Burns Flashcards

1
Q

What is a thermal burn?

A

A burn caused by conduction or convection such as when coming in contact with a hot liquid, fire, or steam

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2
Q

What is an electrical burn?

A

burn caused by the passage of electrical current though the body which typically has an entrance and an exit wound and can cause significant cardiopulmonary or other organ damage

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3
Q

What is a chemical burn?

A

a burn which occurs when certain chemical compounds come into contact with the skin and the skin will continue to burn until the compound is diluted or removed

compounds which can cause burns include sulfuric acid, lye, hydrochloric acid and gasoline

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4
Q

What is a radiation burn?

A

A burn which occurs most commonly with exposure to external beam radiation therapy which can alter the DNA at the site of the burn and the ischemic injury may be irreversible and non-healable

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5
Q

What are the 3 zones of injury for burns?

A

Zone of coagulation

Zone of stasis

Zone of hyperemia

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6
Q

What is the Zone of coagulation?

A

area of a burn that is the most severe and has irreversible cell damage

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7
Q

What is the Zone of stasis?

A

area of less severe damage from a burn that possesses reversible damage and surrounds the zone of coagulation

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8
Q

What is the Zone of hyperemia?

A

area surrounding the zone of stasis that presents with inflammation but will fully recover without any intervention or permanent damage

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9
Q

What is a superficial burn?
How do these burns typically present?
How long do they take to heal?

A

a burn that only involves the outer epidermis

usually presents with redness and slight edema

healing usually takes place without peeling or scarring in 2-5 days

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10
Q

What is a superficial partial thickness burn?
How do these burns typically present?
How long do they take to heal?

A

involves the epidermis and papillary dermis layer (superficial dermis)

Wound is usually extremely painful and exhibits blisters

healing with minimal to no scarring usually takes 5-21 days

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11
Q

What is a deep partial thickness burn?
How do these burns typically present?
How long do they take to heal?

A

burn that involves the complete destruction of the epidermis and the majority of the dermis

Area may appear to be discolored with broken blisters and edema but only presents with mild to moderate pain due to damage of nerve endings

Hypertrophic or keloid scarring may occur in the absence of infection and will heal in 21-35 days

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12
Q

What is a full thickness burn?
How do these burns typically present?
How long do they take to heal?

A

complete destruction of the epidermis and the dermis with partial damage to the subcutaneous layer

Area typically presents with heavy eschar formation and minimal pain

Healing time varies as this burn requires a graft and is susceptible to infection, the smaller the area of damage the faster it heals, some small wounds may not even need a graft, large areas may take months to heal even with grafts

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13
Q

What is a subdermal burn?

How long do they take to heal?

A

complete destruction of epidermis, dermis, and subcutaneous layer and may involve muscles and bones

This burn often requires surgery and calls for an extensive healing timeframe

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14
Q

What is the most painful type of burn?

A

Superficial partial-thickness burns

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15
Q

According to the rule of nines, name the approximate percentage of skin area of each of the following:

Head and neck
Anterior Trunk
Posterior Trunk
Upper Extremity (each) 
Genital Region
Lower Extremity (each)
A

Head and neck-9%
Anterior Trunk-18%
Posterior Trunk-18%
Upper Extremity (each)-9% (4.5% anterior 4.5% posterior)
Genital Region-1%
Lower Extremity (each)-18% (9% anterior 9% posterior)

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16
Q

How does the rule of nines apply for children under 1 year old?

A

9% is taken from the lower extremities and added to the head and neck, for every year of life 1% is distributed back to the lower extremities until the age of 9

17
Q

What is the anticipated deformity for burns to the anterior neck?

What are the splinting types to help address this deformity?

A

Deformity: flexion with possible lateral flexion

Splint: soft collar, molded collar, or Philadelphia Collar

18
Q

What is the anticipated deformity for burns to the anterior chest and axilla?

What are the splinting types to help address this deformity?

A

deformity: shoulder adduction, extension, and medial rotation

Splint: axillary or airplane splint and shoulder abduction brace

19
Q

What is the anticipated deformity for burns to the elbow?

What are the splinting types to help address this deformity?

A

Deformity: Flexion and Pronation

Splint: gutter splint, conforming splint, three-point splint, or an air splint

20
Q

What is the anticipated deformity for burns to the hand and wrist?

What are the splinting types to help address this deformity?

A

Extension or hyperextension of the MCP joints, flexion of the IP joints, adduction and flexion of the thumb, and flexion of the wrist

Splints: wrist splint, thumb spica splint, palmar or dorsal extension splint

21
Q

What is the anticipated deformity for burns to the hip?

What are the splinting types to help address this deformity?

A

flexion and adduction

Splints: anterior hip spica or abduction splint

22
Q

What is the anticipated deformity for burns to the knee?

What are the splinting types to help address this deformity?

A

flexion

Splints: conforming splint, three point splint, or an air splint

23
Q

What is the anticipated deformity for burns to the ankle?

What are the splinting types to help address this deformity?

A

plantar flexion

Splints: posterior foot drop splints, posterior ankle conforming splint, anterior ankle conforming splint

24
Q

What are the advantages and disadvantages of applying Silver Sulfadiazine to a burn wound?

A

Advantages: can be used with or without dressings, painless, can be applied directly, and is effective against yeast

Disadvantages: does not penetrate into eschar

25
Q

What are the advantages and disadvantages of applying Silver Nitrate to a burn wound?

A

Advantages: non-allergenic and application is painless

Disadvantages: poor penetration, makes assessment difficult due to discoloring, can cause severe electrolyte imbalance, and removal of dressings is painful

26
Q

What are the advantages and disadvantages of applying Providone-Iodine to a burn wound?

A

Advantages: antifungal and easily removed with water

Disadvantages: not effective against pseudomonas, may impair thyroid function, and has a painful application

27
Q

What are the advantages and disadvantages of applying Mafenide Acetate to a burn wound?

A

Advantages: penetrates burn eschar and may be used with or without occlusive dressings

Disadvantages: may cause metabolic acidosis, can compromise respiratory function, can inhibit epithelialization, and has a painful application

28
Q

What are the advantages and disadvantages of applying Gentamicin to a burn wound?

A

Advantages: may be covered or left open to air

Disadvantages: has caused resistant strains, ototoxic, and nephrotoxic

29
Q

What are the advantages and disadvantages of applying Nitrofurazone to a burn wound?

A

Advantages: bacteriocidal

Disadvantages: painful application and may lead to overgrowth of fungus and pseudomonas