Burns Flashcards
How many layers does the skin have?
Three:
Epidermis
Dermis
Subcutaneous tissues
Which layer of the epidermis is metabolically active?
The inner layer
Outer layer is dead
How many layers does the dermis have?
Two:
- Blood vessels, nerves, sweat glands appendages
- Barrier that prevents loss of fluid through evaporation or loss of body heat
What makes up the subcutaneous tissues of the skin?
- Mostly fat
- Appendages, blood vessels, and nerves
What skin layers are affected by a first degree burn?
Only the epidermis:
- Epidermal barrier remains intact
- Like a sunburn
- No blistering
Are first degree burns blanching?
Blanching
Treatment for a first-degree burn?
- Analgesics
- Should heal in 2-3 days
- No scarring
What type of burn is full thickness?
3rd degree burn
What characterizes a 2nd degree burn?
Burn through epidermis and part of dermis
How deep does a superficial partial-thickness burn go?
Up to top 1/3 of dermis
What characterizes a superficial partial-thickness burn?
- Vessels, nerves, appendages mostly intact
- Fluid-filled blisters
- Blanching
- No fluid loss
- No infection
- Sensation intact
What characterizes a deep partial-thickness burn?
- 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
What characterizes a 3rd degree burn?
Non-blanching
No sensation
Dry and leathery
Treatment: surgical skin grafting
What is an eschar made of?
Coagulated proteins (3rd degree burns)
What is post-traumatic respiratory insufficiency related to?
ARDS
What should we immediately do with all inhalation burns?
Intubate
With CO poisoning, what two measurements may be normal?
Pulse ox and PaO2
How can we diagnose CO poisoning?
- COHb levels >5 in nonsmokers and >10 in smokers
- Hypercarbia (CO2 over 55 on ABG)
- Metabolic acidosis (on ABG)
What is involved in resuscitation of burn victims?
- 2 large-bore IVs for fluids (14-16 gauge)
- Urinary catheter if >25% of total body surface
- Draw blood for lab studies
In which burns is TBSA % calculated?
2nd and 3rd degree burns
Which burns require referral all to burn treatment center?
- 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
What is the consensus formula for treating burns?
Fluid needs:
- Kg x 2-4 ml x %TBSA
- Half in first 8 hours, then other half next 16 hours
How would we treat a superficial partial-thickness burn to the face?
-Topical antibiotics: Silver sulfadiazine
Do we need topical ABX for superficial partial-thickness burns to the face?
No
