burns Flashcards
what are the 5 primary causes of burns?which is the most common?
fire or flame scalds surface chemical electrical
fire or flame is moost common
classify burn extent
Burn depth Skin layers involved Physical exam Healing First degree , Only epidermis Blanching, painful, and erythematous Typically within 1 week
Second degree/ superficial partial thickness Involves minimal portions of dermis Blanching, painful, and erythematous, with blistering Epithelialize from retained epidermal structures in 1–2 weeks
Second degree/ deep partial thickness Injury extends into reticular dermis Non-blanching, pale and mottled, retains some pain sensation Heal in 2–5 weeks, with severe scarring
Third degree All dermis, into subcutaneous fat Insensate, hard, and leathery Can only heal from wound edges
(Page 1656).
what are the zones of burn injury ?
zone of coagulative necreosis surrounded by zone of stasis abd zone of hyperaeemia
what is the mortality in a patient with 90 % burn
82 %
disadvantage of rule of nine techniques
overestimates burn area
other methods for burn estimation
the Lund–Browder chart or Berkow Formula
what type of shock is fpound in burn p;atients
of hypovolaemic, distributive, and cardiogenic shock, and which fluid resuscitation alone cannot correct.
(Page 1658).
at what burn area systemic effects of burn are seren
20-25 %
endpoints of fluid resuscitation in burn patients
urine output grtr than .5ml per kg and map grtr than 65
when shud abdominal compartment pressure be measured
burns, intra-abdominal pressure monitoring should be considered in patients with burns involving more than 30% TBSA
(Page 1659).
use of colloids in burn
to be avoided in the first 24 hrs
HES to be avoided
how to modulate inflammation in burns
anti oxidants in the form of vitamin c
how to grade inhalational injury ?
A common grading system of inhalation injury developed by Gamelli et al., derived from findings at initial bronchoscopy, is based on the presence of: airway oedema, inflammation, mucosal necrosis, presence of soot and charring in the airway, tissue sloughing or carbonaceous material in the airway
(Page 1659).
treatment guidelines for inhalational injury
nebulized heparin, acetyl cysteine, adrenaline, and lung protective ventilation.
(Page 1660).
systemic therapy for hyper metabolism
of anticatabolic β-blocker (propanolol) and anabolic agents such as growth hormone, oxandrolone, insulin, insulin-like growth factor-1, glucagon-like peptide ketoconazole, or the combination of various agents have demonstrated beneficial effects
(Page 1660).
