Burns Flashcards
Heat Burns depth is related to_____(3)
Contact temperature
Duration of contact
Thickness of skin
Heat burns usually involves what skin layers?
Usually involve epidermis and dermis
How are friction burns created?
Combo of mechanical disruption and heat generated by friction
How are electrical burns created? And what does it cause?
Electrical energy transformed to heat when current passes through body tissue
Disrupts membrane potential
Things that affect the severity of the electrical burns? (3)
Pathway of current
Resistance to current flow
Strength and duration of current flow
Electrical burns are more likely to cause______ issues than thermal burns
Cardiac
What can chemical burns cause?
alterations of the pH and cause the salt membranes to lose integrity and because of that destruction = metabolic processes are impeded.
What is the severity of the chemical burn related to?
Duration of exposure
Nature of agent
Acidic agents can cause what?
necrosis by coagulation
Basic agents can cause what?
necrosis by liquefacation
How is the severity of radiation burns influenced? (3)
dose and time of exposure
types of particles
Sunburns are what type of burn
radiation burns
How long does it take for burns to fully declare themselves?
24-48 hrs
What patient population are burns detrimental to?
Areas of thin skin and adults > 55 or kids < 5
Have deeper burns with less exposure/ intensity because of the thin skin
How are superficial burns manifested and what skin layers are involved?
Involving only the epidermis
Skin intact, red in color
Dry surface, no blisters
Painful, hypersensitive
How long does it take 1st degree burns to heal?
Heals in approximately
3–6 days
What burn is not counted in TBSA?
1st degree (superficial burns)
How are superficial partial Thickness burns manifested and what skin layers are involved?
Involves the epidermis and part of dermis
Mottled red color
Blisters or weeping
Very painful / nerve endings exposed
How long does it take of superficial partial thickness burns to heal?
Usually heals in 10 – 14 days
Minimal scarring
Deep partial thickness burns manifestation and skin layers involved?
Extends more deeply into the dermis
Decreased moisture
Pale in color
Absent or prolong blanching
How long does it take for Deep partial-thickness burns to heal? and what is usually required?
Healing in 21-28 days
Requires skin grafting
Why is there less moisture with deep partial thickness burns than superficial partial thickness burns?
Less pain is usually present in the deeper burn. Since the sweat glands have been destroyed, there is decreased moisture. This can also have consequences of temperature control when a graft is placed (i.e. the skin becomes hot but cannot sweat)
How are full thickness burns manifested and what skin layers are involved?
Full thickness (dermis is destroyed)
Translucent, dry, painless, charred
Non-blanching
What burns are included in burn surface calculations?
All 2nd and 3rd degree burns
escharotomy
done through escar/ burned tissue
cutting down through the escar
Fasciotomy
dont through tissue that has an injury but not a surface injury, cutting down through the fascia
Rule of 9s burn injuries adults
Adult;
Head 9%
Each arm 9%
Each leg 18%
Ant/Post trunk each 18%
Perineum 1%
Rule of 9s burn injuries peds
head and heck 21%
arms; 10%
back: 13%
abdomen; 13%
each leg; 13.5%
buttocks; 5%
genitals; 1%
Palmer method
PATIENTS palm Fingers together = 1%
What are the two conflicting properties that burns can cause
Hypovolemic shock and decreased perfusion
Loss of plasma from microvasculature into interstitium -> increased permeability
Patients with ________ TBSA develop burn shock and need IV resuscitation in an ICU
> 20%
Fluid losses are a function of _____ and _____
Fluid losses are a function of burn size and patient weight
Concerns for under resuscitating burns
↓ perfusion, burn shock, end organ failure
Concerns for over resuscitation burns
Abdominal compartment syndrome, pulmonary edema/ARDS
General metabolic response to trauma (burns)
Auto-cannibalism;
Loss of fat
Loss of lean body mass
Proteolysis
Gluconeogenesis
Lipolysis
Hypermetabolism;because of volume loss/ because of the pain
Insulin resistance
BSA ______ causes metabolic rate to double and can lead to________ (3)
40%
Cannibalism for months;
Immunodepression, recurrent infections, poor wound healing