Burns Flashcards
What age has the best survival rate for burns
15 to 45
In what classification will the epidermis be destroyed?
First degree burn aka superifical partial thickness
In what classification will the epidermis down to deep dermis be destroyed?
Deep partial thickness aka 2nd degree burn
In what classification would the epidermis, dermis, subcutaneous and maybe muscle be destroyed?
Full thickness aka 3rd degree burns
What might you see for first degree burns? How do you treat them?
Sunburn or flash burn; minimum pain; erythema; cool water compress or submerged, no ointments; don’t disturb blister; educate
What would you expect a second degree burn to look like?
Severe pain, blisters, edema, erythema
What would you expect with a third degree burn
No pain, lack of color, edema, leathery texture, possible loss of digits
What is the % of the head, arm, chest, groin,and legs
Head 9%, arm is 9%, chest is 18%, abdomen 18%, groin 1%, legs 18% ( these include anterior and posterior damage)
Dry heat like flames, moist heat from liquid, and hot surface contact are examples of what?
Thermal burn
Caustic agents on skin causes what kind of burn?
Chemical burn
Electrical injury can result in?
V fib
Parkland formula? What does it tell you? What fluid?
4 ml × kg of pt × % of body affected. The amount of fluid resuscitation needed in 24 hrs. Lactate ringers
How do you figure out how much fluid resuscitation is needed in the first 8hrs and the last 16 houra?
Use the parkland formula for the total in 24 hrs. Divide by 2. Divide by 8 for the hourly rate in the first 8 hrs. Divide by 16 for the hourly rate for the last 16 hours
What do you do if a patient has a radiation burn?
Stop tx, disconnect, find a safe place for patient, hydrate, cut clothes off, you special gloves in equipment to remove clothes from patient, get patient to decontamination center, don’t shower the patient because the water needs to be collected
What are the stages of burn injury question
Emergent or resuscitative, acute, and rehabilitative
What prehospital treatment can we give a burn patient?
Limit the severity by removing things that cause damage, cardiac help in monitoring in the first hour is critical, CPR, fluid resuscitation in the field of possible, maintain body temperature cuz we don’t want patient to become hypothermic by placing patient in a warm environment, and get patient to proper hospital
In the emergent phase how long is it? What are the main concerns? What are our goals?
From onset to 48 hours. We are concerned with fluid loss, edema, decreased blood flow and fluid and electrolyte imbalances. The goal is maintaing a patent Airway, fluid replacement, comfort with analgesics, wound care to decrease infection, maintain body temperature and emotional support
What is the time frame for the acute stage of burn injury? Where are the main concerns? What are the goals?
48 hours to wound closure is complete the main concerns are perfusion, pneumonia because of pain breathing too short and shallow breathing, respiratory compromise, infection. The goals are maintaining skin integrity, maintaining adequate nutrition for proper healing, not overloading the patient come encouraging adequate mobility and movement, supporting family
What is the time frame for the rehabilitative stage of burn injury? what are the goals?
From wound closure to the patient reaching the highest level of functioning. The goals are monitoring vital signs to get the patient back to baseline, activity intolerance, mobility concerns secondary to pain, comfort with analgesics but no aspirin due to an increase in GI ulcers and impaired healing, maintain skin integrity and reduce contractures with turning every two hours, and provide family and patient with support
If a patient comes in suffering from smoke inhalation and you see soot what can you do?
Intubate, suction, oxygen therapy with a face mask with humidified air, incentive spirometer for deep breathing, mucolytics to remove mucus, CPR, pain meds
What might you see if burn shop occurs?
A usually occurs in the first 12 to 36 hours, increase capillary permeability leading to fluid leakage and Thurs spacing leading to fluid volume deficit and hemoconcentration, decreased cardiac output, tissue perfusion and agrees bTW, metabolic and respiratory acidosis
When does fluid remobilization occur? What do you expect to
2 days to 2 weeks after burns. Expect to see if fluid shifting back into intravascular spaces, increase blood pressure and cardiac output, hemo dilation. We would expect to Diuresis the patient because you can see CNS changes with decreases in sodium and potassium
What oxygenation issues might you see with smoke inhalation?
Think of a smoky kitchen. So you might see wheezing, respiratory may need to be assessed, there may be a need for oral care
What might you see if you have a patient who comes in from heat inhalation?
Imagine that have been rescued from a burning house so you would see Lorenzo spasms, swollen lips, then maybe horse or an able to speak, decrease respiratory status
With 10 to 20% of carbon monoxide poisoning what might you see?
Headache, dizziness, nausea, abdominal pain
With 20 to 40% carbon monoxide poisoning what would you expect to see?
Drowsiness, irritability, change your personality, hypotension, bradycardia, decreased heart rate, decreased pulse or the skin might be dark red
For a patient with 41 to 60% carbon monoxide poisoning what might you expect
Convulsions and tachycardia
For patient with over 60% carbon monoxide poisoning what would you
Death
What is the treatment for carbon monoxide
Hyperbaric chamber
With burn patients what GI issues and considerations might you have?
There is decreased blood flow because the blood is shunted to the brain heart and vital organs. So you would experience gastric dilation which could lead to a paralytic ileus due to decrease in motility and curling is also which usually occurs after 24 hours of the incident because of decreased blood flow. Stress bleeding can lead to GI ulcers so we give protonix and carafate to keep the stomach. If there’s a decrease in H&H think GI tract
Autograft is what kind of wound covering?
The patients ownskin transplanted
What is homograft or an allograft wound covering?
From a cadaver or a living person
What is hetero graft also known as? What type of wound covering is this?
Xenograft, the from another species like a pig
What graft would you use for the eye
Amniotic membrane
What is cultured skin?
Skin grown from your own skin cells skin grown from your own skin cells
What is the difference between hypertrophic scarring and keloid?
Hypertrophic scarring is the overgrowth of collagen that grows over burns and it will stay the same size where keloid what can grow and change in size
A pressure dressing is individually made for burn victims. When can think when can’t believe them? What are they used for
Stay tight so you wouldn’t use them for an open wound, the individually made, the patient wears them 23 hours per day. And they are used to prevent and reduce hypertrophic scarring
