Burns Flashcards
What are some signs and symptoms of an airway burn?
- evidence of burns to upper torso, neck and face
- facial and upper airway oedema
- sooty sputum
- burns that occurred in an enclosed space
- singed facial hair (nasal, eyebrows, eyelashes, beards)
- respiratory distress (Dyspnoea +/- wheeze and associated tachycardia, stridor)
- hypoxia (restlessness, irritability, cyanosis, decreased GCS)
What are intubated burns patients at risk of?
hypothermia. Once a long term paralytic is administered, temperature management becomes a more significant priority
If a patient has a burn and requires fluid for another reason which guideline do you follow?
volume replacement is calculated for the burn injury only. Manage other injuries accordingly including the requirement for additional fluid
what are patients with electrical burns at risk of?
acute kidney injury secondary to profound muscle damage, they may require extra fluid
Can you use the treat and refer guideline for a burn?
only if the burn is small, isolated, superficial burn with unbroken skin or sunburn
what is the time critical trauma criteria for burns? where should they be transported? and in what time frame?
- >20% TBSA
- >10% TBSA (<15 years old)
- suspected airway burns
- >1000 volt electrical burns
- Alfred/RCH
- <60mins
Burns in what area of the body require assessment by a major burns service?
- burns involving the face, hands, feed, genitalia, major joints or circumferential burns of the chest or limbs
What is the best way to cool a burn?
- with cool running water between 5-15 degrees for 20 mins
When do you stop cooling a burn?
- if the patient begins shivering or has a temp <35 degrees
How do you cool a burn if running water is not available?
cooling can be achieved by immersing the injury in still water, using a spray bottle or applying moist towels
how long should a chemical burn be irrigated?
For along as the pain persists. avoid washing chemicals onto unaffected areas, especially eyes
can you removed burnt clothing, or clothing with chemicals or hot liquid on it?
Remove burnt clothing or clothing containing chemicals or hot liquid when safe to do so. Do not remove any matter that is adhered to underlying tissue. Remove jewellery prior to swelling occuring
how do you minimise swelling?
if clinically appropriate, elevation of the affected area during transport will minimise swelling and oedema, especially in circumferential burns
Can you use cling wrap on a burn?
Cling wrap is an appropriate burns dressing and is preferred for all burns. It should be applied longitudinally to allow for swelling
What is the breakdown of the Wallace rule of nines?
- Head 9%
- Torso 18% (abdo and chest) and 18% back
- Arm 9% in total cirumference (each)
- Leg 18% in total circumference (each)
- groin 1%
Recite the Burns CPG
What is the Jackson Burn Wound Model?
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Zone of hyperaemia
- This area is hyper-perfused and will recover if there are no complications (superficial/1st degree)
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Zone of Stasis
- Tissue directly surrounding the burn that is hypo-perfused. This may be salvageable with appropriate treatment (partial thickness)
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Zone of coagulation
- Irreversible damage to cell and coagulation of proteins (full thickness)
