Burns Flashcards
(25 cards)
Parkland Fluid Resucitation
4cckg body weightPercentBodySurfaceAreaBurned
Give half in first 8 hours post burn (no matter when the patient arrives), then give the other half during the next 16 hours (post first 8 hours)
**Add 25% for inhalation injury
Why do we give IVF to burn patients?
3 zones: zone of coagulation, zone of stasis, zone of hyperemia. IVF pushes the ZOS into ZOH, thereby decreasing the ZOC (i.e. lessening the amout of burn).
Best measurement of resuscitation?
urine output.
TBSA + age ~= ???
Mortality
1st degree burn
Sunburn, erythema, swelling
2nd degree burn
into dermis, really painful, blisters
What do we do with blisters?
CLEAR them (aka pop them). why? b/o a high conc. of inflamm mediators leading to greater damage. If HEMORRHAGIC (blood) blisters… leave them alone, b/c they are protecting deeper tissue structures.
3rd degree burn
painless, penetrates into subcutaneous, need grafting
4th degree burn
penetrates deep, muscle, bone, organ, life-threatening
What is the side effect of silvadene?
If sulfa allergy… abx ointment. Neutropenia common complication (reverses in a few days)
What is Mafenide acetate (Sulfamylon)? Complications?
penetrates eschar & painful. accentuates post-burn hyperventil. Complication = carbonic anhydrase inhibitor (causes metabolic acidosis)
What is the treatment side effect of silver nitrate?
Leaches Na+. K+, Ca2+, Cl- (so hypocalcemia, hyponatremia, hypocloremia)
Are antibiotics necessary in the initial 24-72 hours post burn?
NO!
If a burn is bad and goes all they way around the body or body part, what procedure could help releave the pressure on the underlying tissue?
Escharotomy–cut skin to releave pressure.
What is unique about IVF and electrical burns?
IVF to keep urine output >100cc/hr (tea color common). Use a lot more IVF!
1st degree frostbite
erythema
2nd degree frostbite
blisters
3rd degree frostbite
full thickness into subcutaneous tissue. Usually see tissue loss.
4th degree frostbite
gangrene
What is the rapid rewarm temp of H2O use in Tx of frostbite?
104 degree F or 40 C
What do you not want to do with frostbite?
debride, massage, burn (in rewarm), amputate. Take your time!
What injury do acids cause?
coagulation necrosis
How do you treat hydrofluoric acid chemical injury?
v. painful. 5% CaGluconate and Mg2+ topical, subcutaneous, and intra arterial until the pain stops and stays away.
What type of chemical injury does alkalis or bases cause?
Liquefaction necrosis. penetrates deeper, lasts longer. Tx; flush with H2O even longer. Do not neutralize.
