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Emergency Medicine > Burns > Flashcards

Burns Flashcards

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Royal College: Emergency Medicine flashcards
1
Q

Highest Risk of Burns

A

Age: 18-35

Male > Female

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2
Q

Role of Skin

A

Semi-permeable barrier

Responsible for control of body temp

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3
Q

Cellular Changes Seen in Burns

A

Intracellular influx of Na/H20
Extracellular migration K
Disruption of cell membrane function
Failure of Na/K pump

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4
Q

Hematologic Changes in Burns

A

Increase in hematocrit
Increase in blood viscosity
Anemia due to RBC destruction

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5
Q

When does cell damage occur in burns?

A

113+ F

Denatures protein

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6
Q

3 Zones of Burns

A

Zone of coagulation
Zone of stasis
Zone of hyperemia

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7
Q

Zone of Coagulation

A

Irreversibly destroyed

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8
Q

Zone of Stasis

A

Stagnation of microcirculation

Will extend if not treated appropriately

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9
Q

Zone of Hyperemia

A

Increase blood flow

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10
Q

Burn Size

A

Rule of 9’s

Lund and Browder diagram

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11
Q

Clinical Features of First Degree Burns

A

Erythema of skin
Minimal surrounding edema
Minimal pain

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12
Q

Clinical Features of Second Degree Burns

A

Partial thickness
Very deep sunburn
MUCH MORE painful than 3rd degree

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13
Q

Appearance of Skin in Second Degree Burns

A 
Red/mottled
Blisters with broken epidermis
Considerable swelling
Wet/weeping surfaces
Painful
Sensitive to air
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14
Q

Clinical Features of Third Degree Burns

A

Damage to all skin layers
Subcutaneous tissues
Nerve endings

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15
Q

Appearance of Skin in Third Degree Burns

A 
Pale white or charred
Leathery
Broken skin with fat exposed
Dry surface
Painless to pinprick
Edema
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16
Q

Inhalation Burns

A 
Carbon around nose
Significant respiratory problems
Carbon monoxide exposure
CYANIDE
Intubate early
17
Q

Chemical Burns

A

Alkali worse than acids

IRRIGATE

18
Q

Electrical Burns

A 
More serious than they appear
Deeper structures have more damage
Can cause rhabdomyolysis
Acute renal failure
Urine Output: 100+ mL/h
Mannitol
19
Q

Management of Burns in the ED

A 
ABCDE
Intubate early if airway involvement
2 large bore IVs
Secondary survey
Look for corneal burns
Estimate depth and extent of burn
BSA 20+% needs NG tube
Labs
Tetanus status
Remove jewelry
Monitor distal pulses
Foley
Pain control
20
Q

Labs for Burn Victims

A 
CBC
CMP
ABGs
Carboxyhemoglobin level
CXR
EKG
Urine myoglobin and CPK
21
Q

Dressing for Burns

A

1% silver sulfadiazine (silvadene)
Re-evaluate q24h
Dressing changes BID until it stops wheeping

22
Q

Guidelines to Transfer

A 
Partial thickness of 10+%
Burns involving face, hands, feet, genitalia, perineum, or major joints
3rd degree burns
Electrical burns
Burn + complicating co-morbidities
Children
23
Q

Esophageal Burns

A

Intubate early
Alkali worse than acid
Scope: stop at burn

Emergency Medicine (17 decks)

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