Burns Flashcards
What are the steps for immediate first aid for burns?
- Remove burn clothes and irrigate for 10 mins with cool sterile saline.
- Cover with cling film (layered not wrapped)
- Warm patient to prevent shock (foil blanket)
- Electrical burns - turn off source
At what body surface area should children and adults be referred, what are the other reasons for referral?
- Adults >15%
- Children >10%
- Inhalation injuries
- Burns to face, hands, feet, or genitals regardless of burn size.
What are the signs of a burns inhalation injury?
- Direct injury to face/neck
- Dyspnoea
- Soot around nose/mouth, singed nasal hair
- Harsh cough, change in voice
What is the process for managing a burns inhalation injury?
- Give 100% oxygen until carboxyhaemoglobin levels known, aim for <10% for more than 6 hours.
- Formal airway assessment by anaesthetist, early intubation may be required.
- Extensive circumferential chest burns may impact thorax expansion, consider escharotomy.
What is the management for circulation in a severe burn?
- Fluid resuscitation - Hartmann’s according to Parklands formula
- Volume (ml) = 4 x body weight (kg) x body surface area (%) of burn
- 50% of this for first 8 hours, other half over then next 16 hours.
- Insert urinary catheter and give adequate analgesia
How is the burn surface area estimated?
Rule of nines or Lund and Browder chart
What is this a presentation of?
Red, painful burn.
Superficial epidermal burn
What is this a presentation of?
Pale pink, painful, blistered burn.
Superficial dermal burn
What is this a presentation of?
White, reduced sensation burn.
Deep dermal burn
What is this a presentation of?
White/brown/black, no blisters, no pain burn.
Full thickness burn
What are the main complications of burns?
- Extravasation of fluids - hypovolaemic shock
- ARDS
- Secondary infection (e.g. Staph A)
- Haemolysis - due to heat damage to RBCs
- Compartment syndrome - full thickness circumferential burn in extremity
- Protein loss
