Burns Flashcards
What is cold thermal injury?
Frostbite
Freezing tissue results and ice crystal formation in tissue and cells , cell membranes are destroyed
What are thermal burns?
Most often cause skin damage but can also cause other damage such as esophageal damage related to swallowing of scolding hot drinks
Most common type of burn injury
What is superficial frostbite?
Involves the skin and subcutaneous tissue, usually affects ears, nose, fingers, and toes
Pale to blue to mottled skin appearance
Symptoms of tingling, numbness, burning sensation
Frozen tissue is easily damaged, do not rub, massage, or squeeze
Edema will often occur
Affected area should be immersed in water of 37 to 40°
Blisters will form, debride and apply sterile dressing as needed
Importance is pain management, tetanus shot may be required
What is deep frostbite?
Involves muscle, bone, and tendon
Skin is white, hard, and insensitive to touch
Mottling, gradual progressing to gangrene
Affected area so immersed in circulating H20 Bath until distal flush occurs
Once re-warmed, elevate extremities to reduce edema, Edema can be significant and can happen quickly
IV analgesics usually required related to severe pain when tissue thaws, prophylactic antibiotics before and is at risk for infection
Amputation may be required
What is chemical burns?
Acids: are found in many household cleaners
Alkalis: oven and drain cleaner, fertilizers, I have the industrial cleaners, are more difficult to manage than acidic burns because they’re not as easily neutralized by tissue fluids
Organic compound: phenols, petroleum, including creosote and gas
May result in skin, Eye, or respiratory damage
If inhaled, damage usually occurs below the glottis
Systemic damage can occur, particularly the liver and kidneys
Tissue destruction may occur up to 72 hours after a chemical burn injury
Patients are usually considered unstable unless chemical burn involves a very small area and is not above the chest
What is smoke and inhalation injuries?
Three types of smoke and inhalation injuries
CO poisoning: symptoms are cherry red skin color, headache, nausea and vomiting, and mental disturbances
Inhalation injury above the glottis: Edema can be significant
Inhalation injury below the glottis: pulmonary edema may not be a parent for up to 24 hours at which point may see ARDS
Care for smoke and inhalation injuries?
All patients with any of these injuries are considered unstable, requires stat emergency care
Requires airway support, endotracheal intubation, early transfer to a burn center
What are electrical burns?
Electrical current can cause dysrhythmias, or cardiac arrest, either may occur up to 24 hours after the injury
Severe metabolic acidosis occurs within minutes of injury related to extensive tissue destruction
Massive blood vessels release hemoglobin and tissue damage releases myoglobin into the circulatory system, can be acute tubular necrosis and renal failure
Patient considered unstable
How do you classify Burns?
Depth of burns
Extent of burns
Location of burns
Client risk factors
What are the two different kind of partial thickness burns?
Superficial 1st°, epidermis:
superficial sunburn, heat flash can be the causes
Symptoms are erythema, blanching, pain, and mild swelling
No vesicles or blisters but skin may peel after 24 hours
deep 2nd, epidermis and dermis:
flames, flashes, scalds, contact burns, chemicals, and tar can be causes
Symptoms are fluid filled red, shiny vesicles, wet if vesicles rupture, severe pain related to nerve injury, mild to moderate edema
What is full thickness burns?
Third and 4th°, full skin thickness and destruction of local nerve endings:
Flames, scalds, chemicals, tar, electrical current can be causes
Dry, waxy white, leathery or hard skin
Painless
Require surgical intervention for healing purposes
What is the collaborative care done for a patient with burns?
Remove person from the source of the burn unless it puts you at risk
ABC is priority
Stop the burning process by using water tap water is acceptable
No ice, butter, or Aloe vera
Do not submersed in water if the burn involves more than 10% of the body surface area
Remove as much clothing from the burn as possible
What does airway management involve?
Involves intubation, especially if the burn involves the neck or face
Usually done within two hours of the injury prior to
edema
S smoke inhalation of probable, patient is not deemed to need intubation, a bronchoscopy should be performed within 12 hours of the injury
What does fluid therapy involve?
Essential part of treatment in the presence of extensive Burns, IV fluid therapy and +++ fluids if possible
What does wound care involve?
Begin once ABC’s have been addressed
Full thickness wound: nerve endings are destroyed, so not painful, however, burns are often a very in degrees, so pain is usually felt and is usually severe
Daily cleaning and debridement may be done in a hydrotherapy tub in the burn unit
