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Surgery > Burns > Flashcards

Burns Flashcards

1
Q

burn highest risk ages and gender

A

18-35 yo

Males 2:1

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2
Q

__ age highest risk for scalds

A

1-5 yo highest risk

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3
Q

sunburn is considred a __ burn

A

radiation

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4
Q

thermal burn ex

A

scald, fire injury, smok inhalation, hot grease

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5
Q

electrical burn ex

A

lightning, household electricity

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6
Q

chemical burn

A

acids and alkalis

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7
Q

4 critical assements for burn pts

A

airway
other injuries
burn depth and BSA %
CO or CN poisoning?

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8
Q

perioroal burns and singed nasal hairs sign of..

A

thermal injury to upper airway

= airway edema

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9
Q

besides fluids sap and watching for hypothermia..

A

tetanus booster and treat pain and anxiety

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10
Q

a blistering burn is __ degree

A

partial thickness second degree

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11
Q

burn extending into fascia, muscle bone, organs is __

A

4th degree - life threatening

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12
Q

deep partial thickness burns take __ to heal

A

about 2 mo

considred a 2nd degree burn

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13
Q

t/f 3rd degree burns blanch

A

false,

painless yet need skin grafts

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14
Q

ex of pain meds given for bunr

A

80 mg ibuprofen or tramadol or hydrocodone

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15
Q

what is the urine output goal for burn fluid resuscitation

A

keep it to 30-50 mL per hr in adults

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16
Q

what is the parkland formula

A

LR 4 cc X kg X %BSA = fluid total for 24 hours

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17
Q

if suspect airway injury what should you do?

A

intubate

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18
Q

what are signs of airway injury

A

circumferential chest burns

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19
Q

if a kids is under __ then their head surface area is considred 18% instead of 9%

A

3 yo

20
Q

escharotomy def

A

eschar is the tough leathery tissue remaining after a full thickness burn

cut through this to prvt comprtment syndrome, facilitates circulation etc

21
Q

what is in LR?

A

130 mEq sodium, 109 of chloride, 28 of lactate, 4 of K+, and 3 of calcium

22
Q

what are smaller burns sometimes treated with? and why cant these two options be used in larger burns?

A

bacitracin or Neosporin

in larger burns worry about nephrotoxicity

23
Q

silver sulfadiazine is used..

A

as a porphylais against infection

24
Q

2 types of pts that silver sulfadiazine would cause more harm

A

skin grafts - will be destroyed

sulfa allergic pts

25
Q

why are prophylactic abx are not given unless..

A

worried about cellulitis.. then give cephalexin

26
Q

how often should dressings such as telfa be changed?

A

BID

27
Q

what are most common grafts

A

split thickness grafts aka auto grafts

28
Q

examples of best graft sites

A

thigh, thicker skin of back, buttocks, scalp

29
Q

chemical burns mostly caused by

A

acids and alkalis

30
Q

tx chemical burn?

A

copious irrigation with water

wound care and tetanus

31
Q

what should you NEVER do with a chemical burn

A

try to neutralize it with an acid or base

32
Q

are alkalis or acids more damaging? why?

A

alkalis: penetrate skin deepr and longer

greater danger of toxicity from systemic absorption

33
Q

3 potential complications of electrical burn

A

cardiac arrhythmia

compartment syndrome and rhabdomyolysis

34
Q

look for __ with electrical burns

A

entry and exit wounds
with DC current or contact wounds with AC current
- causes extensive deep tissue damage to electrical conductive tissues

35
Q

electrical burn tx

A

admit and call burn specialist

36
Q

tx of inhalation injury

A

fluids and supportive care

O2 bronchodilators etc

37
Q

2 main causes of inhalation injuries

A

direct heat - upper airway

inhaling combustible products - lower airway

38
Q

direct heat inhalation cause what type of injury

A

swelling that worses in first 24-48 hrs

39
Q

inhaling combustibles causes what type of injury

A

mucosal injuries, bronchoconstriction, obstructions etc

40
Q

sx of CO poisoning

A

HA, lightheadedness, dizziness, confusion, tachypnea, hypoxia

  • *check neuro status
  • *remember CXR and CO levels from arterial stick can be normal
41
Q

tx for CO poisoning

A

high flow administration of 100% O2 on non-rebreather

42
Q

___ can also occur from smoke inhalation

A

cyanide poisoning
odorless / burnt almond smell
consider when sx of CO poisoning yet results arenormal

43
Q

8 criteria to admit to a burn center

A
  1. partial thickness burns over 10% TBSA
  2. burn on face, hand, feet, genitalia, perineum, major jts
  3. 3rd degree burns in any age group
  4. electrical burns (lightening injury) and chemical burns and inhalation injury
  5. pts with comorbidities
  6. circumferential burns of chest or extremities
  7. peds pt in hospital without qualified ped specialist
  8. pts need social, emotional rehab etc
44
Q

what ages make burn pt high risk

A

under 10 or over 50

45
Q

3 indicators for mortality

A

burn size, inhalation injury and age

46
Q

yet what is highest predictor of morbidity

A

age, % tsa, inhalation, plus if extra trauma or PNA

47
Q

what is huge for burn pts?

A

must start PT and or OT orders right during admission
**contractures are huge complication and liability
also psych screening big deal!

Surgery (3 decks)

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