Burns

Question 1

burn highest risk ages and gender

Answer 1

18-35 yo

Males 2:1

Question 2

__ age highest risk for scalds

Answer 2

1-5 yo highest risk

Question 3

sunburn is considred a __ burn

Answer 3

radiation

Question 4

thermal burn ex

Answer 4

scald, fire injury, smok inhalation, hot grease

Question 5

electrical burn ex

Answer 5

lightning, household electricity

Question 6

chemical burn

Answer 6

acids and alkalis

Question 7

4 critical assements for burn pts

Answer 7

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

Question 8

perioroal burns and singed nasal hairs sign of..

Answer 8

thermal injury to upper airway

= airway edema

Question 9

besides fluids sap and watching for hypothermia..

Answer 9

tetanus booster and treat pain and anxiety

Question 10

a blistering burn is __ degree

Answer 10

partial thickness second degree

Question 11

burn extending into fascia, muscle bone, organs is __

Answer 11

4th degree - life threatening

Question 12

deep partial thickness burns take __ to heal

Answer 12

about 2 mo

considred a 2nd degree burn

Question 13

t/f 3rd degree burns blanch

Answer 13

false,

painless yet need skin grafts

Question 14

ex of pain meds given for bunr

Answer 14

80 mg ibuprofen or tramadol or hydrocodone

Question 15

what is the urine output goal for burn fluid resuscitation

Answer 15

keep it to 30-50 mL per hr in adults

Question 16

what is the parkland formula

Answer 16

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

Question 17

if suspect airway injury what should you do?

Answer 17

intubate

Question 18

what are signs of airway injury

Answer 18

circumferential chest burns

Question 19

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

Answer 19

3 yo

Question 20

escharotomy def

Answer 20

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

cut through this to prvt comprtment syndrome, facilitates circulation etc

Question 21

what is in LR?

Answer 21

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

Question 22

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

Answer 22

bacitracin or Neosporin

in larger burns worry about nephrotoxicity

Question 23

silver sulfadiazine is used..

Answer 23

as a porphylais against infection

Question 24

2 types of pts that silver sulfadiazine would cause more harm

Answer 24

skin grafts - will be destroyed

sulfa allergic pts

Question 25

why are prophylactic abx are not given unless..

Answer 25

worried about cellulitis.. then give cephalexin

Question 26

how often should dressings such as telfa be changed?

Answer 26

BID

Question 27

what are most common grafts

Answer 27

split thickness grafts aka auto grafts

Question 28

examples of best graft sites

Answer 28

thigh, thicker skin of back, buttocks, scalp

Question 29

chemical burns mostly caused by

Answer 29

acids and alkalis

Question 30

tx chemical burn?

Answer 30

copious irrigation with water | wound care and tetanus

Question 31

what should you NEVER do with a chemical burn

Answer 31

try to neutralize it with an acid or base

Question 32

are alkalis or acids more damaging? why?

Answer 32

alkalis: penetrate skin deepr and longer | greater danger of toxicity from systemic absorption

Question 33

3 potential complications of electrical burn

Answer 33

cardiac arrhythmia | compartment syndrome and rhabdomyolysis

Question 34

look for __ with electrical burns

Answer 34

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

Question 35

electrical burn tx

Answer 35

admit and call burn specialist

Question 36

tx of inhalation injury

Answer 36

fluids and supportive care | O2 bronchodilators etc

Question 37

2 main causes of inhalation injuries

Answer 37

direct heat - upper airway | inhaling combustible products - lower airway

Question 38

direct heat inhalation cause what type of injury

Answer 38

swelling that worses in first 24-48 hrs

Question 39

inhaling combustibles causes what type of injury

Answer 39

mucosal injuries, bronchoconstriction, obstructions etc

Question 40

sx of CO poisoning

Answer 40

HA, lightheadedness, dizziness, confusion, tachypnea, hypoxia * *check neuro status * *remember CXR and CO levels from arterial stick can be normal

Question 41

tx for CO poisoning

Answer 41

high flow administration of 100% O2 on non-rebreather

Question 42

___ can also occur from smoke inhalation

Answer 42

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

Question 43

8 criteria to admit to a burn center

Answer 43

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

Question 44

what ages make burn pt high risk

Answer 44

under 10 or over 50

Question 45

3 indicators for mortality

Answer 45

burn size, inhalation injury and age

Question 46

yet what is highest predictor of morbidity

Answer 46

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

Question 47

what is huge for burn pts?

Answer 47

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