burns in class

Question 1

which burns might need a referral

Answer 1

• burns to specialty areas or at joints (face, hands, feet, peri area)
• inhalation burns
• chemical
• partial thickness >20 % TBSA
• deep partial thickness
• lightning victim- electrical burn
• circumferential burns ( all the way around that body space)
• frostbite
• SJS

Question 2

TPA with frostbite

Answer 2

• MICROTHROMBI THAT DEVELOPS BLOCKS CAPILLARIES THAT FEED THE REST OF THE DIGIT
• NEED TO GET WITHIN 24 HOURS TO OPEN UP THE TINY CAPILLARIES and clear the blockage

Question 3

superficial burn

Answer 3

pink dry itchy self healing

Question 4

partial thickness

Answer 4

pink blisters and painful

Question 5

full thickness

Answer 5

leathery dry not painful

Question 6

myoglobinuria

Answer 6

• from muscle breakdown that releases high amount of myoglobin in blood
• major concern would be renal damage (red urine because clogged up the renal)

Question 7

what burn injury includes muscle breakdown and causes myoglobinuria, bone fractures, dysrhythmias, and cardiac arrest

Answer 7

-electrical burns

Question 8

care for electrical burns

Answer 8

• EKG fro 24 hour

Question 9

what burn is most at risk for compartment syndrome

Answer 9

• circumferential burn (no compliance left- doesn’t stretch and gets tighter and tighter)

Question 10

3 phases of burn care

Answer 10

• emergent
• acute
• recovery

Question 11

in emergent phase what happens to plasma proteins water and sodium

Answer 11

• when capillary wall is damaged or they become enlarged cap permeability is increased and plasma proteins and other particles move into the interstitial space which contributes to the accumulation of interstitial fluid

Question 12

in emergent phase of burn what is expected in the initial lab work

Answer 12

• low albumin
• high hct: elevated relative to the total volume since there is less plasma- high concentration of hct but they didn’t bleed out (7 or less before giving blood)

Question 13

fluid imbalances that occur in the emergent phase

Answer 13

• plasma in vasculature: decreased
• UOP: decreased- loosing a lot of fluid
• potassium: increased- concentration higher with serum leaving
• Sodium: decreased
• ph: decreased- tissues not getting perfused= lose aerobic metabolism which lowers ph
• hematocrit: increased
• blood pressure: decreased: don’t have the blood return= decreased CO

Question 14

order of care in ED for burn

Answer 14

• airway
• 2 large bore IV (> 18g)
• assess for other injuries
• ointment to wound

Question 15

how to protect pt from secondary injury

Answer 15

• fluid resuscitation!!!!!!!

Question 16

three major complications of a large burn injury

Answer 16

• airway
• infection
• HYPOVOLEMIC SHOCK

Question 17

what type of pt is at risk for inhalation injury?

Answer 17

• enclosed spaces

Question 18

what are the signs of Inhalation injury? AND WHAT is the timeline for airway safety?

Answer 18

• soot (black)
• singed facial hair
• coughing out little black stuff
• voice changes (gargle)
• timeline: see need airway within first 24 or even 48-72

Question 19

best position for inhalation injury

Answer 19

• sitting up
• no pillow (keep airway straight)
• humidified air to prevent mucous plug

Question 20

what data can use as a reliable indicator of appropriate fluid resuscitation?

Answer 20

• urine output

Question 21

how to figure out map

Answer 21

• systolic x 1 + diastolic x 2 divided by 3

Question 22

goals of care in the emergent phase

Answer 22

• FLUIDS
• pain
• prevention of hypothermia

Question 23

what type of drugs are responsible for SJS

Answer 23

• antibiotics and anti-epileptics