Burns Flashcards
Burn Classification
- 1st Degree - Superficial (sunburn)
- 2nd Degree - Partial Thickness (Blisters)
- 3rd Degree - Full thickness (completely destroyed tissue)
Brooke Burn Formula
2cc/kg x BSA = fluids over 24 hours
1st half in 1st 8 hours from time of burn
Universal Burn Formula
2-4 cc/kg x BSA = fluids over 24 hours
1st half in 1st 8 hours from time of burn
Parkland Burn Formula
4cc/kg x BSA = fluids over 24 hours
1st half in 1st 8 hours from time of burn
Preferred Formula
Burn Fluid Resuscitation
- Only count 2nd/3rd degree burns in BSA
- Parkland is the preferred formula
- Lactated Ringers is the preferred fluid
Palmer Method
Represents 1% BSA in both adults and children
Average Urine Output (Adult)
30-50mL/hr
Adynamic Ileus
Seen in patient’s with >20% BSA burns. Decreased bowel movements. Can cause problems in-flight due to the expansion of wet gasses.
Electrical Burn Predictors of Severity
- Voltage and amperage (amperage is better predictor)
- Resistance of internal body structure
- Type of pathway and current
- Duration and intensity of contact
Alternating Current (A/C)
- Household current (110v A/C)
- Will cause continual muscle contractions
- Unable to pull themselves away
- Explosive exit wound
- Causes V-Fib
Direct Current (D/C)
- Victim able to pull themselves away from current
- Discrete exit wound
- Causes asystole
Myoglobinuria
- Common in severe electrical injuries
- Treatment similar to crush injuries
- Maintain a urine ouput of 100mL/hr to perfuse kidneys and prevent renal failure (acute tubular necrosis or ATN)
- NaHCO3 to correct acidosis
- Mannitol to increase UOP and minimize ATN
Acid Burns
- Cause coagulative necrosis
- Dilute with water
- Neutralize hydrofluoric acid with calcium gluconate
Alkali Burna
- Dehydrate cells causing saponification (liquefaction necrosis)
- Dilute with copious amounts of water
- Worse than acid burns
Supraglottic Inhalation Burns
- Injury results from thermal insult
- Above the vocal cords
- Facial burns, carbonaceous sputum, singed facial hair, stridor
- Treat with oxygen, corticosteroids, supportive