Burns: Patho, Classifcation, Complications

Question 1

Can result from: what 5 things?

Answer 1

Heat
Chemicals
Electricity
Sunlight
Radiation

Question 2

Most common causes are ______ from hot liquids and steam, fire, flammable liquids

Answer 2

Scalds

Question 3

Inhalation injury from breathing ____

Answer 3

Smoke

Question 4

Three zones of burn wounds?

Answer 4

Zone of coagulation
Zone of stasis
Zone of hyperemia

Question 5

Zone of coagulation: cells are ______ injured

What occurs to the cells?

Answer 5

Irreversibly

CELL DEATH occurs

Question 6

Zone of stasis: Cells are ______
May ___ without specialized treatment
Usually within ______ hours

Answer 6

Injured
Die
24-48 hours

Question 7

Zone of hyperemia: ______ cell injury. Cells should _____

Answer 7

Minimal

Recover

Question 8

Rule of 9s for ADULT patient:

head and neck?

Answer 8

9%

Question 9

Rule of 9s for ADULT patient:

Anterior trunk?

Answer 9

18%

Question 10

Rule of 9s for ADULT patient:

Posterior trunk?

Answer 10

18%

Question 11

Rule of 9s for ADULT patient:

Arms?

Answer 11

9% each

Question 12

Rule of 9s for ADULT patient:

legs?

Answer 12

18% each

Question 13

Rule of 9s for ADULT patient:

Perineum?

Answer 13

1%

Question 14

For children, what should you use?

Answer 14

Lund-Brower charts

Question 15

Critical: ___% of body with ____ degree burns
___% or more with ____ degree burns
Complications common (resp involvement, smoke inhalation)

Answer 15

10% with third

30% with second

Question 16

Moderate: Less than ___% with ____ degree burns and ______% with ____ degree burns

Answer 16

Less that 10% with third

15-30% with second

Question 17

Minor: Less than ___% with ____ degree burns and ____ % with _____ degree burns

Answer 17

Less than 2% with third

15% with second

Question 18

Epidermal burn is a _____ degree burn

Answer 18

First

Question 19

Epidermal/First Deg:
Damage to \_\_\_\_\_\_ only
\_\_\_\_ or \_\_\_\_ appearance; NO blistering (dry surface)
\_\_\_\_\_\_ edema
Tenderness, \_\_\_\_\_ pain

Answer 19

EPI
Pink or red
Minimal
Delayed

Question 20

Epidermal/First Deg: Healing/Scarring
_______ healing in _____ days
__ scarring

Answer 20

Spontaneous, 3-7

NO

Question 21

Superficial Partial Thickness is a _____ deg burn

Answer 21

Second

Question 22

Superficial Partial Thickness/Second Deg:
_____ and upper layers of ____ are damaged
Bright ___ or ___ appearance
Blanching with _____ capillary refill
Blisters, ____ surface, weeping
_____ edema
Painful, sensitive to _____, ______ changes

Answer 22

EPI, DERMATOME
Pink or red
Brisk
Wet
Moderate
Touch, temp

Question 23

Superficial Partial Thickness/Second Deg: healing/scarring
_______ healing, typically in _____ days
_____ to __ scarring; discoloration

Answer 23

Spontaneous, 7-21

Minimal to no

Question 24

Deep Partial Thickness is a ____ degree burn?

Answer 24

Second

Question 25

Deep Partial Thickness/Second Deg: Severe damage to ___ and ____ with injury to nerve endings, hair follicles, and sweat glands Mixed ____ or ____ ____ appearance Blanching with ____ cap refill _____ blisters, wet surface _____ edema Sensitive to pressure but insensitive to ____ ___ or ____ ____ ____

Answer 25

``` EPI and DERM Red or waxy white Slow Broken Marked Light touch, soft pin prick ```

Question 26

Deep Partial Thickness/Second Deg: Scarring/healing Healing is _____ and occurs through ___ ____ and reepithelialization ______ scarring without preventative treatment

Answer 26

Slow Scar formation Excessive

Question 27

Full thickness burn is a _____ degree burn

Answer 27

Third

Question 28

Full thickness/third degree: Complete destruction of ___, ___, and ___ ___. May extend into ____ _____(ischemic), charred, ___, or ___ appearance ___ blanching, poor ____ circulation _____-like, dry, leathery surface; ______ area ____ pain; nerve endings are destroyed

Answer 28

``` EPI, DERM, SUBCUTANEOUS TISSUE. Muscle White, tan, black No, distal Parchment, depressed Little ```

Question 29

Full thickness/third degree: Scarring/healing: Removal of _____ and skin _______ are necessary due to destruction or DERM and EPI tissue Risk of _____ is increased Hypertrophic scarring and ____ _____ are likely to develop without preventative measures

Answer 29

Eschar, grafting Infection Wound contracture

Question 30

Subdermal burn is a _____ degree burn

Answer 30

Fourth

Question 31

Subdermal/fourth deg: complete destruction of ____, ____, and involves_____, and _____ _____ appearance Destruction of _____ system, may lead to additional necrosis From ______ burns; prolonged contact with ______ Additional complications associated with elec burns: _____, ____ ____ ____, ___ ___ ___

Answer 31

``` EPI, DERM, subcutaneous tissue, muscle Charred Vascular Electrical, flame VFIB, acute kidney damage, SC damage ```

Question 32

Subdermal/fourth deg: Scarring/healing: Heals with ___ ___ and ____ Requires ____ surgery; _____ may be necessary

Answer 32

Skin grafting, scaring | Extensive, amputation

Question 33

Complication of Burn Injury: Loss of skins protective barrier leads to _________ Can progress to ____, _____, _____

Answer 33

Infection | Sepsis, gangrene, death

Question 34

Complication of Burn Injury: Pulmonary complications: Smoke inhalation injury from inhal of hot gases, smoke poisoning; results in _____ _____ and _____ _____ Suspect with burns of the _____, _____ nose hairs

Answer 34

Pulmonary edema and a/w obstruction Face, singed Pulmonary edema has decreased breath sounds and increased fremitus. Accumulation of fluid in the alveolar spaces

Question 35

Complication of Burn Injury: Pulmonary complications: _____ lung disease from burns of trunk And ________

Answer 35

RESTRICTIVE Pneumonia

Question 36

Complication of Burn Injury: Metabolic complications: | Increased metabolic and catabolic activity results in ______ loss, negative _____ balance, and decreased ______

Answer 36

Weight Nitrogen Energy

Question 37

Complication of Burn Injury: Metabolic Complications: | Hypermetabolic state may persist for ____ or ____ after a major burn

Answer 37

Months/years

Question 38

Complication of Burn Injury: Cardiac and Circulatory Complications: Fluid and blood loss can result in _____ or _____ With severe burns, can see ______ and _______

Answer 38

Shock, death Hypothermia, hypovolemia Hypothermia — ST segment elevation, decreased HR

Question 39

Complication of Burn Injury: ____ and _____ scars

Answer 39

Keloid | Hypertrophic