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N304 > Burns > Flashcards

Burns Flashcards

1
Q

What populations are at greater risk of death r/t burns?

A

children, elderly, and diabetics

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2
Q

At what percent of total body area does survival become worse?

A

20 percent

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3
Q

What age group has the best survival rate from burns?

A

15-45

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4
Q

What are the four types of burns?

A

Thermal
Chemical
Radiation
Electrical

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5
Q

Describe the difference between alkalitic and acidic burns

A

Akalitic; clumps the skin and erodes it away

Acidic; necrotic, stops on its own, eschar

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6
Q

What is the damage from an electrical burn dependent on?

A

TYPE of current
PATHWAY of flow
tissue RESISTANCE
DURATION of contact

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7
Q

Describe the difference between coming in contact with direct and alternating currents

A

DIRECT: are thrown away

ALTERNATING: cannot let go and keeps damaging

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8
Q

What factors influence severity?

A 
Depth of wound
Size of wound (rule of nines)
Age of pt
Past med hx
Location of burn injury
Associated trauma
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9
Q

List the three ways that burns are classified

A

1) depth of the injury
2) extent of the body area
3) severity of the burn

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10
Q

Describe the depth that burns can be (degree system)

A

1) superficial burns (first degree)
2) Deep Partial Thickness (2nd degree)
3) Full Thickness (3rd or 4th degree)

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11
Q

Describe the characteristics of a superficial (1st degree) burn.

A

Epidermal tissue only affected

Erythema, blanching on pressure, mild swelling

no vesicles or blisters initially present

Not serious unless large area

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12
Q

Describe the characteristics of a deep partial thickness (2nd degree) burn

A

epidermis and deep layer of dermis

fluid filled vesicles; red, shiny, wet, severe pain

Hospitilization required if over 25 percent involved

can scar significantly d/t extended healing time

can be red, whit, or brown

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13
Q

Describe the characteristics of a full thickness (3rd/4th) degree burn

A

Destruction of all skin layers

immediate hospitalization

dry, waxy white, leathery, or hard skin. No pain

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14
Q

Which chart for calculating TBSA is the most accurate for children and why?

A

Lund and Browder Chart

because it adjusts for age. it is good for children

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15
Q

What type of burns are not involved in TBSA calculations?

A

superficial (1st degree) burns

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16
Q

How is the severity of a burn classified? what are the three groups?

A

based on depth and TBSA

MINOR
MODERATE
MAJOR

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17
Q

Describe the characteristics of a MINOR burn

A

1) <15 percent of TBSA
2) Full thickness <2 percent
3) no involvement of eyes, face, hands, feet, or perineum
4) no pre-existing medical conditions
5) adult under 50
6) no other injury associated with the burn

18
Q

Describe the characteristics of MODERATE burns

A

1) <25 percent TBSA
2) full thickness <10 percent
3) no involvement of eyes, face, hands, feet, perineum
4) no pre-existing medical conditions
5) adult under 50
6) no other injury associated with burn

19
Q

Describe the characteristics of a MAJOR burn

A

1) >25 percent TBSA
2) full thickness >10 percent
3) involvement of eyes, face, hands, feet, or perineum
4) Electric is automatically considered major
5) >50 years old
6) accompanied by other injuries or inhalation burns
7) has pre-existing medical conditions

20
Q

What is the systemic response to a burn?

A

inflammatory response; swelling, edema, increased cap permeability

21
Q

What is the cellular response to a burn?

A

neutrophils go to area

enzymes destroy damaged tissue causing hyperkalemia, increased permeability

22
Q

How much does the CO decrease in the first 30 minutes of a burn?

A

30 percent

23
Q

What happens to renal function in a burn?

A

decreased perfusion to kidneys causes pre renal failure

intra renal failure can occur from necrosis and ischemia

24
Q

What happens to GI function with a burn? What is a risk associated with this?

A

it is suppressed

Paralytic illeus

25
Q

What is the immune response to a burn?

A

macrophages go to area to eat dmgd tissue

immunoglobulins are suppressed which increases risk of sepsis

26
Q

Why would you get a reduction of blood volume with a burn?

A

with the loss of plasma in fluid shift and decreased CO

27
Q

Why would you get decreased urinary output

A

2nd to fluid loss, decreased renal perfusion, and sodium and water retension

28
Q

Why would you get hyperkalemia with a burn?

A

as a result of the damaged cells releasing K+

29
Q

Why would you get metabolic acidosis with a burn

A

d/t the loss of bicarbonate along with Na+

30
Q

Why do you get a Na+ deficit with a burn?

A

large amounts of this are trapped in the edema fluid and by shifts into cells

31
Q

What is hemoconcentration and why does it occur in burns?

A

it is when there is a loss of plasma causing RBC to be more concentrated

d/t a loss of plasma proteins and decreased ability to hold onto the fluid

32
Q

What is the best fluid of choice for crystalloid replacement in burns and why?

A

Warmed RL

because it helps to counteract metabolic acidosis

33
Q

Describe the two formulas used to calculate the total amount of fluid that should be resuscitated in burns.

A

Consensus Formula
2ml x percent TBSA x wt

Parkland Formula
4ml x percent TBSA x wt

34
Q

When using the Parkland Formula, describe the ratios and times that this amount should be given over

A

based on time of burn

1/2 within the first 8 hrs
1/4 within next 8
1/4 within next 8

35
Q

What are the three stages of burn care?

A

EMERGENT
ACUTE
REHABILITATION

36
Q

Describe the EMERGENT phase of burn care

A

from onset to completion of fluid resuscitation

ABCs of trauma care

GOALS:
secure airway, support circulation, comfort, prevent infection through wound care, maintain body temp, provide emotional support

Gain knowledge of circumstances of burn

obtain pre burn wt (if not available use dry wt)

Know health hx because latent conditions can flare up d/t stress

37
Q

Describe the ACUTE phase of burn care

A

from start of diuresis to near completion of wound closure

efforts are pain relief to manage wound

adequate nutrition; prefer NG than parenteral if possible d/t lots of fluids

maintain fluid, electrolyte, acid base balance

monitor for complications

provide emotional support

planning for rehab and discharge

wound management

38
Q

Describe the REHABILITATION phase of burn care

A

often a long process not only encompassing physical injuries but also psychosocial care of individual and family

reconstructive surgery may be necessary to address functional and cosmetic problems

39
Q

What are the four goals of wound management

A

1) Contain bacterial growth
2) Provide comfort
3) Facilitate the healing process
4) Promote restoration and function

40
Q

Why should you not use ice at home to manage? what is an appropriate solution?

A

It vasoconstricts and causes tissue shock

luke warm water is better

N304 (4 decks)

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