Burns Flashcards

1
Q

Name 6 cardiovascular complications of burns

A
  • Increased capillary permeability (fluids-protein loses)
  • vasoconstriction
  • decreased myocardial contractility - TNFA
  • systemic hypotension, organ hypoperfusion
  • organ damage
  • sepsis- leading to multiple organ failure
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2
Q

Name 4 respiratory complications of burns

A
. Bronchoconstriction (histamine)
. Ards
• effects of inhalation injury
. Co toxicity
Pneumonitis
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3
Q

Name 3 metabolic complications of burns

A
• Increased metabolic rate, 3-4x normal
• catabolism (sepsis, non healing)
• disruption gut integrity (sepsis)
Renal failure
Curling ulcers
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4
Q

Name 2 immunologic complications of burns

A

• Down regulation of both humoral and cell mediated responses → immunosupression
• inflammation
Infection

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5
Q

State depth, sensation, heal time, and appearance of superficial thickness burns

A
  • Epidermis only
  • pink/red, dry, small blisters , non-blanching
  • Heal in 5-10 days without scar. Can give moisturizer
  • very painful
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6
Q

State depth, sensation, heal time, and appearance of superficial partial thickness burns

A
  • Superficial dermis
  • Red, blistering, wet,
  • extremely painful
  • heal in 3 weeks without need skin graft
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7
Q

Most serious complication acid Burns?

A

Coagulative necrosis

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8
Q

Most serious complication alkaline burns?

A

Liquefactive necrosis

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9
Q

State depth, sensation, heal time, and appearance of deep partial thickness burns

A

• Deep dermis
. Minimally painful
. Yellow, white, dry leathery, blanching (ischaemia) and Petechiae appearance
•Heal in 3-8 weeks with scarring. Always need skin graft

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10
Q

Name 3 occult complications of electrical injuries

A
  • Acute renal failure
  • cardiac arrhythmia
  • compartment syndrome
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11
Q

Classify the burn in picture 30

A

Superficial burn

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12
Q

Classify the burn in picture 31

A

Superficial partial thickness burn

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13
Q

Classify the burn in picture 32

A

See picture 33

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14
Q

Classify the burn in picture 34

A

Deep partial thickness burn

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15
Q

Classify the burn in picture 35

A

Full thickness

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16
Q

What is considered a minor burn in adults and children in terms of TBSA?

A

Adults <15%

Children <10%

17
Q

What is considered a moderate burn in adults and children in terms of TBSA?

A

Adults 15-25%

Children 10-15%

18
Q

What is considered a severe burn in adults and children in terms of TBSA?

A

Adults > 25%

Children > 15%

19
Q

Describe the rule of nines for burns

A

See picture 36

20
Q

Name 7 criteria for admission for burns

A
  • Severe and moderate burns
  • facial
  • hands
  • genitals
  • electrical
  • chemical
  • inhalation
  • extremes of age
  • Full thickness
  • circumferential burns
21
Q

Which surgical procedure should be done after burns to enable chest expansion?

A

Escarotomy

22
Q

Definitive management of burns (2)

A
  • Sloughectomy and temporary wound coverage

* skin graft once wound granulated

23
Q

Name the 3 local effects of burns

A

• Coagulation - worsen hyperaemia (inflamm)
• stasis -worsen both
. Hyperaemia - worsen coag

24
Q

Treatment Co toxicity?

A

High concentration oxygen

25
Q

Appropriate way to position shoulder joint following burn injury?

A

Abduction

26
Q

Appropriate way to position mp joint following burn injury?

A

Flexion

27
Q

Appropriate way to position neck joint following burn injury?

A

Extension

28
Q

Appropriate way to position wrist joint following burn injury?

A

Extension

29
Q

Appropriate way to position thumb joint following burn injury?

A

Abduction

30
Q

Which 2 signs are most indicative of inhalation burns?

A

Stridor and sternal retraction during ventilation

31
Q

Which type electrical burns have best prognoses?

A

Flash burns

32
Q

Treatment electrical burns?

A
  • Initial debridement
  • decompression fasciotomy
  • aggressive planned debridement and early skin coverage
33
Q

Name 3 late complications electrical injuries

A
  • Delayed cardiac arrhythmia - uncommon
  • complex regional pain syndrome
  • cataracts
34
Q

Management burns? (3)

A

• atls
- airway; if inhalation burn suspected, intubate. Progressive swelling may occur and make intubation difficult.
- breathing: escharotomy to enable chest expansion
-Circulation: parkland formula
. Definitive = sloughectomy and temporary wound coverage.
• skin graft once wound granulated

35
Q

Describe the parkland formula for burns.

A

•4ml x % TBSA according to rule of nines x body mass
• 50% in first 8 hours from time of burn. So if present late, give all fluid
• 50% in last 16 hours
Isotonic ringers lactate = fluid of choice. (do blood gas to confirm no hyperkaelemia - in that case saline)

36
Q

Physiology and complications of burns? (5)

A

• Direct coagulation of microvasculature with extension of injury
• large area skin exposed with secondary infection and activation vasoactive substance → systemic inflammatory response.
• this causes capillary permeability with leakage fluids and interstitial oedema.
• cardiac output reduced and low metabolic rate.
. After full resuscitation, hyper metabolism and increased cardiac output. Here nutritional support should be considered (initially diabetic diet, then high protein. Nb vitamin c)

37
Q

Name 5 signs inhalation burns

A
  • Singing nasal hair and eyebrows
  • carbonaceous sputum
  • closed environment
  • burns to face
  • voice change- hoarse