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AP Final Exam > Burns > Flashcards

Burns Flashcards

1
Q

Burn injuries per year receiving medical treatment

A

450,000

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2
Q

Burn Hospitalizations

A

45,000

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3
Q

Fire and burn deaths per year

A

3,500

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4
Q

Survival rate upon admission to burn center

A

94.8%

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5
Q

Types of Burns

A

Fire/flame, scald, steam, gas, electrical, flash, and chemical

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6
Q

Fire/Flame Burns

A

Direct tissue injury

Burns occurring in enclosed spaces carry high risk of CO/CN poisoning and inhalational injury

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7
Q

Scald Burns

A

Resulting from contact with hot liquids

The more viscous and the longer the contact the more significant the damage

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8
Q

Steam Burns

A

Produce extensive injury from the high heat-carrying capacity of steam
The dispersion of pressurized steam and liquid can cause thermal injury to the distal airways of the lung

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9
Q

Gas Burns

A

Upper airway is at risk for thermal injury and subsequent occlusion due to edema
Distal airway injury is more likely to be due to the direct effects of the products of combustion on the mucosa and alveoli

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10
Q

Electrical Burns

A

Electrical burns produce heat injury by passing through tissue
Most problems from these burns present in patients exposed to more than 1000V
Children can have significant injury after exposure to 200-1000V
Most of the injury is deep in the skin
Cardiac injury is common

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11
Q

Flash Burns

A

Flash burns are a subset of flame burns and are a result of rapid ignition of a flammable gas or liquid

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12
Q

Chemical Burns

A

Alkaline substances and acidic substances can burn the skin and can be associated with systemic toxicity

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13
Q

First Degree Burns

A

Involves only the epidermis, erythema

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14
Q

Second Degree Burns

A

Partial thickness
Either superficial or deep
Deep burns do not heal spontaneously

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15
Q

Third Degree Burns

A

Full thickness

Loss of all epidermal and dermal elements extending to subcutaneous tissue (muscle, tendon, and bone)

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16
Q

Rule of Nines

A

Head and each arm = 9%

Chest, back, and each leg = 18%

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17
Q

Palm Rule

A

Palm = 1%

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18
Q

Lund Browder

A

Used to determine burned body surface area in infants and children

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19
Q

Smoke inhalational injury

A

Thermal lesions and exposure to toxic and asphyxiating fumes

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20
Q

Signs and symptoms of inhalational injury

A

Strider, hoarseness, use of accessory muscles (inc. WOB), facial burns, singing of eyebrows, soot or readiness of mucosa in mouth/pharynx, carbonaceous sputum, accident occurred in confined space

21
Q

Integumentary System

A

Skin and structures derived from it

22
Q

Functions of the Integumentary System

A

Protects the body, helps regulate temperature, eliminates some wastes, helps make vitamin D, and detects sensations such as touch, pain, warmth, and cold

23
Q

Capillary fluid transport is governed by what equation?

A

Starling

24
Q

Systemic spillover causes what phenomenon in the unburned tissue of a burn patient?

A

Fluid accumulation

25
Q

The alveolar microenvironment of burn victims changes how?

A

Surfactant denaturation causes damage to the lungs
Loss of endothelial and epithelial barrier functions
Influx of inflammatory cells

26
Q

Edema may develop within what time period for burn victims?

A

Minutes to 24 hours

27
Q

T/F Burn victims experience a decrease in macrophage, phagocytic and bactericidal functions and increased neutrophils

A

True

28
Q

In burn victims, sloughing of mucosal surface and decreased ciliary function result in…

A

Decreased airflow and gas exchange

29
Q

Carbon monoxide poisoning leads to what condition?

A

Hypoxia

30
Q

Symptoms of Mild (0.08%) Carbon Monoxide Poisoning

A

Headache, asphyxia, dizziness, dry cough, chest pain, nausea, vomiting, visual and auditory hallucinations, and high blood pressure

31
Q

Symptoms of Moderate (0.32%) Carbon Monoxide Poisoning

A

Motor paralysis and loosing consciousness

32
Q

Symptoms of Severe (1.2%) Carbon Monoxide Poisoning

A

Loosing consciousness after 2 or 3 breaths, convulsions, and respiratory arrest leading to death in less than 3 minutes

33
Q

What effect does cyanide have on the body?

A

It inhibits normal cellular metabolism

34
Q

What value must be obtained in a patient with carbon monoxide poisoning?

A

HbCO

35
Q

Baux score is a function of what?

A

BSA plus age

36
Q

A Baux score of what is associated with death in 50% of patients?

A

110

37
Q

Inhalational injuries add how much to the Baux score?

A

17

38
Q

What are the mortality risk factors in burn patients?

A

Age, BSA, inhalational injury, preexisting comorbidities, and concurrent trauma

39
Q

Treatment for Burn Victims

A

Agressive fluid resuscitation (monitor urine output), Oxygen therapy (possible intubation), Escharotomy (incisions made in the skin; prevents restriction of breathing and/or compartment syndrome), antibiotics, debridement (prevent sepsis)

40
Q

Preop Preparation for Burn Victims

A

Obtain clear information on procedure, patient preexisting issues, labs, respiratory status or vent requirements, drips and other drugs, current hemodynamics

41
Q

Preparing the OR for Burn Victims

A

Blood must be available

OR must be very warm

42
Q

What common induction drum should be avoided in burn victims? Why?

A

Succinylcholine

Increased acetylcholine receptor density

43
Q

T/F Burn victims have increased sensitivity to nondepolarizers

A

False

44
Q

T/F Burn victims have increased narcotic requirements

A

True

45
Q

Percent of blood volume lost per percent of BSA excised

A

2% blood volume / 1% BSA

46
Q

Burn victim cardiovascular concerns

A

Hypermetabolic state increases cardiac demand

Levels of circulating catecholamines are greatly increased

47
Q

Burn victim hematologic concerns

A

Coagulopathy or hyper coagulable state

Altered drug metabolism

48
Q

Burn victim renal concerns

A

Toxicity, inadequate fluid ressucitation causing prerenal azotemia, tubular necrosis due to myoglobinurea

49
Q

Burn victim GI concerns

A

Curling’s Ulcers

AP Final Exam (4 decks)

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