Burns, electricity, and TASER emergencies Flashcards
What are the two main factors indicative of burn criticality?
Depth (how many layers involved) and extent (surface area size involved)
Which layers are involved in superficial burns?
Epidermis only
Does blistering occur in superficial burns?
No
Do superficial burns blanch under pressure?
Yes
How do superficial burns appear?
Red, painful, tender
Which layers are involved in partial thickness burns?
Epidermis and dermis
How do partial thickness burns appear?
Dark pink, moist/shiny, very painful
Does blistering occur in partial thickness burns?
Yes
Which layers are involved in full thickness burns?
Through to underlying structures
How to full thickness burns appear?
Thick, dry, leathery, pearly grey or charred black, waxy, may bleed or ooze from vessel damage
Are full thickness burns painful at the site?
No
Circumferential burns have increased likelihood of ____ ____.
Compartment syndrome
Why are airway burns a critical issue?
Swelling may occlude the airway, and IV fluids will increase swelling
How long is cool running water applied to a burn injury?
20 minutes
How long post-burn is cool water ineffective?
Three hours
Cool water should only be applied to minor burn injuries less than ____% in adults and ____% in children.
10% in adults
5% in children
True or false: burn injuries can cause a pt to become hypothermic quickly
True - the thermoregulatory system is compromised
What are the signs of carbon monoxide inhalation?
- Headache (dull, frontal, continuous)
- Fatigue/ataxic/confusion/convulsions
- Tachycardia
- Hypertension
- N + V
- “Roaring” in ears
What are the priority signs of upper airway burns?
- Neck/facial burns
- Singing of nasal hairs/eyebrows
- Tachypnoea/hoarseness/drooling
- Red, dry oral/nasal mucosa
What are the priority signs of lower airway burns?
- Loss of consciousness
- Occurred in enclosed space
- Tachypnoea
- Cough
- Wheezes/crackles
- Carbonaceous sputum
What occurs when acidic compounds interact with skin?
Protein denaturation and coagulative necrosis produces a scar, which limits the depth the acid can penetrate
What occurs when alkalis interact with skin?
Saponification and liquefactive necrosis of body fat. As there is no scar to limit penetration, alkali burns tend to penetrate deeper into tissues than acidic burns
Should neutralising agents be used for chemical burns?
No, because the reaction produces heat. Highest recommendation is water.
What are the concerns with chemical burns?
- Ongoing damage
- Chemical absorption
- Avoiding personal exposure
What are the factors that determine the effect of an electrical current passing through the body?
- Type of current
- Voltage
- Tissue resistance
- Current path
- Contact duration
Which current is three times more dangerous than the other, AC or DC?
AC
AC through the body can produce ____ ____.
Tetanic contraction
High voltage is defined as…
Greater than 1000 voltz
Voltage is defined as…
The electromotive force in the system, thus the greater the voltage the more extensive the injury - this is dependent on resistance.
What human body tissues offer the highest resistance? List them in decreasing order.
Bone, fat, tendon, skin, muscle, blood vessels, nerves.
How do clinical manifestations of electrical burns differ from thermal burns?
- Direct effects on heart and nervous system
- Electrical injury classically involves deep structures
- Small entry and exit wounds do not indicate small extent of damage
- Diversity of manifestations seen in electrical injury
What is the most common dysrhythmia resulting from electrical injury?
Ventricular fibrillation
Currents greater than 5 A cause…
Sustained cardiac asystole
AC 30-200 mA will cause…
Ventricular fibrillation
The energy from electricity is converted to…
Heat
Arc burns are seen in…
External passage of the current from contact to the ground
What are arc burns are associated with?
Extensive damage to skin and underlying tissue
True or false: electrical burns always have two exit wounds
False - may have single or multiple exit wounds
True or false: electrical burns are always full thickness burns
False - can by superficial, partial thickness, or full thickness
TASER shocks result in…
Involuntary muscle contraction and overwhelming pain to the subject, causing them to fall to the ground
True or false: if a current does not produce VF in 5 seconds, it will not produce VF after 1 minute.
True
TASER darts should be removed unless they are embedded in which areas?
- Eyes
- Genitals
- Face
- Neck
Under which circumstances may TASERed pts be left in police care?
May be left with police unless:
- Probes cannot be removed
- Pt requires psychiatric evaluation
- Injury assessment (other than probes) is required
- Substances other than alcohol are involved
- Abnormal 12 lead ECG
- Abnormal BGL
