Burns

Question 1

about how many people are treated for burns each year?
what is the number one cause of burns?

Answer 1

> 486,000
main cause: flames

Question 2

which gender are burns more common in? what is the most frequent age range?

Answer 2

more common in men
age range: 20-30

Question 3

what is the leading cause of fire death in the US?

Answer 3

smoking

Question 4

describe a first degree burn
- which layer of skin is damaged?
- give an example

Answer 4

top layer of skin (epidermis)
EX: sunburn, curling iron, or stove

Question 5

describe a second degree burn
- which layer(s) of skin are damaged?
- give an example

Answer 5

epidermis & part of the dermis
EX: boiling water splash w stove, scold

Question 6

describe a third degree burn
- which layer(s) of skin are damaged?
- give an example

Answer 6

full thickness (epidermis, dermis, subcutaneous tissue)
EX: flame, hot liquids, chemicals

Question 7

describe a fourth degree burn
- which layer(s) of skin are damaged?
- give an example

Answer 7

full thickness (epidermis, dermis, subcutaneous, deep muscle & bone tissue involved as well)
EX: electrical shocks

Question 8

describe the rule of Nines

Answer 8

most common use in adults & EMS; breaks up body parts into nine percentage points of what was burnt

Question 9

describe the lund & browder method

Answer 9

more specific; most seen in hospitals when burn patients are being evaluated; has specific percentages

Question 10

describe the palmer method

Answer 10

size of the patient’s palm & says it’s 1% of their body

Question 11

about how long does a second degree burn take to heal?

Answer 11

about 2-3 weeks; can leave permanent scarring or pigment change

Question 12

is a third degree burn painful?
what does it look like?
describe the recovery phase

Answer 12

not much pain due to burn to nerves, fluid loss, & cell destruction
white & leathery looking; lots of swelling
long recovery: eschar tissue (involves a lot of dressing changes) & skin grafts
loss of movement & function

Question 13

what do fourth degree burns look like?
what is the patient at high risk for?

Answer 13

exposed tendons seen; lots of tissue destruction, skin is black & charred (amputation is likely)
- patient at high risk of shock

Question 14

describe the zone of coagulation

Answer 14

central area of burn
- cells are dying
- most damage has happened

Question 15

describe the zone of stasis

Answer 15

surrounding zone of burn
- tissue may live or may die
- cells are injured

Question 16

describe the zone of hyperemia

Answer 16

outermost zone of burn
- tissue has least damage so is probably going to fully recover

Question 17

when is a patient considered at increased risk for morbidity & mortality w a burn?

Answer 17

> 40% of total body surface area is burned

Question 18

list & describe the priorities of the emergency / resuscitative phase

Answer 18

prevention of shock & respiratory distress*
detection & treatment of concomitant injuries & wound assessment & initial care

Question 19

list 5 on scene responsibilities in the emergent / resuscitative phase

Answer 19

1. remove patient from source / stop burning process
2. establish airway / supply oxygen
3. insert large bore IV line
4. cover wounds w dry cloth / gauze
5. if chemical, irrigate wound continuously

Question 20

describe the duration of the emergent / resuscitative phase
how long is it?

Answer 20

from onset of injury to completion of fluid resuscitation (0-48 hours)

Question 21

list 2 priorities of the acute / intermediate phase

Answer 21

1. *wound care & closure
   - wound debridement
   - wound grafting
2. *prevention or treatment of complications / infection
   - nutritional support
   - pain management

Question 22

describe the duration of the acute / intermediate phase

Answer 22

from beginning of diuresis to near completion of wound closure

Question 23

how must the donor site be taken care of when a skin graft is done? how long does it take to heal?

Answer 23

clear dressing; takes a couple weeks to heal

Question 24

when should you not take skin from a graft site?

Answer 24

when it’s flexible