion
**burns break this barrier and increase risk for infection
all burn injuries are ____
painful to some degree
cause massive fluid loss
and decrease excretory (sweat) ability
what does desquamation mean
peeling of dead skin
describe a superficial burn
- least amount of burn damage
- only epidermis is injured
- red/pink, mild edema, pain
- heals within 3-6 days (desquamation)
examples of superficial burns
sunburn or flash burn
describe partial thickness burn
involves tissue integrity loss of entire epidermis and varying depth of dermis
can be superficial or deep
describe superficial partial thickness burn
- injury to upper third of dermis
- pink, moist, blanch (lighten when pressure is applied)
- blister, pain, mild edema
- heals withing 2 wks (10-20 days)
examples of superficial partial thickness burn
-scalds, flames, brief contact with hot surface
describe deep partial thickness burn
- injury to deeper layers of dermis
- red to white, dry, blanches slowly or not at all
- pain, no blister, soft/dry eschar
- grafts used if healing is prolonged
- healing takes 2-6 wks
- blood flow is decreased
examples of deep partial thickness burn
scalds, flames, prolonged contact with hot surface, tar, grease, chemicals
describe full thickness burns
- destruction of entire epidermis and dermis (no skin cells to repopulate)
- requires grafting
- black, brown, yellow, white, red
- hard, dry leathery eschar
- severe edema
- sensation and pain are decreased d/t lack of nerves
- healing takes wks to months
describe eschar
dead tissue that need to slough off or be removed before wound can heal
specific descriptors for full thickness burns
- circumferential- blood flow and chest may be reduced for breathing
- escharotamies or fasciotomies to relieve pressure
what is circumferential
completely surrounds an extremity or the chest
what is escharotomies and fasciotomies
escharotomies: incisions through eschar
fasciotomies: incisions through eschar and fascia
describe deep full thickness burns
- healing takes wks to months
- extends beyond skin and damage to the bone, muscle, or tendons
- back skin
- no sensation or pain
- need early excision or grafting
- amputations may be necessary
cardiac changes with burns
- initially increased HR and C.O. d/t initial fluid shift and hypovolemia
- eventually C.O. improves with fluid remobilization
pulmonary problems that can be a major cause of death
- resp problems d/t superheated air, steam, toxic fumes, and smoke
- *these are a major cause of death in pt with burns (esp tend to occur if burn happened outdoors)
pulmonary changes with burns
- potential airway obstruction if heat in upper airway causes inflammatory response and edema
- chemical and toxic gases cause airway injury
metabolic changes with burns
- hypermetabolism d/t increased secretion of catecholamines, ADH, aldosterone, and cortisol
- cause increased need for calories and O2 (may need 2x or 3x as many calories as normal)
- increased core body temp
immune changes with burns
- destroy protective layer, puts at risk for infection
- inflammatory response often inhibits immune response
- antibiotics may be needed prophylatically
