Burns Flashcards
Define burns
- Tissue injury secondary to a transfer (absorption) of energy
- Effects depend on intensity and duration of burns
What is the fourth leading form of trauma?
Burns
What is the setting of the majority of burns?
- Domestic setting (cooking)
What is the etiology of burns?
- Global: Scald, then flame
- US: Flame, then scald
- Contact: touch a hard, hot surface
- Scald: touch a hot liquid
- Inhalation
- Chemical: liquid burn regardless of temperature
- Electrical
- Radiation
- Steam: combo between temp and hot water
- Flash: subset of flame
- Frost bite
Where do men and women most typically get burns?
- Men: outdoor setting, flame
2. Women: indoor setting, scald
How is mortality estimated for burn pts?
- Pt’s age + percentage of burn
2. Length of stay (days) = percentage of burn
What are the functions of the skin?
- Physical protection
- temp regulation
- Fluid regulation
- Sensory perception
- Metabolism
- Excretion
- Immunological
Why don’t you need immunosuppressants for transient skin grafts?
Immunosuppression due to skin loss
What is the pathophys of burns?
- fluid loss/shift
- Predisposition to infection
- Hypothermia
4.
What is the most stressful trauma the body can sustain?
Burn
Doubles basal metabolic rate
What are the zones of burns?
- Zone of hyperemia: Peripheral
- Zone of stasis: middle
- Zone of coagulation: center
Why shouldn’t ice or cold water be put on a burn?
Will further damage/destroy skin
What are the new classifications of burn?
- Epidermal (1st)
- Partial thickness (2nd)
A. Superficial
B. Deep - Full thickness (3rd)
What is the best way to evaluate depth of burn?
Clinical exam
What are the characteristics of an epidermal burn?
- Dry red skin, blanches with pressure
- Painful
- Heals: 3-6 days
What are the characteristics of a superficial partial thickness burn?
- Blister, moist red skin, weeps, detaches with rubbingblanches with pressure
- Painful to temperature and air
- Heals: 7-21 days
What are the characteristics of a deep partial thickness burn?
- 3.
What are the characteristics of a full thickness burn?
- white/grey/black lethary skin
- Painless bc nerve endings are gone
- Heals:
What is the palmar method of calculating burn SA?
- Pt’s entire hand = 1%
What is the BSA burn of an entire hand burn?
2.5 bc it includes the front, back, and web spaces
What is the rule of nines for BSA burns?
BSA is divided up into segments that are assigned either 9 or 18%.
Which method should be used?
- Palmar method
What are the admission criteria for burns?
- > 10% TBSA burn (excluding superficial burn)
- Full thickness burn
- Special areas, burns, or circumstances
What is the mneumonic for burn management?
MD TTIERA
- Mechanism
- Depth of burn
- TBSA
- Trauma
- Intubation
- Resuscitation
- Escharotomy
- Admission
What labs are needed for burn pts?
- CBC
- CMP
- ABG
- UA
- CO
- CXR
- EKG
- S/U
- myoglobin
- eye exam
Are abx used as prophylaxis in a burn pt?
NO
What is the most popular resuscitation formula?
Parkland’s: 4ml LR/kg/% TBSA
1. First half over 8 hrs, second half over next 16 hrs
How is resuscitation efficacy gauged?
- Urine output
A. 1/2cc/kg/hr: 30 cc/kg
B. if urine output is poor, increase fluid by 1/3 - HR
How are blister’s managed?
- Good biological dressing
- Management
A. undisturb
b. puncture
c. unroof and debride - Factors:
A. age
b. size
c. sterility
d. interference with functionality
Dakin’s formula equals?
Bleach
