Burns Flashcards
Chemical Burn
-stronng acids and alkalis reacting cause thermal energy
-alkaline more severe than acids
Electrical Burn
-volt contact
-AC burns more severe
Radiation Burn
-depend on dose
Superficial Burns
-1st degree, epidermis
-sunburn
-red, blanches under pressure
-3-5 days
Superficial-Thickness Burns
-superficial 2nd degree, epidermis and papillary dermis
-sunburns, contact burns
-red, moist, blistered skin, edema, painful
-10-14days
Deep Partial Thickness Burns
-deep 2nd, epidermis and derms
-hot liquids, buns
-eschar and blisters
-may be painful or have insensivity
Full Thickness
-3rd, subcute
-immersion scald, flame, steam, chemicals
-mottled white, grey, black
-little pain
Subdermal Burns
-4th degree burn, destruction dermis
-fat, muscle, bone, tendon
-charred
-needs surgical intervention
Rule of Nines
-9% for each area of burn
Lund-Brower Classication
-pediatric scale to account for different head and limb limbs
Palmar Method
-palm sizes to determine burn size
Burn Effect: CV System
-burn shock: perfusion unable to meet demands of body
-need fluids
-BP
-dysrhythmias
-check pulses
Brun Effect: Pulmonary Sys.
-50% need intubation
-pulmonary dysfunction (5-35%)
-carbon monoxide from smoke (50%)
-airway inflammation
Burn Effect: Metabolism
-BMR maybe 2-3x with burns
-elevated body temp and o2 needs
-decrease in body mass
Burn Effect: Immune System
-75% of deaths related to infection
-loss of barrier function
-decreased perfusion for imflammatory response
-bacteria from open skin
PT Treatment of Burns
Debridement
Infection Control
Dressings: silver sulfadiazine cream
Team work
Education
Scar Management
-cleansed and moisturized
-compression to prevent scarring (3weeks)
-mobilization
Hypertrophic Scar
-rasied scar within bounds of injured region
-overproduction of collagen
-red, raised, darker
-repeated injury or porlonged inflammatory/proliferative phase
Keloid Scar
-extends beyond boundary of the injured site
-tissue trauma
-darker
Scars
-inelastic
-dependent on 02
-prolonged pressure can limit scar by limiting 02
Contractures
-loss of ROM through skin tightening
-prevent through Rom splinting and functional activites
1-4d for scar contracture
5-21d for tendon contracture
2-3 weeks for adaptive muscle shortening
1-3 months for lig/joint restriction
Positioning for Burns
-avoid pressure
-no burn surfaces touching
-avoid friction
-avoid contractures
ROM Treatment
2x
-through full range
Surgical Interventions for Burns
-Escharotomy: incision through burn wound to subcutaneous tissue
-done with massive edema and inelastic eschar, no distal pulses
-Fascitomy: decrease pressure to improve distal circulation
