Burns

Question 1

Three key things related to Burns

Answer 1

1) Airway
2) Fluid Shifts
3) Infection

Question 2

Skin

Answer 2

largest organ in the body

Question 3

Etiology of Burns

Answer 3

Energy Transfer

Question 4

thermal burns

Answer 4

dry heat
moist heat
contact with hot or rough surfaces

Question 5

dry heat

Answer 5

house fire or explosion

Question 6

moist heat

Answer 6

contact with hot liquids or steam

Question 7

contact with hot or rough surfaces

Answer 7

hot metal, tar or grease. Often causes a full-thickness burn.

Question 8

chemical burns

Answer 8

home or industrial, acids, organic compounds, home cleaners

Question 9

electricity

Answer 9

surface injury might look minimal, but internal injuries might be severe.

Look for entrance and exit wound

Question 10

Ionizing radiation

Answer 10

from radioactive material. Can be from therapeutic radiation, usually minor skin irritation.

use gloves to remove

Question 11

Smoke and Inhalation

Answer 11

can occur at the same time as a thermal or chemical burn.

Question 12

When are systemic responses to burns elicited?

Answer 12

after 30% of TBSA is burned

Question 13

Jackson’s Zone

Answer 13

Coagulation
Stasis Zone
Hyperemia

Question 14

Coagulation

Answer 14

worse part of the burn, most direct contact, irreversible tissue loss

coagulation of proteins

Question 15

Stasis Zone

Answer 15

occurs around the coagulation zone, hopefully salvageable

Question 16

hyperemia

Answer 16

most outer edge of the burn with edema, heals pretty quickly

Question 17

Cardiovascular

Answer 17

increase capillary permeability,

increase heart rate, decrease cardiac output

Question 18

Integ

Answer 18

Think of zones and what happens at the local response

Question 19

Vasular

Answer 19

leakage from the intravascular department to the interstitial department

hypovolemic, hypotensive

Question 20

Fluid and Electrolytes

Answer 20

hyponatremia, sodium and water follow each other, hyperkalemic

decreased protein

Question 21

Pulmonary

Answer 21

inflammation mechanisms can cause edema, most overlooked reason when people die, cyanosis,

Question 22

Gastrointestinal

Answer 22

massive stress can leave to ulcer, curling ulcer

Question 23

Metabolic

Answer 23

will increase 2-3 times, increase intake of calories, increase protein, hard time regulating temp

Question 24

Immunologic

Answer 24

decrease in overall immune function, higher risk for infection, lost primary barrier against infection

Question 25

Superficial-thickness

Answer 25

Epidermis is the only part of skin injured

Question 26

Superficial Partial-Thickness

Answer 26

Caused by injury to the upper third of the dermis, leaving a good blood supply blanches Heal in 10-21 days

Question 27

Deep Partial-Thickness

Answer 27

Extend deeper into the skin dermis and fewer healthy cells remain. no pain potential graft

Question 28

Full-Thickness

Answer 28

Destruction of the entire epidermis and dermis, leaving no cells to repopulate

Question 29

Rule of nines

Answer 29

Quickly estimate the total body surface area that is burned | Multiples of nine

Question 30

Rule of Palms

Answer 30

their palm is 1%

Question 31

Deep full thickness burns

Answer 31

may have to amputate | muscle, bones, and tendons

Question 32

General care for all types of burns

Answer 32

Assess for airway patency Administer oxygen as needed Start IV and fluids Perform head to toe assessment

Question 33

Chemical burn care

Answer 33

DO NOT WET THEM! Brush off dry chemicals on skin and clothing Remove patients clothing

Question 34

Electrical Burns care

Answer 34

Separate the patient from the electrical current Smother any flames that are present Initiate CPR Obtain EKG entrance and exit wounds

Question 35

Radiation Burns care

Answer 35

Remove patient from source Remove clothing with tongs or lead protective gloves If patient has radioactive particles on skin, send to radiation decontamination center Help patient bathe or shower

Question 36

Flame burns

Answer 36

smother flames | remove smoldering clothing and all metal objects

Question 37

Resuscitation

Answer 37

onset to 24/48 hrs ``` airway edema pain fluid shifts, hypovolemia(ARDS-->ABG) decreased cardiac output ```

Question 38

Acute

Answer 38

36-48 hrs after until wound is closed

Question 39

Rehabilitation

Answer 39

wound closure to highest level of functioning

Question 40

Resuscitation phase problems

Answer 40

airway, fluid imbalance, edema, decreased cardiac output, body temp, pain, hypotensive, decreased cardiac output, decrease urine output

Question 41

ABCDE

Answer 41

Airway (inhalation injury) Breathing (inhalation injury, pulmonary fluid overload) Circulation (FLUID SHIFTS, hypotension, fluid overload, urine) Disability (LOC, pupils, neuro) Exposure/environment (energy source, jewelry or clothes, chemical exposure, warmth)

Question 42

Parkland Formula

Answer 42

4ml/kg/TBSA

Question 43

signs of airway closure

Answer 43

hoarseness, hard cough, difficulty swallowing

Question 44

Acute phase

Answer 44

``` Worried about airway and replacing fluids Daily weights More focused on infection Risk for pneumonia increases Kidneys kick back in Increase in urine Lose some of the initial edema ``` increase calorie and protein graft

Question 45

Rehabilitative Phase

Answer 45

Begins with wound closure and ends when the patient returns to the highest possible level of functioning Psychosocial care, ways to dress their wound, make up to cover it, talk to people similar,

Question 46

large bore IV

Answer 46

18g or larger

Question 47

Health Promotion and Maintenance

Answer 47

``` check bathe water use pit holders wear sunscreen do not smoke around oxygen have an exit plan never reenter buildings ```