Burns

Question 1

4 types of burns

Answer 1

Thermal, Radiation, chemical, and electrical

Question 2

Definition of superficial (1st degree burn)

Answer 2

Limited to epidermis, appears red or gray, cap refill preserved and not initially blistered

Question 3

Definition of Partial thickness (2nd degree) burns

Answer 3

Involves dermis, can be superficial or deep
Superficial: blistered pink wet, heals in 1-2 weeks minimal scarring
Deep: >2 weeks to heal, significant scarring, white, wet, bleed. Cutaneous sensation maintained

Question 4

Definition of full thickness (3rd degree) burns

Answer 4

Dermis and fat
Loss of adnexal structures
White/yellow, black/charred appearance
Stiff dry skin does not bleed cutaneous sensation is lost

Question 5

Risk factors for severe systemic complications from burns

Answer 5

Partial/full thickness, >40% TBSA burned
>60 yrs old or <2 yrs old
Presence of simultaneous major trauma or smoke inhalation

Question 6

Most common systemic complications from burns

Answer 6

Hypovolemia
Infection (typically strep and staph)
Hypoalbuminemia
Metabolic acidosis
Low electrolytes
Rhabdo
Hypothermia
Ileus

Question 7

Burn tx plan

Answer 7

Initial: remove offending source, washout wound
Partial and full thickness will need debridement
LR (4mls/kg) x TBSA % = fluid replacement over 24 hours
First 1/2 of amount over first 8 hours, the rest can be administered over the subsequent 16 hours