*Burns injury Flashcards
What is the % burn by each body area?
Rule of Nines
What formula is used for calculating fluids needed in first 24hrs in burns?
Parkland formula - only used for those with >15% TBSA burns
What is the Parkland formula?
4ml x % burn x body weight in kg = Z ml in first 24hrs
HALF is given in the first 8hrs
2nd HALF given over remaining 16hrs
What does soot around nose and mouth + wheeze indicate in burns?
Inhalation and airway burns +/- airway oedema - usually requires intubation by anaesthetist
Which burns should be referred to burns unit?
> 10% of TBSA in adult or >5% in child
Full thickness burns >5% TBSA
Burns of face, feet, hands, perineum, genitalia, major joints
Circumferential burns
Chemical/electrical burns
Burns in presence of major trauma or comorbidity
Burns in the very young patient or elderly
Burns in pregnancy
Suspicion of NAI
How long should burns be held under cold water? What else should be done?
20min in first aid –> cover with cling film in layers (not wrapped circumferentially)
Why use cling film on burns?
Stops nerve endings being exposed to air –> less painful
What is the difference between superficial, partial and full thickness burns?
Superficial burns = usually dry, with minor blistering and erythema. Painful. e.g. sunburn or minor scalds. Involve the epidermis.
Partial thickness burns = moist and red, usually with broken blisters and normal capillary refill. Involve the dermis. They are usually painful unless they are deep dermal. Deep dermal burns may also have sluggish capillary refill.
Full thickness burns = dry, charred and often white. They are painless and have absent capillary return. They have destroyed the epidermis and dermis and have begun to destroy the underlying subcutaneous tissue.
How do you dress a burn? What is done with blisters?
Blisters should be de-roofed, dressed with a non-adherent dressing and reviewed in 48 hours in dressing clinic.
De-roofing blisters allows you to accurately judge the depth of the burn.
What are the causes of burns?
Thermal
Electrical
Chemical
What are the types of thermal burns?
Scalds - superficial
Flame - NB: inhalation is included here
Contact - deep dermal, full thickness
What are the types of electrical burns?
Domestic
High tension
Flash
Entry + exit burns
What are the types of chemical burns?
Acidic
Alkaline - worse as cause saponification
What are the zones of a burn?
Coagulation - maximum damage, irreversible
Stasis - less tissue perfusion
Hyperaemia - usually full recovery
When might you get falsely reassuring O2 sats in a burns incident?
When there has been CO poisoning - this will bind to Hb and give falsely high readings
