Burns

Question 1

Responsibilities of the skin

Answer 1

• Thermoregulation
• Prevention of fluid loss
• Vitamin D synthesis
• Sensory contact
• Physical barrier

Question 2

what is the main mechanism of heat exchange and what does this relate to?

Answer 2

the skin and cold exposure
- responsible for 90% of total heat loss

Question 3

Alcohol in relation to cold exposure

Answer 3

• alcohol vasodilates which makes warm blood cold

Question 4

Freezing injury causes…

Answer 4

vasoconstriction and localized ischemia

Question 5

RF for frostbite:

Answer 5

-Alcohol
- wind chill
-exposure
-Altitude

Question 6

stage 1 of cold burns would be considered…

Answer 6

-Superficial frostbite/frostnip
-skin will turn red and feel cold to touch

Question 7

signs of stage 2 Frostbite would be considered…

Answer 7

-skin may appear blue
- Ice crystals begin to form in the skin
- skin may begin to feel warm = and signs of damage may begin to occur

Question 8

stage 3 Frostbite presentation:

Answer 8

-most severe stage
- loss of muscles and sensation
-skin color is blue splotchy
-required immediate medical attention

Question 9

stage 4 of frostbite describes:

Answer 9

permanent anatomical and functional loss

Question 10

Frostbite Tx:

Answer 10

• remove from cold exposure
• Rapid rewarming
  1. Ibuprofen
  2. water bath
  3. air dry
• Tetanus shot due to risk of infection

-bandage area once re-warmed and stabilized

Question 11

the big No-no’s

Answer 11

-Do not rewarm until you can keep it warm
- No direct heating
- No rub or massage
- No pressure

Question 12

the big Do’s

Answer 12

• Do body heat
• Do use warm water
• Do support and stabilize

Question 13

What are some considerations for a patient with frostbite?

Answer 13

• Most recover
• determine the extent of injury that may require surgery

Question 14

a heat burn should show signs of healing within…

Answer 14

10 days if not refer to the burn unit

Question 15

Most vulnerable population in relation to burns:

Answer 15

Children and Adults

Question 16

what should you use and not use on a burn?

Answer 16

-Use tap water (active cooling)
- do not use ICE, vasoconstriction

Question 17

First-degree burns affect what layer of the skin?

Answer 17

-the epidermis
- sunburn

Question 18

How would you treat a First-degree burn?

Answer 18

• usually heals on their own

Question 19

What layer of the skin does second-degree burns affect?

Answer 19

• involves the epidermis, and dermis layer
  -blisters, red, swollen and painful

Question 20

Is a second-degree burn treatable?

Answer 20

• as long as it does not cover more than 10% of BSA it can be treated in outpatient
  -Tx depends on the severity and can include
• antibiotics
  -dressing changes

Question 21

what skin layers do you lose in third-degree burns?

Answer 21

-full-thickness, it destroys
- epidermis
- dermis
- underlying fat and connective tissues

Question 22

do you feel pain in third-degree burns?

Answer 22

No, nerve damage/ death

Question 23

Presentation of a Third-degree burn:

Answer 23

• Leathery skin
• waxy appearance

Question 24

what could be the complications of a third-degree burn?

Answer 24

• heal slowly
• epidermis and hair follicles destroyed
  -new skin will not grow back

Question 25

A patient comes in with a burn, you determine the burn is a second-degree burn that covers more than 10% of BSA, what would be the next step in care management?

Answer 25

-check for flu shots and tetanus -refer to a burn center

Question 26

what % of a third-degree burn would a patient require hospitalization and a burn center?

Answer 26

>1%

Question 27

does a patient with a second-degree burn or worse to the face, genitals, encircled hands,s or feet require hospitalization?

Answer 27

Yes, and a burn center

Question 28

what is the biggest risk for all burns?

Answer 28

Infection -cover/bandage - shaving cream