BURNS Flashcards
most common type burn
scald
water 60 c-140 Fahrenhet
can create partial or full thickness
Criteria for transfer burn
any third degree burn
partial thickness burn greater than 10%
burns to: hand, face, 3, genital, perineum, major joints
Electrical burns
Chemical burns
Inhalational injury
Burn with comorbidity that may complicate management
children if personnel requirement inadequate
PaO2 : FiO2 ratio suggested for intubation and smoke inhalation
250
This is a ratio of arterial oxygen pressure to percentage of inspired oxygen
400-500 normal
Markers suggesting intubation and inhalational injury
PCO2 greater than 50
PaO2 less than 60
Rule of 9’s total body surface area
entire head / face = 9 (neck alone 1%) entire upper extremity = 9 entire lower extremity = 18 anterior trunk ( chest and abdomen) = 18 posterior trunk ( upper and lower back) = 18
Pediatric rule 9
head 18%! Entire lower extremity 14% remaining of the same: the entire upper extremity 9% Anterior trunk 18% Posterior count 18%
total body surface area associated with 50% mortality
80%
Parkland formula
Start with burns over 20% 4 cc x kilogram x total body surface area 50% administrated over first 8 hours 50% administered over the next 16 hours RINGER'S LACTATE
Parkland formula and to fluid resuscitation and burns with kids
start with burns over 10% Parkland and.. must add maintenance (+glucose): 4, 2, 1 1-10 kg: 4 mL/kilogram 10-20 kg: 40 mL / h + 2 mL /kg/hr >20 kg: 20 mL / h + 1 mL / kg / hr
CO level associated with coma
40-60%
Greater than 60% fatal
Silver sulfadiazine
Silvadene
Antifungal
Does not penetrate eschar
Mafenide acetate
Sulfamylon Penetrate eschar painful excellent for fresh skin grafts Carbonic anhydrous inhibitor Retained chloride-hyperchloremic metabolic acidosis
Silver nitrate
Does not penetrate eschar
Hyponatremia-common
methemoglobinemia
Days needed to it take eschar to separate from partial thickness burn
10-14
what burns are included in total body surface area present for
partial thickness second-degree burns and full thickness third degree burns both included
what is the reduction and clearance time needed for carbon monoxide poisoning with 100% face mask
from 320 minutes down to 80 minutes
ATM hyperbaric
advantages of early excision
decreased burn sepsis
Decrease length of stay
Increased blood transfusion
Possible change in survival if associated with inhalational injury
Most common cause of death from burn complication
Pneumonia X.?
Used to be sepsis from burn
which direction does cover monoxide poisoning shift dissociation curve
to the left
Right is right
what age to start using the rule of 9
3 and older
was used to treat hydrogen cyanide toxicity
Hydroxocobalamin
sodium thiosulfate is slow on set
signs and symptoms of hydrogen cyanide poisening
ST elevation
Lactic acidosis
what type of chemical burn requires wiping off powder instead of water
powdered lye
Avoid activating aluminum hydroxide with water
Chemical burns to require water dilution
Form at acid
Hydrochloric acid
Acetic acid
formic acid is associated with what
hemoglobinuria
hemolysis
wishes treatment of hydrofloric acid burn
calcium
Topical calcium gluconate
Subcutaneous calcium
IV calcium gluconate
Interarterial infusion may be helpful in severe cases
Need continuous cardiac monitoring
Refractory hypopotassemia may indicate need for emergent excision of burn area
Early excision of burn wound is associated with
decreased reconstructive surgery
Decreased hospital length of stay
