Burns Flashcards
Cause of thermal burn
Direct contact with hot object/steam
What is the severity of an electrical burn based on? (2)
Duration of contact
Strength of voltage
Which is a worse chemical burn - acid or alkali?
Alkali
What determines the severity of a burn? (3)
Depth of burn
Amount of skin involved
Associated clinical features
What is a partial thickness burn
Epithelial elements are spared
What features suggest a partial thickness burn? (3)
Erythema that blanches on pressure
Retains pinprick sensation
Bleeds on irritation
Further 3 classifications partial thickness burn
Superficial erythema
Superficial partial thickness
Deep partial thickness
Features superficial erythema burn (3)
Blanching erythema (b/c cap dilation) \+/- blistering Germinal layer = intact
How long does it take for superficial erythema burns to heal?
Within days
Features superficial partial thickness burn
Through epidermis –> germinal layer
Dermal appendages remain intact
Intense blistering and sloughing skin
How long does superficial partial thickness burn take to heal?
> 2w
Features deep partial thickness burn
Extends into germinal layer
Destroys dermis + appendages
Def of full thickness burn
Complete destruction of the skin and germinal layers
how do most full thickness burns heal?
By dense scar tissue with contracture and deformity
Clinical features full thickness burn (3)
Non-blanching
Doesn’t bleed on needle test
No sensation
What chart allows for accurate estimation of a burn SA?
Lund + Browder chart
What is the rule of 9’s
9% : H+N Each arm Front of each leg Back of each leg 18%: Front of trunk Back 1% Perineum
Features suggesting inhalation injury (6)
Hx of enclosed fire stridor Incr RR or SOB Singed nasal hair Facial burns Cough/sputum
Why do you get hypovolaemia from burns injury?
Loss of epidermis + plasma exudation through capillaries –> loss of plasma
—> intravascular depletion + shock
Why do you get anaemia from burns injury?
Destruction of RBC
Is pain more in superficial or deep burns?
Superficial
Immediate 1st aid Mx burns
Remove overlying clothes
Apply cool water to area
Cling film
Systemic Mx burns
IV opiates
Fluids
Manage nutrition
Mx partial thickness burns
Simple non-adherent dressings
If hands are involved in superficial partial burns, what extra treatment should be done?
Cover in sulfadiazine cream
Place in polythene bag
Mx full thickness burn
Total excision wound
+ skin grafting
Mx circumferential burn
Incision w/ escharotomy
Early complications burns (2)
Sepsis
Wound contractures
Causative agent <1 week spesis of burns
S. pyogenes
Causative agent >1 week burns
Pseudomonas
Late complications burns (4)
Sepsis
Acute peptic ulcer
AKI
Psychological
What is the Parkland Formula
used to calc vol of Hartman’s in 1st 24hrs
4ml x SA burn x kg
1/2 in 1st 8h
1/2 in other 8-24hr
When should grafting be performed on burns?
<5 days
Indications - Specialist Burns centre referral
Burn >30% TBA Circumeferential burn Inhalation injury Chemical or electrical burn Extremes of age
