Burns Flashcards
What are the 5 types of burns?
- Thermal
- Chemical
- Smoke Inhalation Injury
- Electrical
- Cold thermal
What are thermal burns?
Burns that are caused by flame, flash, scald, or contact with hot objects
MOST COMMON
What are chemical burns?
Result from tissue injury and destruction from necrotizing substances(acid)
- immediately take out contacts and take off clothes containing chemicals
What is smoke inhalation injury?
Airway injuries resulting from inhalation of hot air or noxious chemicals that needed to be treated as soon as possible
What are three types of smoke inhalation injury?
- Carbon monoxide poisoning
- inhalation injury above the glottis
- inhalation injury below the glottis
What is the signs and symptoms of carbon monoxide poisoning?
Cherry red skin, headache, dizziness, nausea, breathlessness, collapse, loss of consciousness
What is the signs and symptoms of inhalation injury below the glottis?
Manifests as acute respiratory syndrome
- injury depends on length of exposure to smoke or toxic fumes
- causes inflamed airways with pulmonary edema
What is the signs and symptoms of inhalation injury above the glottis?
True medical emergency caused by hot air, smoke, or steam
- facial burns, singed nasal hair , hoarseness, painful swallowing, darkened oral membranes
What are electrical burns?
result form coagulation necrosis caused by intense heat generated from an electrical current. Can potentially cause spine injuries, death, and/or direct damage to nerves and vessels
What are Cold thermal injuries?
frostbite
What is a superficial partial thickness burn?
1st degree burn that involves the epidermis, reddened skin, and pain at injured site
example: sunburn
What is a deep partial thickness burn?
2nd degree burn that involves the epidermis, dermis, intense pain, and white/reddish skin with blisters
example: burn from the stove
What is a full thickness burn?
3rd degree burn that involves epidermis, dermis, fat, muscle, and bone with little to no pain
example: fire
What are the two methods that estimate total body surface area burned?
Lund-Browder Chart and Rule of Nines
What are the four phases of a burn injury?
- prehospital care
- emergent (resuscitation)
- acute (wound healing)
- rehabilitative (restorative)
What is prehospital care?
Removes the person from the source of the burn and stop the process. First stage of a burn injury.
Electrical: you remove pt from contact of source Chemical: you brush solid particle off skin
Small thermal burn: Cover with cool, damp towel
large thermal burn: Watch ABC, do not put body in cool water, will CAUSE shock. remove clothing and wrap in dry sheet
Inhalation injury: observe for signs of respiratory distress and treat quickly
What is the emergent phase? Primary concerns?
Second phase of a burn injury.
-Period of time required to resolve the immediate problems resulting from burn injury lasting up to 72 hrs
- includes respiratory, cardiovascular systems, wound care, drug therapy, nutritional therapy
PRIMARY CONCERNS: hypovolemic shock and edema
What happens during hypovolemic shock?
massive shift of fluid out of the blood vessels as a result of increased capillary permeability causing a decrease in osmotic pressure. Blood goes to important organs(brain and heart)
What is the normal insensible loss of body fluid per hour?
50 ml/ hr
sweating, breathing
What is the severely burned patient loss of body fluid per hour?
200-400ml/hr
What is the complications in the respiratory system in the emergent phase?
The main concern is airway management.
complications: upper respiratory tract injury, direct insult at the alveolar level, pneumonia, pulmonary edema
What is the complications in the cardiovascular system in the emergent phase?
Blood goes to the two most important parts of the body: Brain and heart
complications: arrhythmias, edema, necrosis, ischemia
What is the complications in the urinary system in the emergent phase?
Decrease blood flow to kidneys causes renal ischema
complications: acute tubular necrosis
What consists of wound care in the emergent phase?
should be delayed until a patient airway, adequate circulation, and adequate fluid replacement have been established
cleansing: done in hydrotherapy tub, cart shower, shower, or bed
debridement: done in OR and loose necrotic skin is removed
How long can can someone stay in an immersion tank? Why?
20-30 minutes. Any longer can lead to cross contamination of wounds
What is the most important measure to be done as soon as the burn patient is able?
range of motion. Must move or it can lead to contractures
What immunization is given routinely to all burn patients?
tetanus
What consists of nutritional therapy in the emergent phase?
- When bowel sounds return, the patient may eat.
- 5000kcal/day
- supplements, fluid replacement as needed
What is the acute phase in a burn injury?
- Begin with mobilization of extracellular fluid and subsequent diuresis
- Concluded when the burn area is completely covered by skin grafts or when the wounds are healed
- Necrotic tissue begins to slough, formation of granulation tissue
- watch for infections
How do you prevent curling ulcers?
Feed right when there is bowel sounds
What are the three types of excision and grafting in the acute phase?
- eschar
- removed from subcutaneous tissue or fascia - cultured epithelial autographs (CEA)
- grown skin from biopsies obtained from patients own skin - Artificial Skin
- For life threatening full thickness pr deep partial thickness wounds where conventional autografts is not available or advisable
With smoke inhalation injuries, what would you look for when the pt comes to the hospital?
Swelling, singed nasal hairs, horse voice
How do you prevent contractors in a burn patient?
Move as soon as possible and as much as possible. Keep up with ROM
If a pt has swelling from burns, what do you do?
Elevate limbs
What are the priorities when it comes to burns?
oxygen and airway
How would a burn patient receive medication?
Iv route
