Burns Flashcards

1
Q

How to prevent burns?

A
  • Working smoke detectors and carbon monoxide detectors monoxide detectors
  • Create emergency plan escape plan
  • never leave cooking food or open flames unattended.
  • Install childproof devices.
  • Never leave young children unattended.
  • Check electrical cords for damage.
  • Keep fire extinguishers and practice stop, drop and roll.
    -Set home water heater to 120 degrees.
  • Wear protective clothing, use sunscreen, avoid tanning beds,
  • Do not smoke or have flame in room with oxygen in use.
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2
Q

How to determine the depth of thermal burns?

A

-The temperature the skin is heated to.
- The duration of contact with the heat source.

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3
Q

What are thermal burns?

A

Fire, Steam, scald, hot objects or liquids.

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4
Q

What are electrical burns?

A

Contact with lighting or electrical energy sources.

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5
Q

What can electrical burn cause?

A

neurological problems
Cardiac arrest

Common causes: work related: powerlines and children from electrical cords or sockets.

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6
Q

What is chemical burn?

A

contact with industrial/household chemicals (acids, alkalis, organic compounds)
- gasoline
-hydrofluoric,
- drain cleaner
-oven cleaner -
-bleach

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7
Q

How to treat chemical burn?

A

Continuous irrigation with water.

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8
Q

Type of burns

A

Thermal
Electrical
Chemical
Radiation

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9
Q

What are radiation burns?

A

-Sun
-Tanning
- X-rays
-radiotherapy
-Nuclear accidents

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10
Q

What does a radiation burn look like?

A

Can look similar to thermal burns.
-erythema
-edema
-blisters
-pain

-Cause: NVD, HA, Fever and fatigue

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11
Q

describe Superficial

A

-epiderma layer
-heal within 3-7 days
-pink/red, pain
-Most commonly known as sunburns

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12
Q

describe superficial partial- thickness

A

-Epiderma layer

-Blister, pink/red, blanches.

  • heals within 1-2 weeks.
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13
Q

describe deep partial thickness

A
  • Demis layer:

blister, waxy, pink/cherry red, edema.
-no blanching, pain around edges, decrease sensation
- heal withing 3-6 weeks.
-may require surgical debridement or skin grafting.

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14
Q

describe full thickness.

A

Subcutaneous layer:

leathery, dry white/brown/tan/black eschar, no blanching, no pain.
- require surgical excision and grafting

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15
Q

Burn wound healing: inflammation phase

A

Begins immediately after injury, vasodilation, increase in capillary permeability

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16
Q

Care of minor burns

A
  • Cool compression or cool water
  • provide analgesic
  • use lotion in intact skin
  • cleanse with mild soap and tepid water
  • apply anti microbial agent to non-intact skin
  • Apply a dressing if clothing is irritating
  • drink plenty of fluid
  • reach to observer for infection
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17
Q

Burn wound healing: proliferation phase

A

2-3 days after burn, granulation tissue forms, epithelial cells cover wound

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18
Q

Burn wound healing: remodeling phase

A

May last for years, collagen fibers reorganize, scars contract, fade

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19
Q

Total body surface area: ( TBSA): underestimating?

A

Underestimate: means we don not give enough and the patient can go into shock and organ failure.

20
Q

Total body surface area: TBSA overestimating

A

We give too much they cannot tolerate and May develop pulmonary edema

21
Q

How to determine the survival?

A

Age and medical history are most important in determining survival because small burns can fatal to older adults

22
Q

Age and medical history are most important in determining?

A

Survival, small burns can be fatal to older adults.

23
Q

Severity of a burn is determined by:

A
  • presence of inhalation
  • patient age
  • past medical history
  • presence of concomitant injury
  • anatomical location of burn injury
24
Q

Infants and children lifespan considerations.

A

Different developmental stages = different burn types

  • be alert to signs of child abuse when history does not match injury**
25
Q

Adolescent: lifespan Considerations

A

Forewarn about edema/ changes in child’s body from injury response

26
Q

Pregnant women: lifespan consideration

A

Complication treatment and threatens fetus

  • relationship between % of TBSA involved and fetal- maternal survival *
27
Q

Lifespan considerations: Older adults

A
  • Most burns accidentally
  • greatest risk of death
  • May not tolerate fluid resuscitation and surgery
  • skin less elastic and harder to heal
28
Q

Zone of coagulation

A

area with most contact with heat source and most severe damage, eschar often present, and no pain because all nerves destroyed.

29
Q

Zone of stasis

A
  • surrounds zone of coagulation.
  • damaged with impaired circulation.
  • most at risk area to become deeper and convert to zone of coagulation if fluid resuscitation is not adequate.
30
Q

Zone of hyperemia

A

outermost area with increase blood flow and usually more minimal and recovers in 1-2 weeks.

31
Q

Full extent and depth of a burn

A

is not known for 24-72 hours.

32
Q

functional changes

A
  • Long term morbidity
  • impaired function: burns to hands, feet, genitalia, perineum and major joints.
  • Altered appearance burns to face
  • May require multiple lifelong plastic and reconstructive surgeries to maintain function.
33
Q

Inhalation injury

A

Exposure to heat
asphyxiants
Smoke

  • May not occur for 24-48 hours after injury
  • Most common in patients that was injured/trapped in an enclosed space (car, house) or if they have face, neck or chest burns.
34
Q

Upper airway injury

A

-above the glottis
-Most Common
-involves nose, throat mouth.

35
Q

Lower airway injury

A

below the glottis
Most often chemical

36
Q

carbon monoxide poisoning

A

Carboxyhemoglobin level >10% with S&S

37
Q

Airway management

A

100& humidified O2
-cough/deep breathing
- Elevated HOB
- Endotracheal intubation

38
Q

S/S of inhalation injury

A
  • Facial burns
  • Signed nasal and facial hairs
  • Carbonaceous sputum (SOOT), hypersecretions
  • Naso- or Oropharynx erythema
  • Excessive agitation/anxiety (hypoxia)
  • Tachycardia -
    intercostal retractions -flaring nostrils
    -Inability to swallow
  • Hoarseness, grunting, brassy voice
    -Rales, Rhonchi, Diminished breath sounds
39
Q

S/S Carbon monoxide poisoning

A

-Mild headache and confusion
- Severe headache, flushing vision changes
- disorientation, nausea
- Irritability, dizziness, vomiting
_Tachypnea, tachycardia
- Coma, Seizure, death

40
Q

Two most concerning electrolytes during burn shock

A

Potassium and Sodium

41
Q

Burn shock is a combination of

A

distributive and hypovolemic shock

42
Q

Burn shock occurs from?

A

Massive fluid shift due to increased capillary permeability ( 8-36 hours)

43
Q

Explain pathophysiology of burn shock

A

Electrolytes, water, plasma, protein leak out into interstitial space called third spacing.

44
Q

Burn shock: W/o fluid resuscitation develop

A

hypotension
tachycardia
Decrease urine output.
AMS
Multi-organ failure

45
Q
A