Burns

Question 1

Burns

Answer 1

Water evaporating from skin, denaturing the proteins that make up cell membranes

Question 2

Four types of burns

Answer 2

Thermal

Electrical

Chemical

Radiation

Question 3

Three layer of skin

Answer 3

Epidermis

Dermis

Hypodermis

Question 4

What are thermal Burns

Answer 4

Generally the most common type of burn

Result from exposure to contact with steam, flames, flash, hot surfaces or hot liquids with a temperature above 115 degrees Fahrenheit

Question 5

Types of burn and severity of the burn depends on what?

Answer 5

Number of layers of skin affected

Question 6

What percentage of burns are estimated to be preventable

Answer 6

75%

Question 7

Electrical Burns

Answer 7

Damage done by electricity entering the body and travelling through the tissues

Question 8

What part of the body suffers most damage

Answer 8

Extremities suffer the most tissue damage because their small size results in higher local current density

Question 9

Severity of electrical Burns depend on 4 things

Answer 9

Type of current

Amount of current

Path of current

Duration of contact with current

Question 10

Number one concern with electrical burn is

Answer 10

Cardiac dysrhythmias

Question 11

Common arrhythmias following electrical burns are

Answer 11

PVCs

V-tach

V-fib

Question 12

Injuries following electrical Burns

Answer 12

Skin burns at entrance and exit sites

Possible fractures and / or dislocations from violent muscle contractions

Internal injuries may also include muscle and nerve damage, and blood clots from current passage

Question 13

Chemical burns

Answer 13

Strong acids or bases

Question 14

Tissue damage factors are

Answer 14

Chemical concentration

Quantity

Manner and duration of exposure

Question 15

Injuries following a chemical burn

Answer 15

Injuries to the skin as well as internal organs (liver and kidney)

Volatile chemicals cause damage via inhalation -airway compromised

Question 16

Common items that cause chemical burns

Answer 16

Bleach

Concrete mix

Drain or toilet bowl cleaners

Metal cleaners

Swimming pool chlorinators

Question 17

Chemical burn signs and symptoms

Answer 17

Redness, irritation, burning, pain or numbness at the site of contact

Formation of blisters or black dead skin at the contact site

Vision changes if the chemical gets into your eyes

Low blood pressure

Faintness, weakness, dizziness

Shortness of breath or severe cough

Headache

Muscle twitching or seizures

Cardiac arrest or irregular

Question 18

Chemical burns removal

Answer 18

PPE

Remove all pieces of clothing with chemicals on them

Flush chemicals with copious amounts of water. If dry chemicals are on the skin they should be brushed off before irrigation

Question 19

Radiation

Answer 19

Burns due to radioactive materials

Question 20

Three types of radiation

Answer 20

Alpha

Beta

Gamma

Question 21

Alpha radiation

Answer 21

Lowest level

Week source of energy

Stop by clothing or first layer of skin

Question 22

Beta radiation

Answer 22

Medium strength

Stop by light clothing or uppermost layer of skin

Question 23

Gamma radiation

Answer 23

Powerful electromagnetic emitted by radioactive substances

Travels through the body without hesitation

Nearly impossible to protect from x-rays

Question 24

Three important factors for radiation Burns

Answer 24

Duration of exposure

Distance from The Source

Shielding between you, patient, and source

Question 25

Inhalation injury

Answer 25

Classified as CO poisoning, heat inhalation, and smoke inhalation Most frequent injuries occur when the patient is trapped or confined to a small space

Question 26

Byproduct of combustion

Answer 26

Co poisoning

Question 27

CO2 binds to hemoglobin?

Answer 27

257 times stronger than oxygen

Question 28

CO is?

Answer 28

Colorless Odorless Tasteless

Question 29

Co poisoning signs and symptoms

Answer 29

Altered loc Normal skin colour and condition, no apparent cherry-red are cyanotic skin Headache, irritability, dizziness, fainting Convulsions, apnea, SOB

Question 30

Breathing in flames and gases do not result in heat transport therefore?

Answer 30

Injuries damage the upper Airways Heat does not transport down to the lungs Supraglottic (hypopharynx) is where swelling occurs ---Area capture is crucial

Question 31

Inhalation signs and symptoms

Answer 31

Brassy, non productive cough Horse voice Stridor Mouth, nose burn Airway edema, erythema Singed facial are nose hairs Sooty sputum

Question 32

1st degree burn

Answer 32

Involves the upper epidermis and dermis only

Question 33

1st degree burn signs and symptoms

Answer 33

Redness Tenderness Pain No blisters Skin intact

Question 34

2nd degree burn

Answer 34

Similar to 1st degree - reddened, painful, edematous. Blisters formed Partial thickness burn because the dermis is still intact and able to completely regenerate skin

Question 35

3rd degree

Answer 35

Full thickness burns penetrate entire dermis - destroying ability to regenerate May involve blood vessels, nerves, muscle tissue, bone and even internal organs White leathery appearance w/ underlying clotted vessels Anesthetic Charred

Question 36

Using the palm of the hands in order to calculate burn %

Answer 36

1%

Question 37

Burn % in an adult

Answer 37

``` Head - 9% Front - 18% Back - 18% Arms - 9% each Legs - 18% each Groin - 1% ```

Question 38

Burn % in an infant

Answer 38

``` Head - 18% Front - 18% Back - 18% Arms - 9% each Legs - 14% each ```

Question 39

Reasons to go to a burn treatment center

Answer 39

2nd + 3rd degree burns - 10% BSA if age <10 or >50 2nd + 3rd degree burns - 20% BSA any age Burns to face, hands, genitalia, perineum, and skin over major joints 3rd degree Specialized burns Pre-existing significant medical disorders Significant other injuries

Question 40

What are specialized burns?

Answer 40

Electrical Chemical Inhalation Circumferential chest or extremity injury

Question 41

Parkland formula

Answer 41

4 x kg x BSA 1/2 fluid given over first 8 hours, and other 1/2 over 16hrs. Volume of fluid given is based on the time elapsed since the burn

Question 42

Tx - Dressing

Answer 42

Rapid cooling - may help progression After removal from source of burn, cooling should be done w/ clean water max 1-2 minutes. (Longer can be detrimental, may induce hypothermia and shock) After cooling apply clean dressings. Be attentive to warning signs of hypothermia

Question 43

If time of injury is >30 min?

Answer 43

Do not cool

Question 44

Burns >10% BSA

Answer 44

Apply clean dry sheets

Question 45

Burns <10% BSA

Answer 45

Apply clean moist dressing

Question 46

If 2nd and 3rd degree BSA >10%?

Answer 46

Establish vascular access NS 500mL/hr prn to maintain hemodynamic stability to a total maximum 3L

Question 47

Considerations for dry chemicals

Answer 47

Do not flush w/ water unless in the eyes; water can cause the burning to increase w/ some chemicals Remove wet dressing from large burns (>10% BSA) after burning is stopped to prevent hypothermia

Question 48

Considerations for airway burns

Answer 48

Paralytics should be used w/ caution; ensure that the patients anatomy and/or injury will allow for intubation