burns Flashcards
broadly what are the causes of burns ?
thermal
electric
chemical
radiation
what are skin burns divided into ?
superficial thickness
partial thickness
full thickness
what is an example of a first degree burn ?
sunburn , involves the epidermis
when does scarring begin to happen in burns ?
in second degree deep dermal
what is the extent of a burn ?
percent of burnt skin surface area in relation to the whole body surface area
what are the three distinct zones of trauma associated with thermal injury ?
zone of coagulation
zone of stasis
zone of hyperemia
what are the haematological changes associated with burn ?
leukocytosis and neutrophilia
anemia and coagulation
when does the subacute phase take place?
48-72 hrs
when does permeability of cells normalize ?
48 hrs
what happens in the subacute phase ?
SIRS happens
thee hypermetabolic response
what effect do burns have on the thyroid gland ?
cause hypothyroidism
what is the body’s response to the hyper-metabolic response ?
hyperdynamic state ensues
what are the causative organisms in cases of infected burns ?
earlier on - strep pyogens
later - pseudomonas aeeriguinosa
what is the leading cause of mortality in burns ?
acute phase - renal failure
subacte phase - sepsis and MODS
what type of chemical burn is worse ?
alkalis are worse no coagulation process
what is the initial management of chemical burns ?
strip the patient of all their clothes and irrigate the area - shower the patient
what can be seen on a patient as a sign off inhalation injury ?
blackening around the nasal or oral cavities
what is the initial management of inhalation injury ?
- Administer humidified air by mask
- Antibiotics
early elective intubation
what is Wallace’s rule of 9 ?
each limb is 9%
head and neck is 9%
each limb is 18%.
torso front is 18% and back is 18%
what is the most accurate chart for the assessment of TBSA ?
lund and browder
burn with capillary filling ?
superrficcial burn
burn that does not blanch but has some sensation ?
deep partial thickness
burn that feels leathery and has no sensation ?
full thickness
what is the parkland formula ?
4ml per kg per 1% of BSA of hartmanns solution
half the expected amount is given over 8 hours the rest over 16 hours
what is thee maintenance fluid for children ?
below 10 kgs give 4ml/kg/hr
10-20 kg give 2ml/kg/hr
above 20 give 1ml
what is the most widely accepted topical treatment for wounds ?
silver sulfadiazine
when should grafting be performed ?
within 5 days of injurry
what is the best covering for excised areas ?
autograft split skin from unburnt areas