Burns

Question 1

Skin function

Answer 1

Barrier
Thermoregulation
Vitamin D synthesis
Sensory

Question 2

Layers of skin

Answer 2

Epidermis
Dermis
Subcutaneous fat
Muscles, tendons, bones

Question 3

Epidermis key factors

Answer 3

Reproduces all the time leads to shedding skin
First line of defence
Contains melanin

Question 4

Dermis key factors

Answer 4

High elastic layer contains collagen, elastin, muco polysaccharides

Nerve endings
Blood vessels
Sweat glands
Hair follicles

Question 5

Subcutaneous key factors

Answer 5

Adipose tissue
Insulator for hot and cold
Energy reserves for body
Cushion

Question 6

Muscles/tendons/ bones key factors

Answer 6

Prone to hypoxia and anaerobic metabolism in burnt state

Bones still living tissue and can be damaged by burns

Question 7

Eye burns

Answer 7

Irrigate with lots of water

Very susceptibile

Question 8

Types of burns

Answer 8

THERMAL
Flame, scald, contact, steam, flash

CHEMICAL
Acid/ alkali

ELECTRICAL
Flash burns entry and exit wounds

Question 9

Classifications of burns

Answer 9

Superficial
Superficial partial
Deep partial
Full thickness

Question 10

Superficial burns

Answer 10

Eperdermis involvement only
Blister after 24 hours
Heal 3-5 days
Pain relief and water

Question 11

Superficial burns

Answer 11

Partial dermis involvement
Blisters develop in minutes
Nerve endings exposed
3 to 4 weeks healing

Question 12

Deep partial

Answer 12

Reaches subcutaneous
Appears white and waxy
Likely to scar
Hair grows back 7-10 days

Question 13

Full thickness

Answer 13

Dry and leathery
Loses elasticity
Circulation compromise, nerve endings destroyed

Question 14

Rule of 9s -

Answer 14

Head front - 4.5 back - 4.5

Arm front -4.5 back -4.5

Torso - 18

Back -18

Leg front -4.5 back -4.5

Genitalia - 1

Question 15

Burns shock

Answer 15

Hypovolaemia - massive loss of fluid

Cardiac contractility reduced due to multiple organ dysfunction - CO reduced

Cellular affects metabolism and immune system

Question 16

2 major factors influencing body’s response to shock

Answer 16

Surface are affected

Depth of burn on

Question 17

Cardiovascular response to burn

Answer 17

Increased capillary permeability
Evaporate fluid
Vasodilation
Massive oedema associated with burns

Question 18

Hyper metabolism

Answer 18

Increased glycogenolysis

Provides energy for repair but affects metabolism

Patient may become tachycardic, tachypnoic, hyper pyrexic and hyperglycaemic

Question 19

Immune response to burns

Answer 19

Severely immunosupressed

Bacteria in gut can entree blood stream and lead to sepsis

Question 20

How to do cricoidthyroidotomy

Answer 20

45 degree towards feet attach tubing 1 second on 4 seconds off use biggest cannula and do not allow kink

Use to allow time or if no other choice

Question 21

Complications of cricoidthyroidotomy

Answer 21

Penetration of adjacent structures subcutaneous emphysema 
Swelling 
Severe bleeding 
Damage to larynx 
Injury to thyroid or parathyroid gland

Question 22

CO poisoning

Answer 22

Gas not visible
When incomplete combustion

Give oxygen on 100% as it binds to the haemoglobin

Will have nausea, headache

Question 23

Hydrogen cyanide poisoning

Answer 23

Not visible, almond smell
Plastic burning

Mild - nausea, dizziness, drowsiness, hyperventilation and anxiety

Moderate - reduced conscious level, vomiting, convulsions, hypotension

Severe - coma, fixed dilated pupils, cvs collapse, deep failure, cyanosis

Give 100% O2 regardless of sats

Question 24

Smoke inhalation

Answer 24

May have airway burns

Treat with salbutamol