burns

Question 1

what are the different types of burn injuries

Answer 1

1. Scalds- most common, full thickness burn, heat can be retained due to clothes
2. Flash and flame- if clothes involved can lead to deeper burn
3. Contact- touching anything really hot or cold
4. Electrical- can cause severe muscle, cardiac, skin damage
5. Chemical- acids or special chemicals
6. Radiation- explosion of gas etc, sunburn, clothes protect skin with this injury

Question 2

tissue involvement in skin burns

Answer 2

1. superficial burn- epidermis, nerve endings exposed, very painful, 7-10 days healing
2. partial thickness burn-
   - superficial partial thickness- top of dermis
   - deep dermal- deeper layers of dermis, hair follicles, sweat glands possibly involved, may require skin grafting, very painful
3. full thickness burn- hypodermis, through nerve endings (no pain), blood vessels coagulated, very long healing time, significant scarring

Question 3

local effects of burns

Answer 3

• pain
• vasodilation
• increased capillary permeability
• loss of fluid and electrolytes
• loss of heat
• loss of protective skin barrier

Question 4

management of burns- fluid resuscitation

Answer 4

• resuscitation time calculated from time of burn injury and burn extent
• fluid resuscitation adequacy: measured by urine output
• lactated ringers is the fluid of choice

Question 5

what is burn depth decided by

Answer 5

colour, surface, capillary refill, sensation, hairs present, healing time

Question 6

burn injury management

Answer 6

• analgesia
• antibiotics
• blisters- pop the blister and deb-ride it, beware of red rings
• burn dressings- absorb exudate, prevent infection, reduce pain

Question 7

what are the 3 determinants of mortality for a burn injury

Answer 7

1. extent of burn injury
2. patient age
3. burn wound depth

Question 8

what are systemic effects of burns

Answer 8

• insulin suppression
• bone marrow suppression
• hypovolaemia
• stress ulceration
• collagen fibre denaturing