Burns and Bites Flashcards
burn that appears wet, BLISTERS, painful. partial thickness or deep partial thickness
second degree thermal burn
burn that involves subcutaneous tissues and is a/w electrical burns
fourth degree thermal burn
burn that is red, painful, appears dry, and no blisters. superficial
first degree thermal burn
full thickness burn with white eschar. NOT painful
third degree thermal burn
parkland formula
4 x weight (kg) x BSA for fluid resuscitation- give half over first 8 hours. remaining half over 16 hours
burn assessment
fluid resuscitation using parkland formula, maintain urine output at 0.5 ml/kg/hour, and heartrate less than 120 bpm
burns involving __ at risk for severe complications
face, perineum, hands, and feet
birn tx
would care- silver sufadiazine dressings and silver release dressings, debridement and grafting - split thickness skin graft and free graft
burn maintenance tx
early and proper grafting, splint and ROM exercises, elevate, compression dressings
complications of burns
infection and sepsis syndrome, circumferential burns, stress gastritis and ulcers, and seizures in children
most susceptibe in frostbite injury
skin and muscle over tendons and bone
how does frostbite injury develop
looks white and waxy, painless at beginning. After rewarming, becomes mottled blue/urple, very painful, and blisters form. sloughing may occur
rewarming in frostbite
done in warm water bath for 20-30 minutes. no massage! do not thaw until warmth can be maintained
hypothermia
core body temp less than 35 degrees C
shivering stops at …
less than 32 degrees C
what organ is most sensitive in hypothermia and what can result?
heart- V. Fib happens between 21-24 degrees C
BP and HR in hypothermia
BP normal, heart rate slow
EKG on hypothermia
PR is lengethened, J wave at junction of QRS and ST segment
hypothermia causes patients to become…
coagulopathic..watch for clots!
labs in hypothermia
hypoglycemia, dehydration, elevated amylase
what’s worse, acidic or basic burns?
basic burns- keep burning while acidic burns form eschar, but don’t burn deeper
tx of human bites
medical urgency. if skin broken, abx. cleanse and irrigate would, anesthetize, debride, give tetanus vaccine
types of human bites
clenched fist injury (“fight bite”, can occur with fracture) or occlusive bites (crush injury, break the skin)
bacteria in human bites
Eikenella corodens, HBV can also be transmitted
bacteria in dog and cat bites and abx
pasturella multicoda, augmentinq
dog and cat bites tx
clean and irrigate wound, anesthetie, debride. get xray to check for cat teeth
Rabies virus produces
encephalitis, nearly always fatal
types of spider bites
lactrodectus (black widow) or loxosceles (brown recluse)
spider bites prognosis
heal slowly, self limited
tx for lactrodectus sp. bite
calcium gluconate or opiods and benzos will help relive pain. self-limited.
wound excision helpful in spider bites?
NO
snake bites have 2 major effects
hemotoxins- anticoagulation and hemolytic anemia causing ATN and neurotoxins that act on Ach receptors and block condution- that can cause paralysis of respiratory muscles
non venemous snake bites tx
cleanse area, give tetanus vaccine
venemous snake bites tx
determine envenomation - administer antivenom only if moderate or severe envenomation has occured. If coral snake bite- give antivenom no matter waht.
labs/tx in snake bite
type and crossmatch, coags, CBC, UA, ABCs, apply compressive bandage, keep patient still and warm, remove rings, antivenom
