Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

emergency medicine > burns > Flashcards

burns Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

list layers of skin

A
  1. epidermis: 10% of skin thickness
  2. dermis: 90% of skin thickness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is a superficial or first degree burn? what layers of skin are involved? how long does it take to heal?

A
  • only the epidermis is involved
  • red, painful, no blisters
  • heal within 7 days without scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

managment of a superficial or first degree burn

A
  • frequent moisturization: 4-6 x daily with non-perfumed water or petroleum based product that has low alcohol content
  • OTC NSAIDs for pain
  • wash area with mild soap and water
  • consider tetanus booster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is a partial thickness burn? what layers of skin are involved? how long does it take to heal?

A
  • extends partially into dermis
  • most will heal without grafting in 7-21 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

partial thickness burns are divided into what two types

A
  1. superficial
    • pink, moist, blisters, painful
  2. deep
    • pink to white, decreased cap refill, may be less painful
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

management of a partial thickness burn (outpatient)

A
  • keep wound moist
  • debride wound
  • dressing change 1-2 x daily
  • wash wound with each dressing change with mild soap and water
  • PO narcotics?
  • tetanus booster
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

extra management for superficial partial thickness burns

A
  • petroleum based moisturizer vs bacitracin
  • covered with occlusive dressing such as Xeroform, covered with roll gauze
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

extra managment for deep partial thickness burns

A
  • petroleum based moisturizer vs bacitracin and cover with occlusive dressing such as Xeroform, covered with roll gauze unless eschar present
  • eschar => silver sulfadiazine cream on 4x4, covered with roll gauze
    • slough or piece of dead tissue that is cast off from the surface of the skin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is a full thickness aka third degree burn? what layers are involved?

A
  • epidermis and full thickness dermis involved
  • hard, lethary, insensate
    • ​doesnt feel pain
  • only small burns will heal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

managment of full thickness aka third degree burn

A
  • almost always requires surgery
  • debride wound
  • silver saulfadiazine cream on 4x4, covered with roll gauze
  • change dressing 2x daily, wash wound with mild soap and water
  • PO narcotics
  • tetanus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a beyond full thickness burn

A
  • involvement of
    • muscle
    • tendon
    • bone
    • blood vessel
    • nerve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the ABA referral criteria: referral to burn center

A
  • partial thickness burns >10% of TBSA
  • burns involving face, hands, feet, genitalia, or major joints
  • third degree burns
  • burns + cocomitant trauma
  • burns + preexisting medical disorders that could complicate management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

oxygen is give to burn patients via a

A

100% oxygen non-rebreather

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what signs would suggest airway compromise and need to intubate

A
  • closed space injury
  • carbonaceous sputum
  • facial burns
  • COHb > 5
  • hoarse voice
  • singed facial hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

why is pulse ox not reliable in burn patients

A
  • carbon monoxide has 100x higher affinity for Hb, oximeter reads as O2
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is the preferred tx for cyanide toxicity

A
  • hydrocobalamin (cyanokit)
    • binds to CN to form vit B12
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is the number one cause of death related to fires

A

smoke inhalation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

four aspects of tx of inhalation injury

A
  • mechanical ventilation
  • pulmonary toilet: set of methods used to clear mucus and secretions from the airways
  • PNA prevention
  • supplemental nutrition
19
Q

when is parkland resuscitation used for burns

A

burns 20% TBSA or greater

  • >20% at highest risk for burn shock
20
Q

what is the rule of 9’s

A

adult

  • head: 9%
  • front of torso: 18%
  • back of torso: 18%
  • each arm: 9%
  • genital area: 1%
  • each leg: 18%
21
Q

how does burn create state of shock

A
  • increased perfusion to injured area -> edema
  • increased capillary permeability
  • decreased oncotic pressure
  • pt becomes hypotensive
22
Q

how can you assess whether you are maintaining adequate tissue perfusion to end organs of burn victims

A
  • urine output
    • adult: 0.5 mL/kg/hr
    • use foley catheter to monitor
23
Q

what is the parkland formula

A
  • 4mL Lactated ringer x weight (kg) x TBSA = 24 post burn total fluid
    • half of volume is given in first 8 hrs post burn
    • rest is given in remaining 16 hours
24
Q

over resuscitation in burn victims can lead to abdominal compartment syndrome which causes

A
  • decreased renal blood flow -> renal failure
  • intestinal ischemia
  • respiratory failure
25
Q

clinical presentation

  • decreased urine output
  • elevated bladder pressure (>25 mmHg)
  • increased peak expiratory pressure
  • poor ventilation
A

abdominal compartment syndrome

26
Q

tx of abdominal compartment syndrome

A
  • if unable to reverse, decompressive laparotomy
27
Q

incubation period of tetanus

A

4-14 days

28
Q

tetanus vaccine recommended every

A
  • protection from vaccine lasts 10 yeas
  • common practice to administer secondary prevention of last vaccination > 5 years
29
Q

what is the tetanus immunization schedule for children

A
  • DTap at
    • 2 mo
    • 4 mo
    • 6 mo
    • 15-18 mo
    • 4-6 yrs
30
Q

what type of burns require specialized care

A
  • chemical burns
  • electrical burns
  • circumferential burns
31
Q

managment of chemical burns

A
  • copiously irrigated with water
  • monitor progress with litmus paper
32
Q

what is important to monitor after a electrical burn

A
  • cardiac abnormalities
  • rhabdomyolysis
    • current follows path of least resistance and damage may be hidden under good skin
33
Q

what burns have the highest risk for compartment syndrome

A
  • circumferentially burned extremities
34
Q

what are the 6 P’s when assessing for compartment syndrome

A
  • Pain
  • Paresthesia
  • Pallor
  • Paralysis
  • Poikliothermia: inability to regulate core body temperature
  • Pulselessness
35
Q

escharotomy

A
  • incision through burned skin to underlying subcutaneous tissue
36
Q

fasciotomy

A
  • incision through the fascia overlying muscle compartments of an extremity
37
Q

where are incisions made in a escharotomy/fasciotomy

A
  • mid-medial and mid lateral on extremity
38
Q

differentiate between allograft and xenograft and autograft

A
  • allograft: donor human skin
  • xenograft: skin from animal, usually pig
  • autograft: patien’ts own skin
39
Q

why is nutritional support so important in burn victims

A
  • resting metabolic rate elevates
40
Q

list chronic complications of burns

A
  • chronic ulceration
  • scar contractures
  • hypertropic scarring
41
Q

what is major concern with chronic ulcerations in burn victims

A

development of squamous cell carcinoma (marjolin ulcer)

42
Q

differentiate between keloid and hypertropic scars

A
  • keloid: overgrowth of scar tissue, beyond area of injury
  • hypertrophic: thick, raised red, does not extend beyond original injury
43
Q

what are scar contractures

A
  • connective tissues replaced with fibrotic tissue
  • causes decreased ROM leading to shortening of muscle

emergency medicine (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions