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Surgery Test 1 > Burns > Flashcards

Burns Flashcards

1
Q

How many layers does the skin have?

A

Three:
Epidermis
Dermis
Subcutaneous tissues

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2
Q

Which layer of the epidermis is metabolically active?

A

The inner layer

Outer layer is dead

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3
Q

How many layers does the dermis have?

A

Two:

  • Blood vessels, nerves, sweat glands appendages
  • Barrier that prevents loss of fluid through evaporation or loss of body heat
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4
Q

What makes up the subcutaneous tissues of the skin?

A
  • Mostly fat

- Appendages, blood vessels, and nerves

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5
Q

What skin layers are affected by a first degree burn?

A

Only the epidermis:

  • Epidermal barrier remains intact
  • Like a sunburn
  • No blistering
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6
Q

Are first degree burns blanching?

A

Blanching

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7
Q

Treatment for a first-degree burn?

A
  • Analgesics
  • Should heal in 2-3 days
  • No scarring
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8
Q

What type of burn is full thickness?

A

3rd degree burn

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9
Q

What characterizes a 2nd degree burn?

A

Burn through epidermis and part of dermis

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10
Q

How deep does a superficial partial-thickness burn go?

A

Up to top 1/3 of dermis

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11
Q

What characterizes a superficial partial-thickness burn?

A
  • Vessels, nerves, appendages mostly intact
  • Fluid-filled blisters
  • Blanching
  • No fluid loss
  • No infection
  • Sensation intact
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12
Q

What characterizes a deep partial-thickness burn?

A
  • Vessels, nerves, appendages mostly destroyed
  • Blanching
  • Fluid loss
  • Infection
  • Sensation may not be intact
  • Dry and thickened skin
  • Red or white
  • Often no pain
  • Hypertrophic scarring
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13
Q

What characterizes a 3rd degree burn?

A

Non-blanching
No sensation
Dry and leathery
Treatment: surgical skin grafting

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14
Q

What is an eschar made of?

A

Coagulated proteins (3rd degree burns)

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15
Q

What is post-traumatic respiratory insufficiency related to?

A

ARDS

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16
Q

What should we immediately do with all inhalation burns?

A

Intubate

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17
Q

With CO poisoning, what two measurements may be normal?

A

Pulse ox and PaO2

18
Q

How can we diagnose CO poisoning?

A
  • COHb levels >5 in nonsmokers and >10 in smokers
  • Hypercarbia (CO2 over 55 on ABG)
  • Metabolic acidosis (on ABG)
19
Q

What is involved in resuscitation of burn victims?

A
  • 2 large-bore IVs for fluids (14-16 gauge)
  • Urinary catheter if >25% of total body surface
  • Draw blood for lab studies
20
Q

In which burns is TBSA % calculated?

A

2nd and 3rd degree burns

21
Q

Which burns require referral all to burn treatment center?

A
  • Partial-thickness >25% in adults and >20% in kids
  • Full-thickness >10%
  • 2nd or 3rd degree burns to face, hands, genitals, feet and joints
  • Inhalation, electrical or chemical burns
22
Q

What is the consensus formula for treating burns?

A

Fluid needs:

  • Kg x 2-4 ml x %TBSA
  • Half in first 8 hours, then other half next 16 hours
23
Q

How would we treat a superficial partial-thickness burn to the face?

A

-Topical antibiotics: Silver sulfadiazine

24
Q

Do we need topical ABX for superficial partial-thickness burns to the face?

A

No

25
Q

What kind of nutrition do burn victims usually need?

A

Enteric

26
Q

What is a potential side effect of silver sulfadiazine?

A

Leukopenia

27
Q

What kind of antibiotics are used in treating deep 2nd and 3rd degree burns?

A
  • Silver sulfadiazine
  • Mafenide
  • Anticoat silver dressings
  • Poloxamer- bacitracin and polymixin B
28
Q

What is a potential side effect of Mafenide?

A

-Metabolic acidosis

29
Q

What are the benefits of Mafenide?

A

-Penetrates eschar better then silver sulfadiazine

30
Q

What are the benefits of using anticoat silver dressings?

A

Can change every 5 days: better tolerated by pt.

31
Q

When are meshed skin grafts used?

A

Partial-thickness burns

32
Q

What is a curling ulcer?

A

A stomach ulcer caused by burns

33
Q

What characterizes superficial frostbite?

A

-Involves skin and SubQ tissues

34
Q

What characterizes deep frostbite?

A
  • Skin and SubQ

- Underlying tissues: wooden consistency

35
Q

Treatment for frostbite?

A

-Warm water: 40-42 degrees C for 20-30 mins

36
Q

What kind of chemical burns go deep?

A

Alkali

37
Q

What kind of burns do acids cause?

A
  • Not as deep as alkalis

- Eschar forms limiting penetration

38
Q

What effect do organic compounds have when they damage skin?

A

Dissolve cell membranes

39
Q

Treatment for chemical burns?

A
  • Brush off any powders

- Irrigate with water

40
Q

Possible complications of electrical burns?

A
  • Rhabdomyolysis (damages kidneys; need fluids)
  • Arrhythmias (get EKG for asystole, v-fib)
  • Compartment syndrome (insert needle for pressure reading)

Surgery Test 1 (7 decks)

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