Burns and Frostbrite Flashcards
What is the equation to determine how much IV fluid to gve a burn patient for fluid resuscitation?
When should it be given?
the Parkland equation
4 cc fluid x body weight (kg) x TBSA of burn
Give half the fluids over the first 8 hours and the other half over the next 16 hours
(if there’s an inhalation injury add 25% more fluids)
What vitamin do they often supplement IVF with?
Ascorbic acid
When the body is burned it goes into hyperdrive to try to heal. This produces lots of free radicals, so give ascorbic acid since it’s an antioxidant
Why is giving IVF so important for treating burns?
THere are three zones to the burn: coagulated (dead) stasis (in limbo) and hyperemia (increased blood flow - will heal)
Giving IVF pushes the stasis zone into the hyperemia zone and you save more tissue
NOTE: it will partially convert to the zone of coagulation within the first 24 hours, so you need to get fluids in the patient IMMEDIATELY
What is the best measure of fluid resuscitation success?
urine output - put a foley in everybody
In what burns do we calculate TBSA?
only in 2nd-4th degree burns - not in 1st degree
What does the TBSA + age predict?
likelihood of mortality
Which is more painful? 2nd degree or rd degree burns?
2nd degree
in 3rd degree burns, the damage is down in the subcutaneous tissue where the nerve would have been, so it’s painless
What are the three medications we can use for burns?
Silvadene
Mafenide acetate (Sulfamylon)
Silver Nitrate
What is the main complication with silvadene use?
neutropenia
What is the main side effect of sulfamylon?
It’s a carbonic anhydrase inhibitor, so it causes metabolic acidosis
What is hte main concern with silver nitrate?
It can leach Na+, K+, Ca2+, and Cl-
So you get hypocalacemia, hypokalemia, hyponatremia, etc.
Are antibiotics needed right away for burns?
Not in the first 3 days
after that, if there are signs of infection yes
What is an escharotomy and why is it performed?
it’s a circumferential incision make in the skin over a burn
when you have really bad burns on your extremities, the burn will cause proteins to denature and contract.
If it’s bad enough, they’ll contract so tight that they cut off circulation, so you need to make temporary incisions so they can continue breathing and perfusing.
WHat is the main characteristic of an electrical burn?
there’s an entry and an exit wound
the damage comes to whatever’s in between
Why do you got a ton of IVF to patients with electrical burns?
the electricity basically cooks the muscle and it breaks down
the byproducts can block up the kidneys, so you need to give lots of fluid to avoid renal dysfunction
