burns Flashcards
whats the most frequent age group to have burns
20-30
describe education on burn prevention
- high risk behaviors should be avoided (alcohol/drug abuse/smoking)
- smoke detectors/CO monitors/fire extinguishers
- keeo matches and lights out of reach of children
- avoid extension cords/electric cords under rugs
- home exit plan/drill
- community education
whats the leading cause of fire death in the US
smoking
hoe can age effect burn severity
young/old ppl have less fat tissue, more burn damage
describe first degree burns
- top layer of skin - epidermis
- common burns like sunburn
descrbe second degree burns
- epidermis and part of dermis
- blistering, edema, 2-3wks healing period
- permanent scarring/pigment change
- flash flame/scold, usually associated with cooking
describe third degree burns
- full thickness = epidermis, dermis, and subcutaneous
- fluid loss
- cell destruction, swelling
- white/leathery skin, eschar/slough
- long recovery, skin grafts
- some loss of movement and function
- not much pain r/t loss of nerve function
describe fourth degree burns
- full thickness with deep tissue/muscle/bone involved
- can occur from electrical shock
- high risk of shock
- skin turns black/charred
- amputation likely
what are some methods to determine the extent of body surface area affected by the burn
- rule of nines (commonly used in adults, good for field)
- lund and browder method (super specific)
- palmer method (size of pts hand and counts it as 1%)
describe burn injury
result of chemical injury or heat transfer from one site to another, causing tissue destruction
mechanisms of burns:
- heat
- chemicals
- radiation
- thermal
- inhalation
what are the three zones of a burn
- zone of coagulation
- zone of stasis
- zone of hyperemia
describe zone of coagulation
central area of burn
most damage, cells are dying here
describe zone of stasis
surrounding zone
tissue might live or might die
describe zone of hyperemia
outermost
tissue will probs fully recover
what are some clinical manifestations of burns
- CV alterations (decreased CO, hypovolemia, shock, increased vascular permeability, third spacing)
- fluid and electrolyte imbalance
- alterations in resps
- kidney alterations
- immunologic alterations
- thermoregulatory alterations
- GI alterations (digestion issues)
- pain responses
describe the prolonged hospital lengths of stay r/t burns
- multiple surgical interventions
- extensive pain control
- immobilization
- rehabilitation
- prolonged IV meds
- increased risk for morbidity and mortality
what are the three treatment phases of burns
- emergent/resuscitative phase
- acute/intermediate phase
- rehabilitation phase
describe on scene of emergent/resuscitative phase
- remove patient from source/stop burning process
- establish airway/supply oxygen
- insert large bore IV line
- cover wounds with clean dry cloth/gauze
- is chemical, irrigate wound continuously
what are the top priorities for the emergent/resuscitative phase
- prevention of shock
- prevention of resp distress
describe the duration of emergent/resuscitative phase
from onset of injury to completion of fluid resuscitation (0-48hrs)
what are priorities in the acute/intermediate phase
- wound care and closure (wound debridement and grafting)
- prevention or treatment of complications/infection
- nutritional support
- pain management
describe the duration of the acute/intermediate phase
from beginning of diuresis to near completion of wound closure
donor site for skin grafting should be kept…
clean, moist, and covered
usually take 2wks to heal
what are some priorities for the rehabilitation phase
- prevention and treatment of scars and contractures
- different types of rehabs
- functional and cosmetic reconstruction
- psychosocial counseling
