Burns Exam 3 Flashcards
What is the function of the skin
- Contain body fluids
- Maintain elasticity
- Physical appearance
- Identity
- Sense organ
- Barrier against infection
- Maintain body temp
As far as anatomy is concerned, what is the epidermis of the skin
Outer proof waterproof layer
What is the dermis of the skin
Elasticity, hair follicles, sebaceous glands, sweat glands, nerve fibers for pain, temperature, touch, pressure
What is the subcutaneous layer of the skin
Connective tissue and fat
What is a superficial partial burn
AKA FIRST DEGREE BURN
reddened dry, painful area
What is a example of a superficial partial burn
Sunburn
What is a partial thickness burn
AKA SECOND DEGREE BURN
Blistering, skin may slough off, moist and weepy, very painful
Red under blisters
( pale areas are deeper partial thickness and may convert to full thickness)
What is a full thickness burn
AKA THIRD DEGREE BURN
Dry and non elastic
Color may be white, tan, cherry red or charred.
Little or no pain or sensation to burned area
How is severity of a burn determined
Depth of burn
% of body surface area burned
What is the burn size estimate
Victims palm is 1% BSA
What is the fluid of choice for burn patients
LR bc it mimics normal intravascular fluid
It treats hypovolemia and intracellular Na deficits
For fluid resuscitation, how much LR should a Child 5 years and younger receive
125 ml/HR
For fluid resuscitation, how much fluid should a child 6-13 yrs of age receive
250 ml/HR
For fluid resuscitation, how much fluid should a person 14 yrs and older receive
500 ml/ HR
What is considered the first survey of a burn patient
Provide fluid resuscitation
What is considered secondary survey of a burn patient
Obtain weight and closely estimate BSA
What is a thermal burn
Flame, flash, scold, contact
What is the leading cause of burns in children
Scalds ( thermal burn)
What are the ABCs of a thermal burn
Stop the burning process
Cool the burn never use ice
What is a complication of electrical burns
Immediate fatal arrhythmias ( v fib, or systole)
May be at a higher risk for arrhythmias later
Assess for other trauma ( C- spine, fractures)
Assess for compartment syndrome - fasciotomy may need to be done to release pressure
What is myoglobinuria
Damaged muscle that release myoglobin
It precipitates in the kidneys resulting in kidney failure
What color is the urine of a patient with myoglobinuria
Port wine colored urine
What is a target UO of a person with myoglobinuria
75-100 cc HR
What type of blood products does west pen give to large burn BSA patients
FFP
What type of dressing is preferred for a burn patient
Dry dressing are preferred but, less than 10% TBSA can use a wet dressing, no ointments
What are commonly used topicals of a burn patient
Silver sulfadiazine
Sulfamylon
Enzymes ( accuzyme)
Bacitracin, neomycin
What is the therapuetic use of sliver sulfadiazine
Does not penetrate eschar May cause leukopenia Wide spectrum Minimal pain Low toxicity Contraindicated with sulfa injury
What is sulfamylon
Penetrates eschar Can be painful Wide spectrum Used on ears, nose, (cartilage) Contraindicated with sulfa allergy Can cause metabolic acidosis
What are enzymes ( accuzyme)
Made from papaya fruit,
Disolves eschar
Well tolerated, may burn for first 5 minutes, harmless to healed intact tissue
What is bacitracin, neomycin
Does not penetrate eschar
May be used on face
Low toxicity
Used on skin grafts until healed
What are pressure garments
Constant pressure to keep scar flat
Worn 23 out of 24 hours a day
Worn for 18-24 months
Very warm to wear
What should a burn patient use for itching
They must never scratch
Give the anti histamine (Zyrtec)
Loss of plasma in a burn patient is greatest when
4-6 hours after the burn injury
