Burns

Question 1

are partial or 1st degree burns included in BSA calculation

Answer 1

no

Question 2

most common cause of death in ped burn pt

Answer 2

1. sepsis (drug resistant organisms)

2. resp failure

Question 3

phases of burn injury

Answer 3

early - up to 48hrs
hypovolemia
vascular response
cardiac function change

cap leak

comp syndrome (circumferential burns, fluid leaks)

hyper-metabolic state 3d-2yrs

risk of infection 1wk onwards

Question 4

fluid in ped burn management

Answer 4

**start at time zero
Parkland + 75% of maintanance (due to risk of hypoglycemia) **always subtract initial resus fluids

(patient weight) x (% TBSA) x (3 mL/Kg/%TBSA) = Total resuscitation fluid in first 24 hours after injury

50% of total resuscitation volume given in first 8 hours after injury _________ mL in 24 hours / 2 = _____________ mL in first 8 hours after injury

Adjust for pre-calculation fluid administration _______ mL in first 8 hours - _________ mL resuscitation fluid already administered = ________ mL remaining for first 8 hours after injury

Question 5

how to avoid under/over fluid resus

Answer 5

Urine output

0.5-1 ml/kg/hr output

avoid boluses

Question 6

phases of analgesia + sedation of burns

Answer 6

maintanance

MS- 5-40mcg/kg/hr, 100mcg/kg bolus Q 15 PRN

break through

ket- 1mcg/kg/min

procedural

fent- 3-5 mcg/kg