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Kellie: SD EM #1 > Burns > Flashcards

Burns Flashcards

1
Q

What is the 3rd leading cause of accidental death in the US?

A

You guessed it… burns

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2
Q

What is the most common type of burn?

A

Thermal burns

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3
Q

Soft tissue is typically burned when it is exposed to temperatures above ??

A

115F or 46C

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4
Q

What are the 4 types of burns?

A

Thermal, chemical, electrical, radiation

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5
Q

What does thermal energy do to proteins?

A

Denatures and coagulates

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6
Q

Is tissue in the zone of coagulation salvageable? What about the area SURROUNDING it?

A

Zone of coagulation - irreversible destruction; Area SURROUNDING zone of coagulation is salvageable

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7
Q

Is perfusion increased or decreased at the outer margins of the burn?

A

Increased

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8
Q

Is perfusion increased or decreased surrounding the zone of coagulation?

A

Decreased

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9
Q

How large does a burn have to be for a patient to develop systemic responses to vasoactive mediators?

A

Greater than 15-20%

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10
Q

Myocardial depression from a burn occurs when a patient’s TBSA is greater than or equal to ___% burned

A

40

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11
Q

Burn shock and burn edema occur when the TBSA is greater than or equal to ____% burned

A

40

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12
Q

How long does systemic capillary leak persist for?

A

18-24 hours

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13
Q

What causes the reduction in oxygen carrying capacity that could exacerbate burn shock?

A

Local blood cell destruction and reduction of RBC mass

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14
Q

Largest body organ?

A

Skin

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15
Q

This is the outermost layer of skin composed of cornified epithelial cells. Outer surface cells die and are sloughed off as newer cells divide at the stratum germinativum/basale.

A

Epidermis

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16
Q

This is the middle layer of skin composed of primarily connective tissue. It contains capillaries that nourish the skin, nerve endings, and hair follicles.

A

Dermis

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17
Q

Layer of adipose and connective tissue between the skin and underlying tissues

A

Hypodermis

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18
Q

Who has “thin skin”

A

Less than 5 or older than 55

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19
Q

Involves only the epidermis; skin is red, dry, and PAINFUL; no blisters, blanches with pressure

A

Superficial

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20
Q

How long does it take a superficial burn to heal?

A

4-7 days

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21
Q

Involves epidermis and extends into dermis; Skin is red, moist, painful to TEMP AND AIR, and blisters may be present; Blanching is still present

A

Superficial partial thickness burn

22
Q

How long does it take for a superficial partial thickness burn to heal?

A

14-21 days

23
Q

Involves epidermis and deeper into dermis; Skin is whitish or yellowish, perception of pressure can be felt but there is usually no overt pain; Blanching is absent, 2-point discrimination is diminished. This burn WILL SCAR.

A

Deep partial thickness burn

24
Q

How long does it take for a deep partial thickness burn to heal?

A

21 days to 3 months

25
Q

Burns through all layers to subcutaneous tissue; Charred and black to pale and waxy white, leathery, painless (except in surrounding area of more superficial burns); Only deep pressure can be felt

A

Full thickness burn

26
Q

Will a full thickness burn heal on its own?

A

NO! Skin grafting required

27
Q

Extends into deeper tissue (fat, bone, muscle) and may require amputation

A

4th degree burn

28
Q

What are the two types of burns that are likely to cause a full-thickness burn

A

Chemical and electrical

29
Q

When do you use TBSA?

A

Only for burns more severe than superficial

30
Q

A persons hand including fingers represents ___% of total BSA

A

1%

31
Q

What is the rule of 9’s?

A 
Entire head and neck 9%
One entire arm 9%
One entire leg 18%
Entire back and buttock 18%
Entire chest and abdomen 18%
32
Q

Diagram that improves estimations for children as their head size relative to the rest of the body is of a higher percentage than in adults.

A

Lund and Bowder diagram

33
Q

Partial thickness burn greater than 10% BSA; burns that involve face, hands, genitalia, feet, perineum; electrical/chemical burns; burns w/ smoke inhalation injury; other things that I am too lazy to type

A

Refer to burn center

34
Q

Where do you treat a minor burn?

A

Outpatient

35
Q

Where do you treat a moderate burn?

A

Admit to hospital

36
Q

Where do you treat a major burn?

A

Refer to burn center

37
Q

Cool burns down in cool/room temp water; pain management; clean burns with soap and water; MAYBE pop blisters (hopefully I love popping blisters); Silver sulfadiazine

What type of burn is this the treatment regimen for?

A

Minor!

38
Q

How do you treat a burn infection?

A

Admission and IV abx

39
Q

Stabilize ABCs; Assess for smoke inhalation injury; remove hot and burned clothing; transfer to burn center; look for single or multi system trauma

What type of burn is this the treatment regimen for?

A

Moderate to severe

40
Q

_____ _____ can rapidly lead to airway edema

A

smoke inhalation

41
Q

Most common cause of death in burn victims/

A

Inhalation injury

42
Q

Do you always assume inhalation injury in any person confined in a fire environment?

A

YES

43
Q

How do you treat for smoke inhalation injury?

A

Intubate PRN or use high-flow O2

44
Q

Best way to improve circulation in a burn patient?

A

IO

45
Q

Best fluid for burn patients?

A

Lactated ringers

46
Q

What formula will determine how much fluid a burn patient needs?

A

Parkland formula

47
Q

Parkland formula for children?

A

Galveston formula

48
Q

What must you monitor for if more than 10% of a patient’s BSA is burned?

A

Hypothermia

49
Q

When do you order a full diagnostic workup for a burn?

A

Moderate and severe burns

50
Q

What causes more than 75% of fire-related deaths?

A

Pulmonary dysfunction

51
Q

What do you do when interstitial pressure rises to the point of compromising vascular flow? What causes this?

A

Eschar formation - need escharotomy to return blood flow

52
Q

HHOTIE signs of sepsis

A

Hyperventilation, hyperglycemia, obtundation, thrombocytopenia, intolerance of enteral feeding (diarrhea, ileus)

Kellie: SD EM #1 (6 decks)

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