Burns Flashcards
List the 2 care objectives for Burns.
- To identify and Mx potential airway burns as a priority.
- To minimise the impact of injury by maintaining tissue and organ perfusion, minimising pain and appropriate burn wound cooling and minimising heat loss during transfer to hospital.
List the 7 signs and symptoms of airway burns.
- Evidence of burns to upper torso, neck and face
- Facial and upper airway oedema
- Sooty sputum
- Burns that occurred in an enclosed space
- Singed facial hair
- Respiratory distress (dyspnoea +/- wheeze, associated tachycardia, stridor)
- Hypoxia (restlessness, irritability, cyanosis, decreased GCS)
Burns patients who receive intubation are at increased risk of ______? Once a long-term paralytic has been administered _______ management becomes a more significant priority.
Hypothermia.
Temperature management.
If a patient has burns requiring volume replacement and other injuries requiring fluids, should further fluids be given in addition to those calculated for the burns?
Yes. Fluids calculated for burns are for the burn injuries only. Other injuries will require additional fluids.
What is the increased risk associated with electrical burns?
Acute kidney injury secondary to profound muscle damage - these may require extra fluid.
Which burns are likely to be appropriate for the Treat and Refer pathway?
Small, isolated, superficial burn with unbroken skin, or sunburn.
How long should burn cooling occur for?
Does this include pre-AV arrival cooling time?
20 mins.
Yes. Timeframe includes any prior initiated cooling.
When should burn cooling be ceased?
If the pt begins shivering, or has a temperature ≤ 35°C.
What is the most appropriate method and temperature for cooling a burn? What methods should be avoided?
With gentle, running water between 5 - 15°C.
Ice/iced water is not desirable, avoid dirty (eg. dam) water due to infection risk.
If running water is not available to cool a burn, how else might cooling be achieved?
Immersing injury in water, using a spray bottle or applying moist towels.
How long should chemical burns be irrigated for, and what do you need to be mindful of?
Irrigate for as long as pain persists.
Be mindful of temperature management and avoid washing chemical onto unaffected areas.
What should be removed from burns patients?
Do not remove…?
Burnt or chemical contaminated clothing (if safe to do so) and jewellery prior to swelling occurring.
Do not remove matter that is adhered to underlying tissue.
What note is made about minimising heat loss for burns pts?
Normothermia is vital. Assess temp. ASAP and protect the pt from heat loss where possible.
What note is made about elevation for burns?
If appropriate, elevate affected area during transport to reduce swelling and oedema, especially in circumferential burns.
What note is made about dressing for burns?
Cling wrap is an appropriate burns dressing and is preferred for all burns. It should be applied longitudinally to allow for swelling.
