Burns Flashcards
Burns
damage to tissues from heat, chemicals, smoke, electrical currents or coldness. Can cause fluid to leave vessels to go to the affected area, increasing capillary permeability, which then causes sodium, protein, water and plasma to deplete and move to the injury-causing edema and potentially hypovolemic shock
Thermal Burns
burn from the heat that is the most common type of burn
Smoke Inhalation
injection of hot air or noxious chemicals that causes damage to the resp tract, classified into above or below the glottis
Inhalation Above the Glottis
thermally produced that causes mucosal damage from smoke, steam or air where mechanical obstruction may occur
S&S of Inhalation Injuries
facial burns clothes burned singed nasal hair history of being trapped in a burning house or near burning hoarse throat painful swallowing redness around the face resp depression carbonaceous sputum smoky breath pulmonary edema can take 12-24h before symptoms full mature and show
Inhalation Below the Glottis
a most common cause of death with house fires and burns increased length of exposure where the fumes burn below the glottis that manifests as resp distress
Chemical Burn
burns from acidic and basic organic or inorganic compounds that cause burns and system toxicology
S&S of Chemical Burns
chemical still on the skin degeneration of exposed tissue localized pain edema of the surrounding tissue discolouration of the skin decreased muscle coordination resp distress paralysis
S&S of All Burns
redness edema of the affected tissues shivering/fever altered mental status possible necrosis and decreased cap refill dysrhythmia/cardiac arrest tissue ischemia blisters pain dynamic ileus impaired circulation decreased GFR
CO Poisoning
incomplete combustion of burning materials introduced into the system causes CO to displace O2 in the body, causing death, hypoxia, and impaired circulation. TX is O2 admin and may not appear from the outside to have burns
Electrical Burns
coagulation necrosis from the intense heat from an electrical current that may have direct damage to nerves and vessels, for tissue anorexia, current can pass through vital organs producing life-threatening squaleae
S&S of Electrical Burns
leathery, white or charred skin
entry and exit point for some burns
can burn clothing from sparks near the entry point
impaired touch sensations
if intense electrical current then can cause no pain with such severe nerve damage
head or neck injury
fractures or dislocation from the force of the electrical current
contact points having thermal burns
Cold Thermal Burns
coming into contact with such severe cold it damages the skin instantly, like frostbite
Complications of Burns
head and neck injury cardiac arrest dysrhythmia hypovolemic shock fluid replacement being too fast that it causes system edema kidney failure pneumonia physical disabilities and nerve damage diarrhea or constipation due to the system prioritizing things ulcer development
Classification of Burns
extent, location, depth and risk factors
Superficial Burns
1st degree, only the epidermis is affected where it is red, blanches on pressure, pain with mild swelling, no vesicles or blisters
Partial Thickness Burn
2nd degree, where it burns through the dermis and epidermis, blisters filled with fluid, red, shiny, mild to moderate swelling, and may cause nerve damage or epithelial healing compromisation
Full Thickness Burn
3rd and 4th degree. 3rd is everything but the bone burned and has nerve/muscle involvement. Dry, waxy and leathery texture to the burns with impaired circulation to the surrounding tissues, visible thrombosed vessels and insensitivity to pain bc nerves are shot
4th degree is even burning the bone and everything the 3rd degree has
Burn Management General
IV meds of antibiotics, fluids (lactated ringers if >15% BSA), and pain analgesics
tetanus vaccine
prevention of infection
dry dressings with little cling wrap for circulation
stabilizing spine
O2
monitoring input and output
wound care is delayed until circulation and fluid replacement therapy has occurred/starting
debridement to remove necrosis
Emergent Phase Burn Management
resuscitative care, solving the major complication, ABCs and prevention of further progression
Acute Care Burn Management
wound care, fluid replacement, exercise, grafting, pain management, physical and occupational therapy, nutritional therapy and psychosocial care
Hypovolemic Shock
a syndrome characterized by decreased blood flow decreased venous return, decreased stroke volume and CO, cellular O2 supply gone, decreased tissue perfusion, loss of intravascular fluid, and impaired cellular metabolism. Causes imbalance in O2 supply and demand, and the nutrients from the impaired circulation
Absolute Hypovolemic Shock
eternal loss of whole blood or loss of other bodily fluids
Relative Hypovolemic Shock
fluid shifts from internal bleeding or other massive vasodilation pooling of blood or fluids
Second and Third Spacing
fluid and sodium shifting into the interstitial space from increased permeability capillary with insensible loss of fluids
