Burns Flashcards
epidermis
Define
- Outermost layer of the skin
Dermis
Define
- Second layer of the skin that contains capillary beds and sensory structures
Subcutaneous
Define
- 3rd layer of the skin with all the fatty connective tissue and larger blood vessels
BSA
Define this accronym
Body surface area
Burn shock
Define
- Results from extensive vascular bed damage that allows both fluid and protein molecules in the plasma to leak into surrounding tissue
- this causes extensive swelling
you find a newly burned pt with hypoperfusion. what are you considering FIRST to be the cause of this?
- consider direct blood loss from from an associated external or internal hemorrhage since edema from a partial or full thickness burn doesnt develop for a few hours, fluid loss is not our immediate concern
Laryngeal edema
Define
- Swelling of the larynx fron inhalation of superheated air
eschar
Define
- Tough leathery burned skin seen in a full thickness burn
Common lung sound from inhalation burns
Stridor
Cyanide
What is its action when inhaled into the body
- Interferes with the ability of the cells to use oxygen
Carbon minoxide
What is its action when inhaled into the body
Binds with hemoglobin and imapirs the ability of the blood to deliver oxygen to the cells
ARDS
Whats that stand for?
Acute respiratory distress syndrome
How can burns affect the kidney function?
- Decreased blood flow from fluid loss (caused by the burn) can decrease the blood flow to the kidneys
- Burn injuries causes waste products to form in the blood becuase of cell distruction since kidneys function is to filter blood a blockage can form
3 major classifications for burns
No sub catagories on this card
- First degree - superficial
- Second degree - Partial thickness
- Third degree - Full thickness
First degree burns
S/S
- Red skin
- Pain at the site
- Tenderness
- No blisters
Second degree burns
S/S
- Blisters
- Intense pain
- White to red skin
- Moist and mottled
Third degree
S/S
- Leathery skin (Eschar)
- Charring, dark brown or white
- Skin hard to the touch
- No pain
- Pain at peripery of the burn
Superficial burn
effects what layers of the skin?
epidermis only
Partial thickness burn
Effects what layers of the skin?
- Epidermis and dermis
What are the sub catagories of a partial thickness burn?
- Superficial partial thickness
- Deep partial thickness
weeping wound
Define
- Small leaks in the capillary beds caused by the burn results in wet skin
Superficial partial thickness burns
S/S (4)
- Thin walled blisters
- Skin is red and weeping
- Skin blanches with pressure
- Skin is tender to the touch
Deep partial thickness burns
S/S
- Thick walled blisters prone to rupture with any body movement
- Skin can be a variable of color with patchy areas that are red to a cheesy white
- Skin doesnt blanch with pressure
- Skin is wet or a waxy dry
- Pain receptors can be damaged but the pt can still feel pressure at the site
- Poor cap refill
Full thickness burns
Involve what layers of the skin
Plus S/S
- Eschar skin
- White and waky to dark brown or black and charred skin
- doesn’t blanch with pressure
- Deep burns
forth degree burns
Involve what layers of the skin
- all of them and deep into the tendons, ligaments, muscle, bone , blood vessels, and nerves
This is really bad
considering partial thickness and full thickness Burns
Minor burn BSA %
Adult
Partial thickness
* Adult 5%-10% BSA
Full thickness
* <2% BSA
considering partial thickness and full thickness Burns
Moderate burn BSA %
Adult
Patial thickness
* 10%-20% BSA
Full thickness
* 2%-5% BSA
considering partial thickness and full thickness Burns
Major burn
Adult
Partial thickness
* >20% BSA
Full thickness
* >5% BSA
How to determine severity of burns
(5)
- Depth of burn
- Location of burn
- Patients age
- Preexisting medcal conditions
- Percentage of body surface area involved
what are the critical burn locations
(7)
- Face
- Eyes
- ears
- hands
- feet
- genital or groin region
- Burns on major joint areas
Circumferential burns
Define
- Burns that encircle a body area like the arm, leg, or chest
Comparment syndrome
Define
- A condition where pressure inside the muscle groups become dangerously high and cut off blood and oxygen supply
Most important thing to reassess when compartment syndrome comes into play with our burned victums
CMS
What age groups tolerate burn injuries the worst
Why?
- Under the age of 2
- over the age of 50
- Because of their relatively larger skin surface in relation to body mass, children have greater fluid loss and thinner skin
- old people have underlying medical conditions that affect their response to burns
What preexisting conditions are the heavy hitters that can turn minor or moderate burns into critical conditions?
(4+1)
- Cardiovascular
- Pulmonary
- endocrine
- Neurological
- Being old if you consider that a preexisting condition (this is the +1)
major types of burns
- Thermal
- Inhalation
- Chemical
- Electrical
- Radiation
- Flame
- Contact
- Scald
- Steam
- Gas
- Flash
how long do you cool down a burn?
60-120 seconds
* Don’t give them hypothermia while trying to stop the burning
First step in caring for burns
Remove the pt from the source of the burn and stop the burning
liquid or semisolid burn
Emergency care & what don’t you do
Ex. oil, grease, tar
- Cool the burn with water or saline
- Do not attempt to remove the substanc ebcause this can cause further tissue damage
Dry chemical burns
Emergency care
- Brush it away before flushing with copious amounts of water or saline
Considerations for dressing burns
(3)
- Avoid materials that shred or leave paticles behind
- Never apply any type of ointments, lotions, or antiseptics to burn injuries
- Never break or drain blisters
