Burns Flashcards
Wound care basics
mild soap and water
normal saline
COVER open wound
leave wide margin of intact skin around dressing
keep moist
What to avoid putting on wounds
povidone-iodine
alcohol
hydrogen peroxide
Removing bandage
remove if leaking/time to change
do so CAREFULLY
use adhesive remover
Factors affecting wound healing (many)
nutrition
location
secondary diagnosis (e.g. diabetes)
lifestyle - not protecting wound
stress
infections
How does stress impact wound healing?
increases catecholamines
vasoconstriction
Most common complain with skin lesions
pruritis
Relief of symptoms
cooling bath or ice pack
prevent scratching
-mittens for young children
-short nails
-antipruritic meds
Signs of skin infections
leaking
hot/warm
worsening pain/pain that doesn’t improve
odour
redness
Most common cause of impetigo contagiosa
strep or staph
highly contagious
Signs and symptoms of impetigo contagiosa
redness macule that becomes vesicular
ruptures and spreads
honey-coloured crusts
Management of impetigo
careful removal of debris
bactericidal ointment
antibiotics if severe
What is a potential complication of impetigo?
cellulitis
Signs of cellulitis
red
swollen
firm
pain
abscess
Diaper dermatitis causes
irritation from urine and feces*
detergent
chemical irritants
e.g. diaper wipes
What can diaper dermatitis progress to?
candidiasis
Sign of candidiasis
satellite lesions crossing inguinal folds
Atopic dermatitis (eczema)
a type of pruritic eczema that begins in infancy
hereditary component
associated with food allergies, asthma, allergic rhinitis
Most frequent cause of burns in toddlers
hot-water scald
Most frequent cause of burns in older children
flame-related burns
kids are obsessed with fire
Burns related to child abuse
does the story fit location of burn?
does kid have ability?
cigarette burn
subversive burn
Extent of burn injuries described as….
total body surface area
use age-related charts
Depth of burn injury descriptors (4)
first degree
second degree
third degree
fourth degree
first degree burn
superficial
e.g. sunburn, brief scalf
dry surface
second degree burn
partial thickness
e.g. scalds, flash flame
blistered, drainage, edema
third degree burn
full thickness
e.g. fire, contact with hot objects
tough, leathery, pale white brown or tan, black
fourth degree burn
full thickness and underlying tissue
Signs of an inhalation burn
resp distress
WOB
coughing up
singed nose hairs
burns around mouth
Priority for burns
ABCs*
airway maintenance!
Therapeutic management emergency care priority for burns
stop burning process
assess patient’s condition
cover burn to prevent contamination
transport to appropriate level of care provide reassurance
What is critical in the first 24 hours after a burn?
fluid replacement therapy
Other care considerations
nutrition - enhanced metabolic demands
meds
-antibiotics
-analgesics
-anesthetics
Surgery that may be done for burns
skin graft
