Burns Flashcards
what is the most common type of burn?
thermal burns
what are the chemical compounds in acids that cause burns?
hydrochloric, sulphuric and hydrofluoric acids
what are the chemical compounds in alkalis that cause burns?
hydroxide, ammonia and ammonia hydroxide
what are the different types of burn injury?
1) chemical burns
2) smoke and inhalation injury
3) electric burns
define smoke and inhalation injury
breathing noxious chemicals or hot air causes damage to tissues of respiratory tract
what is a major predictor of mortality in burn patients?
smoke inhalation
what are the 3 types of smoke and inhalation injury?
1) carbon monoxide poisoning
2) inhalation injury above the glottis
- thermally produces
- total airway obstruction
3) inhalation injury below the glottis
- chemically produced
- lower airway injury
what is the major cause of deaths at fire scenes?
caused by CO and asphyxiation
what is the most severe type of burn?
electric
define electric burn
intense heat generated from an electric current
why system do burns destroy?
integumentary system
what are the 3 layers of skin?
1) epidermis
2) dermis
3) subcutaneous tissue
what are burns defined by?
1) partial thickness
- epidermal and dermal injuries
- some skin elements viable for regeneration
2) full thickness
- destruction of all skin elements and subcutaneous tissues
- muscles, tendons and bones
what are the 2 categories of partial thickness skin destruction?
1) superficial (1st degree) : erythema and blanching. Skin may peel or blister. This is an epidermal burn. tactile and pain sensation is intact
2) deep (2nd degree burn) : fluid filled vesicles that are red and shiny and wet if the vesicle pops. mild to moderate edema
- epidermis and dermis involved. epithet regeneration remains viable
what are the 2 categories of full thickness skin destruction?
3rd and 4th degree burns: dry waxy white hard skin. insensitive to pain because of nerve damage as well as muscles and bones
- surgical intervention advisable for healing
which chart is used to show which percentage of body is burned and is more accurate to pt’s age to body size area?
adult lund-browder chart.
which chart is used for initial assessment to percentage of burns covered?
adult rule of nines
what does burns on the face, neck, trunk and back result in?
mechanical obstruction secondary to edema (respiratory obstruction)
what does burns to hands, feet, joint and eyes result in?
difficulty with self care and daily life functions
what are burns to the ears nose, butt and perineum susceptible to?
infections
what are burns to extremities result in?
circulatory compromise and possible euro impairment
what are the phases of burn management?
1) prehospital care phase
2) emergent phase
3) Acute phase
4) Rehabilitative phase
define the prehospital care phase
- taking the person away from the source of the fire but rescuers must also protect themselves
- if burn is small cooling in a minute interval can help not make the burn go deeper. but if burn is larger, CAB is priority
- never immerse in cold water because it can lead to heat loss aka vasoconstriction
define the emergent phase
this is the phase where you need to resolve any life threatening conditions
- primary concerns are onset hypovolemic shock and edema
- phase ends with fluid mobilization and diuresis begin
- dynamic ileus: no or diminished bowel sounds
what is the greatest concern for fluid and electrolyte shifts during the emergent phase?
hypovolemic shock; massive shifts of fluid out of the blood vessels which increases capillary permeability
what happens to insensible loss?
normally is is 30-50mL but with burns it increases significantly
what pressure decreases in the emergent phase?
colloid osmotic pressure resulting in fluid to shift to intravascular depletion resulting in edema and increase BP
how is sodium and potassium and album affected in emergent phase?
sodium shifts to interstitial spaces until edema subsides
sodium decrease, album decrease, potassium increase
how much fluid therapy for burns?
2 large bags
define acute phase
1) begins with the mobilization of extracellular subsequent diuresis
2) concluded when the burned area is completely covered by skin grafts or when the wound heals
when does healing begin in acute phase?
when WBC surround the burn wound and phagocytosis occurs
- granulation tissue forms
how do partial thickness and full thickness burns heal in the acute phase?
partial thickness heals from edges
full-thickness burns heals from skin grafts
what do partial thickness burns form?
eschar and it will need to be removed then re-epithalization will occur
what do full thickness burns require to heal?
debriment and skin grafting
what is a complication of the acute phase?
insulin increase = hyperglycaemia = high blood glucose because of the high metabolic demand
define the rehabilitative phase
begins when burn wound start to heal and when the client is able to resume a level of self care activity
what is the common complication in the rehabilitative stage?
skin and joint contractures
what are some pathophysiological changes in the rehab phase?
- burn wounds either heal by primary intention or grafting
- layers of epithelialization begin to rebuild
- collagen fibres add strength to weakened areas
what creams are to be used?
an emollient water based cream
