Burns Flashcards
What burn category?
red, dry, painful
Blanchable
No blisters
Superficial
superficial burns heal w/in ____ days with/without scarring
7 days, without scarring
What burn category?
pink, moist blisters
painful
blanchable
superficial partial thickness
What burn category?
mottles color/patchy white-red
non-blanching
pain w/ pressure, not inherently painful
blisters
deep partial thickness
Partial thickness burns extend to the _______ and have ______ scarring
dermis
minimal to severe scarring
Superficial burns extend to the _____ and have _____ scarring
epidermis
no scarring
Tx of superficial partial thickness burn:
keep moist w. petroleum + xeroform dressing
debridement
common mechanism for superficial partial thickness…
water scald
common mechanism for deep partial thickness burn…
oil scalds, flames
Tx of deep partial thickness burn
keep moist w. petroleum + xeroform dressing
debridement
PT
+ sulfadiazine if eschar
How often to change dressings for partial thickness burns?
QD/BID
What type of burn?
dry, non-blanching
hard-leathery
painless
full thickness
Initial tx for chemical burn
copious water irrigation
In electrical burns, you must monitor for ____ and fluid resus of ______ ccs of urine/kg/hour
cardiac abnormality
1-2 cc urine/kg/hour
Circumfrential burns are high risk for…
compartment syndrome
2 procedures for circumferential burns…
escharotomy
fasciotomy
Pulse ox isn’t reliable for CO poisoning… what is?
carboxyhemoglobin levels
MC cause of death related to fire…
smoke inhalation
Pt. p/w:
HA/AMS
Cheery Red skin
Hypotension, arrhythmia, CV collapse
cyanide poisoning
Tx of CN poisoning…
cyanokit
3 upper airway inhalation sxs…
hoarseness
stridor
substernal retractions
4 lower airway inhalation sxs
tachypnea
decreased BS
w/r/r
accessory mm
4 staples of inhalation tx…
mech. vent
pulmonary toilet
PNA prevention
supp. nutrition
The below are indications for what procedure?
• Closed space smoke exposure • Carbonaceous sputum • Facial burns • COHb >5 • Hoarse voice • Singed facial hair
intubation
What is incredibly important to monitor for circulation resus in burns?
I&Os
Normal urinary output for adults…
0.5 ml/kg/hr
are diuretics indicated in acute setting for burns?
no
Burns > ___ require parkland resus
20% BSA
Parkland formula…
4mL LR x kg x TBSA = 24 hours post-burn total
What is the distribution of parkland formula over 24 hours?
half in 1st 8 hours
Is TPN recommended in burns? Why or why not?
no, increased mortality
Preferred nutrition therapy
duodenal enteral support
What type of diet for burns?
high carb, low fat
protein needs for burns…
1.5-2 g/kg
vitamin/mineral supplements for burns…
vit. A, E, D, C
Selenium
Zinc
The below indicate what?
• Partial-thickness burns of > 10% of TBSA
• Third-degree burns in any age group
• Burns that involve the face, hands, feet, genitalia, perineum,
or major joints
• Electrical burns, including lightning injury
• Chemical burns
• Inhalation injury
• Burn injury in patients with preexisting medical disorders
that could complicate management, prolong recovery, or
affect mortality
• Any patients with burns and concomitant trauma…
• Children in hospitals without qualified personnel or
equipment to care for their burn injuries
• Burn injury in patients who will require special social,
emotional, or rehabilitative intervention
burn center referral
W/in 3-5 days, what type of pathogen causes infx in burn patients?
G+ (staph aureus)
Burn pt. p/w:
• Decreased urine output • Elevated bladder pressure (>25 mmHg) • Increased Peak Expiratory Pressure • Poor ventilation
abd. compartment syndrome
3 chronic complications of burns…
chronic ulceration
scar contractures
hypertrophic scarring
Major concern for chronic ulcerations…
marjolin ulcer (CA lesion)
