Burns Flashcards
What are burns caused by?
The transfer of energy from heat to the body.
What are the layers of the skin
Epidermis
Dermis
Hypodermis
What are the 3 stages of burn injury
Zone of Necrosis
Zone of Stasis
Zone of Hyperaemia
What does the skin do?
Barrier to infection
Body temp regulation
Prevention of fluid loss
Why do we need to calculate the extent of burns?
Burns over 15% and 10% in children require fluid replacement.
20-30% are likely to cause mass inflammation meaning even greater importance of fluid replacement.
What do we do for burns first aid?
Safe approach Remove from flame. CABCDE Cool with running tepid water for 20 minutes, up to 3 hours from burning. Cool wet dressing can help, don't apply ice packs. Warm patient, be aware of hypothermia. Split cooling if needed Cling film in strips not wrapped Analgesia Elevate Burton limbs Remove jewelry, clothes if not adhered.
What should you consider with burns?
C- Assess for cat heam. Will not appear secondary to a burn due to fluid loss. May happen after IED etc.
A- check for airway burn Look for facial burns Hoarseness Strider Carbonaceous Singed facial hair Give 02 and sit up Diffinative airway required. OPAS, NPAs don't work. Evacuation immediately
B- look for circumferential chest burns
Need escoropth by surgeon
C- consider access, consider fluids to maintain radial pulse
D- assess AVPU/GCS consider hypoxia and systemic toxicity
E- full exposure and assess TBSA
Consider burns resuscitation fluids
Look for limb circumferential burns
Assess distal circulation.
What burn depths are there?
Superficial- Not included in % Affect epidermis Red Very painful No blisters Heals within 7 days Brisk cap refill
Partial thickness- Affect Dermis and epidermis Pale pink/ dark pink/blotchy red Blistering Some/all blisters may have broken Painful but may vary Cap refill varies on depth Heals within 2-3 weeks
Full thickness Extend through Dermis and into underlying areas Dry, leathery/white/black No blisters No pain besides at edges No cap refill Surgical intervention required.
How is TBSA estimated?
Serial halving devide into quarters Rule of 9s Head 9 Front 18 Back 18 Arms 9 Legs 18 Genitals 1
Hand method
(Patient hand)
Lund and border chart
What is the parkland formula?
4ml x weight in kgx TBSA, crystaloid
Half in first 8 hours from time of burn
Other half in remaining 16
Does not include other losses and maintenance.
What urine output should be expected from adequate fluid replacement?
0.5-1.0ml/kg/hr
What considerations should be taken for electrical burns.
SAFE approach
Underlying tissue damage may be more extensive than skin area visibly burned
Treat visible burns first as per first aid principle
Consider distal circulation in affected limbs
What considerations should be taken for chemical burns?
SAFE, PPE
Rove visible chemicals increase irrigation time.
Refer to CGO’s for guidance
Trest as thermal burn when decontaminated
Alkalis liquify tissues.
Acids coagulate and create s barrier to penetration.
What should be remember with phosphorus
Carefully remove contaminants
Keep area irrigated or apply soaked dressing.
How should casualties be traiged
T1 Over 25% TBSA
Inhalation injury
Escharotomy indicated
T2 over 15%
Needs IV fluids
Burns to special areas
T3 remainder
Chem and electrical T2 minimum.
