Burns Flashcards
Carbon Monoxide poisoning
Most frequent cause of death at burn scene
- Has greater affinity for hemoglobin than oxygen
- Binds as carboxyhemoglobin
- Prevents RBCs from transporting oxygen to tissues
- PaO2 and SaO2 levels are normal
- Must measure COHgb levels ( > 60 % - death )
Rule of nines
- Head ( ant + post ) - 9 %
- Ant torso - 18 %
- Post torso - 18 %
- Leg ( ant + post ) - 18 %
- Arm ( ant + post ) - 9 %
- Genitalia - 1%
Involves epidermis, pink and red in color, blanches with pressure, mild edema, painful, heals - 3-5 days
E: sunburn
Superficial burn
Involves epidermis + possibly part of the dermis, pink or red, blisters , mild to moderate edema, heals - 2 weeks
E: scald burn with brief contact
Superficial Partial Thickness burn
Red or white, moderate edema, painful, soft dry eschar ; heals - 2-6 weeks - graft can be used .
E: scald, grease burn with prolonged contact
Deep Partial Thickness burn
Black, brown, - leathery appearance; severe edema, may or may not be painful, eschar is hard and inelastic; heals - weeks to months - possible loss of function and digits - graft required
E: prolonged exposure to source
Full Thickness burn
Parkland formula
4 ml x weight (kg) x TBSA (%)
1/2 of the volume over first 8 hours ( begins at the time of the burn )
1/2 over remaining 16 hrs
Bactericidal agent; little eschar penetration; transient leukopenia within 2-3 days
Silver Sulfadiazine (Silvadene)
Bacteriostatic, fungicidal; zero penetration of eschar ; turns everything black; hypotonic - Na and K depletion
Silver Nitrate
Hydrophilic based cream ; effective aginst gram +/- organisms; rapid diffusion eschar; causing burning pain for 20 min after application - Medicate !! can cause electrolyte imbalances - metabolic acidosis, respiratory alkalosis (monitor ABGs)
Mafenide Acetare ( Sulfamylon)
Homograft/Allograft
from another human (cadaver)
Heterograft/Xenograft
from an species - pigskin
Autograft
from another part of your own body
Cardiac dysrhythmias are often evident in … burns
electrical
Electrocuted patient - red/burgundy color urine - why ?
release of myoglobin from damaged muscles
