Burns Flashcards
Prognostic variables for survival
age, size and depth of burn, inhalation injury, other trauma
Prognosis numbers, expected to survive or not
<120 is expected to survive, >140 is not expected to survive
thermal burn
burns due to an external heat source
How do thermal burns affect the skin
raise the temperature of the skin and tissues, causing cell death and/or charring
When are skin grafts used with thermal burns
2nd or 3rd degree burns
What does the severity of a thermal burn depend on
the temperature, duration of contact, if in an enclosed space
Radiation burn
burns due to prolonged exposure to ultraviolet rays of the sun or other sources of radiation
Chemical burn
burns due to strong acids, alkalis, detergents, or solvents
Electrical burns
burns from electrical current, either alternating (AC) or direct (DC)
Why are most electrical burns not apparent with the naked eye
most travel underneath the skin
When should cooling of burns occur to get results
within 2-4 minutes of burn
Should water/wet dressings be used
no, it will make the patient hypothermic which causes more problems for the patient
When can continued cooling be used
thick fluids, burns less then 10% BSA
Should we be cooling burn patients or keeping them warm
keeping warm
What does burned facial hair tell us
increased risk of airway damage
s/s of impacted airway
signed nasal hair, blistering around mouth, soot on tongue or in pharynx, carbonaceous sputum, hoarse voice, difficulty swallowing, labored respirations, restlessness, confusion, combative behavior
When are patients immediately intubated
burned hair, full skin thickness burn
Why is carbon monoxide dangerous
it will stick to hemoglobin instead of oxygen, no oxygen getting to the body
What burn patients get oxygen
all
How do burns affect breathing
skin loses compliance not allowing air to be drawn into the lungs, we don’t know how to treat injured lungs
Fluids of choice for burn patients
crystalloids, lactated ringers, normal saline (only up to 3L)
Should there always be a pulse in burn patients
yes, if no pulse start CPR
what to assess for disability
alertness, voice, pain, responsiveness
How should burn patients be acting
alert and yelling
How to assess exposure
remove all clothing and jewelry quickly to look at patient’s skin, protect from hypothermia, look for other additional life-threatening injuries
What is treated first: burns or other traumas
other life-threatening traumas are treated before burns
What is calculated to get fluid resuscitation needs
burn size and depth
What burn patients get the most fluid
children, electrical burns
What is the primary goal of fluid resuscitation
preserve and restore tissue perfusion to prevent ischemia
Importance of dry weight
want to get patient back to dry weight within 48 hours
What is the frequency of resuscitation assessment
continuous
What is the frequency of emergent assessment
every 15 minutes
What is the frequency of urgent assessments
every 30 minutes
What is the frequency of non-urgent assessments
every 120 minutes
What is the purpose of a primary survey
focuses on stabilizing life-threatening conditions (ABCDE)
How does shivering affect the body
increases metabolic demand
What is the purpose of a secondary survey
Complete a head to toe assessment, gather health history and chief complaint information
