Burns Flashcards
1st degree burns
sunburn (epidermis)
2nd degree superficial dermis (papillary)
painful to the touch, blebs and blisters, hair follicles intact, blanches
2nd degree deep dermis (reticular)
decreased sensation, loss of hair follicles, needs skin grafts
3rd degree burns
leathery (charred parchment) down to subcutaneous fat
4th degree burn
down to bone, adjacent adipose or muscle tissue
how to 1st and 2nd degree burns heal?
by epithelialization, primarily from hair follicles
Preferred fluid for resuscitation in burns
LR
Parkland formula
use for burns >20%, give 4 cc/kg x %burn in first 24 hours, give 1/2 volume in first 8 hours
when can parkland formula underestimate volume requirements
inhalation injury, ETOH, electrical injury, post-escharotomy
Can you use colloid in 1st 24 hours after burn?
No - causes increased pulmonary complications, Can use after 24 hours
child abuse accounts for ___% of burn injuries in children
15%
concerns - child abuse - burns - history
delayed presentation, conflicting histories, previous injuries
concerns - burn - child abuse - exam
sharply demarcated margins, uniform depth, absence of splash marks, stocking or glove pattern, flexor sparing, dorsal location on hands, very deep localized contact injury
what causes lung injury in burns
inhalation of carbonaceous materials and smoke, not by heat
burn patient has facial burns and wheezing, worry about
lung injury
