Burns Flashcards
How are burns classified
Depth
Extent
Location
Patient Risk factors (diabetic, elder patient, pediatrics)
What is the epidermis
nonvascular protective outer layer
What is the dermis
lies beneath the epidermis
contains CT, and blood vessels, hair follicles, nerve endings, sweat glands, and sebaceous glands
What is subcutaneous tissue
lies under the dermis
connects major vascular networks
fat
nerves and lymphatics
What are 1st degree burns
superficial partial thickness
sunburns
may have water blisters
What are 2nd degree burns
deep partial thickness
what are 3rd degree burns
full thickness
Characteristics of 1st degree burn
erythema (bright red), blanching, pain, water blisters only
may peal after 24 hours
What causes 1st degree burn
sunburn/flash burns
How do you treat 1st degree burn
Acetaminophen
Aloe vera gel
cool compress
Characteristics of second degree burns
epidermis and dermis involved
fluid-filled vesicles or blisters
What causes 2nd degree burns
flames scalds chemicals tar contact burn
Initial Cleaning of 2nd degree burns
remove clothing remove loose skin remove blisters clean and disinfect (may need surgical debridement/ skin grafting)
Modern treatment for 2nd degree burns and traditional
hydrocolloids hydrofiber sillcone alginate polyurethane Traditional:: silvadene paraffin gauze
Characteristics of 3rd degree burn
destruction of entire epidermis and dermis
dry and often painless
Define escharotomy
to release circumferential burn eschar and improve circulation to distal extremity
What is shock
a clinical syndrome involving impaired tissue perfusion and oxygenation
Burn Shock
state of hypovolemia that is life threatening and can begin 20 minutes ater injury
Evidenced by a severe drop in blood pressure and increased HR
- allow for an increased permeability
Electrolyte shift following burns
increased intracellular sodium leading hyponatremia
decreased intracellular K
Na/K pumps damaged
Magnesium and calcium may be lost through leakage from damaged tissue
define burn
an injury to the tissue of the body caused by heat, chemicals, electric current, radiation
define thermal burns
caused by flame, flash, scald, or contact hot object
The severity of thermal burns are dependent on?
the burning agent, and the duration of contact time
define chemical burns
results of contact with acids, alkalis, and organic compound
what are the three types of smoke and inhalation injuries?
metabolic asphyxiation
upper airway injury
lower airway injury
Metabolic asphyxiation causes what?
oxygen delivery impairment or oxygen consumption by tissue impairment
What are the consequences of metabolic asphyxiation
hypoxia and death when carbooxyhemoglobin has occurred
upper airway injuries result from what?
inhalation injury to mouth, oropharynx, and or larynx
Manifestation of upper airway injuries
redness, blistering, and edema (which can become lethal)
lower airway injury results from what?
breathing in toxic chemicals or smoke
where do lower airway injuries occur
trachea, bronchioles and alveoli
Clinical manifestations of lower airway injury
presence of facial burns or singed nasal or facial hair dyspnea carbonaceous sputum wheezing hoarseness altered mental status
When does pulmonary edema appear in lower airway injury
may not appear until 12-24 hours after the burn
Define electrical burns
result from intense heat generated from an electric current
consequences of electrical burns
damage to nerves and vessels, causing tissue anoxia and death
The severity of electrical burns is dependent on what
amount of voltage, tissue resistance, current pathways, and amount of voltage
Risks for patient who has suffered an electrical burn
dysrhythmias, cardiac arrest, severe metabolic acidosis, and myoglobinuria
Phases of burn management
emergent, acute and rehavilitative
what is the greatest initial threat to a patient with major burns?
hypovolemic shock
what is second spacing
when fluid moves into the interstitium following a burn
what is third spacing
when fluid moves into areas that normally have minimal to no fluid
how are RBC lost as a consequence of a burn
by hemolysis from free radicals
direct loss from the burn
thrombosis in capillaries
what are the immunologic changes that occur as a result of a burn
skin barrier destroyed
bone marrow depression occurs
immunoglobins decreased
what three organ systems are susceptible to complications during the emergent phase?
cardiovascular system
respiratory system
urinary system
what is an escharotomy
incision through the full thickness of the burn
