Burns - Paeds Flashcards
Airway paeds burns, when to intubate?
- reduced conscious state
- inhalation/airway injury
- ?need for transport?
What to do if have circumferential chest burn?
restricting ventilation?
maybe escharotomy to decompress
how to deal with Breathing in paeds burns?
expose chest
ventilation
Airway need to consider also?
Cervical spine control
How to assess Airway in child?
Are they crying?
Difference between strider vs. wheeze?
Stridor: inhale
Wheeze: exhale
How to help airway maneuvers?
Jaw thrust
Chin lift
Airway devices that can be inserted?
-Gadel/Orgo-pharyngeal airway - use tongue depressor and don’t twist
- Naso-pharyngeal device
- endotracheal
Breathing need to consider?
Supplemental O2 maxed.
Circumferential chest burn?
Circulation needs to consider?
Haemorrhage control
Pulses, CRT
IV access
Circumferential limb burn?
BP in kids?
Not really useful
Shouldn’t be too low.
How to test capillary return in burns?
Elevate limb above heart
Then press mail bed for 5 seconds
Returns in less than 2 seconds
Check ALL 4 LIMBS
How to treat limb burn?
Always elevate
Disability looks at?
Neurological (AVPU)
Pupils: size, symmetry
Look for:
Head injury?
Systemic intoxication
Need for intubate: P in the poo
Exposure ?
Environmental control
What things to control in the environment?
Clothing, jewelry, front, The BACK!!!
Warm room, blanket
Cover wound
Baer hugger
2 Depth of burns?
Superficial
Deep
Epidermal burns counts?
Nope
Depth of burns?
Epidermal Superficial dermal Mid dermal Deep dermal Full thickness
First aid for burns? How long? What to use? What not to use?
20 minutes at least
Cold running water only
Or cold water compress
NO ICE.
Burn wound assesssment look at?
Depth
Circumferential?
%TBSA
Escharotomy need to be done how?
In anatomical position always
How to calculate TBSA?
Rule of 9s
Palmar method: 1%-1.5% of patient’s hand
Lund & Browder chart
Rule of 9s For adults?
9% heads Front 18% BAck 18% Arms: 9%, 5( Legs: 18%, 18% GRoin: 1%
Rule of 9s for kids?
18% head
Front back: 18%, 18%
Legs: 14%, 14%
Arms: 9%, 9%
fluids in Kids need what?
Dextrose needed For maintenance. Prevent Hypoglycaemia
Analgesia for burns kids?
Usu. IV opiods
3 views for trauma X-rays?
Lateral c-spine
CXR
Pelvis
Blood tests for trauma burns?
Trauma bloods: FBE, UEC, CMP, LFT
Temp
ECG
bHCG (I’m obliged to do this)
What tubes?
Gastric decompression
Secondary survey? What is AMPLE history?
Allergies Meds PMHx - health issues Last ate - Sx or aspiration risk Event that happened
Secondary survey is?
Head to Toe examination
Tetanus status
Would care: cling film
Reassess primary survey
How to refer?
ANZBA referral criteria
Things to think about?
Non-accidental injury?
