Burns injury

Question 1

Define burns injury

Answer 1

Caused by excessive temperature and fire, chemicals , electrical current

Assessed by the size (% of the body covered) and the thickness (first to 4th degree-full thickness(

Question 2

Aetiology and risk factors (TYPES) of burns injury

Answer 2

Can be thermal, electrical, chemical
Care-often non-accident (20% are abuse)

Local response-coagulation of tissues and microvascular changes-swelling

Systemic-when 20% of the body is covered-fluid loss and vasodilation (capillary leak, oedema, organ dysfunction
will self limit in well resuscitated patients
big risk for secondary infection

First degree-like severe sunburn
Second-Scalding injury
third degree-flame or contact
4rth-high voltage injury

risk factors-male, young

Question 3

Epidemology of burns injury

Answer 3

UK
250000 per year
175000 attend ED
only 12000 are admitted

4th degree are quite rare in the end

180000 in the world die from it-mainly in developing countries

Question 4

Signs and symptoms of burns injury

Answer 4

First degree-Red, painful to touch, dry
Second degree-Wet, painful to touch, red, swollen
Third degree-epidermis and dermis-white/mottled, not painful
4th degree-tendon, muscle and bone involved-dark black, insinuate

commonly expect smoke inhalation-hoarse voice, harsh cough, stridor
And secondary staph aureus cellulite

Question 5

Investigations of burns injuries

Answer 5

The main issue is to assess the burn-degree and % of body covered
usually se burns calculator for fluids given

FBC-hypovalemia, thrombocytopenia
Carboxyheamoglobin-high in smoke inhalation
wound biopsy culture/histology-sepsis

Question 6

Management of burns injury

Answer 6

Any major burns (25% of body, partial thickness)-send to ressuss
ask specialists
Airway-bronchospcoy can help with smoke inhalation. or intubation
breathing-burns can impair thorax, and cause pneumothorax
give 100% o2
Circulation-IV fluid -2 large bore cannulas-crucial lifelines
reassess-4x weight x % coverage of body=ml of hartmans/24h

Cool the burn, warm the patient
(don’t cool patient-intensify shock)
Decompress if compartment syndrome
dont burst blisters
Parafin gauze
Iv morphine
Abx prophylaxis
dressings