Burns Flashcards
Causes of burns
- Thermal
- Radiation
- Chemical
- Electrical
Cell damage occurs at temps >______F
113F (45C)
How do you get radiation burns?
UV light or non-solar
- Sunlight
- tanning beds
- XRs
- radiation trmnts
what can cause chemical burns?
- strong acids
- Strong bases (Alkalines like cement, lye, paint thinner, gas)
- can cause deep tissue necrosis that progresses several hrs after exposure
SS of impending airway obstruction
Stridor
Hoarseness
Respiratory distress, tachypnea, hyperpnea
Cough
SS of internal injury
- Tachycardia
- Oropharyngeal burns– These are important when identified; however, significant esophageal involvement may occur in the absence of oropharyngeal lesions
- Drooling
- Subcutaneous air
- Acute peritonitis– Abdominal guarding, rebound tenderness, and diminished bowel sounds
- Hematemesis
Consult ____ for chemical burns
MSDS and poison control
Complications of chemical burns
- Airway obstruction due to tissue edema
- Bowel perforation
- Fluid loss from vomiting, third spacing, GI bleeding
- Metabolic acidosis is acid is ingested
- Hypocalcemia if hydrogen fluoride (gasoline)
- Later: Strictures, fistulas, motility issues(hypo), GI CA
third spacing = pulling fluid from vasculature and putting it towards tissues needing help
Trmnt of chemical burns
Symptomatic Patients:
ABC
Emergent GI consult for EGD
Minimally symptomatic:
Can be D/C after 2-4 hrs observation, tolerating oral fluids, has normal labs, speech and mentation
What are electrical burns?
Burns at the cellular level due to electroporation of the cell membranes from a massive current of electrons.
High voltage, >1000V, will cause damage to deep tissue, especially conductive tissues such as muscles, nerves, and blood vessels.
Look for source and ground points, may have both
Severity of electrical burns depends on
Type of current (direct [DC] or alternating [AC])
Voltage
Duration of exposure
Body resistance
Pathway of current (which determines the specific tissue damaged)
AC vs DC
AC travels in various directions (Alternating current)
DC travels in 1 direction (Direct current)
Is found in defibrillators/batteries
Often throws person off source, stronger, but shorter exposure
where is AC found?
Is found in plug ins
Lower voltage and causes muscle contraction, so it is difficult to pull away, lower voltage, longer exposure
AC traveling through the heart for even 1 sec can cause VF
Arm to arm or to foot cross the heart
The following symp are most likely to occur from which type of burn?
* Muscular contractions
* Seizures
* Ventricular fibrillation
* Respiratory arrestdue to central nervous system (CNS) damage or muscle paralysis may occur.
* Cardiac arrest
Electrical burns
Burn WU
- ECG and cardiac enzymes if any potential for contact with heart
- UA for myoglobin
- CT/MRI for unconscious patients, due to possible other injuries