Burns pt1 Exam 1 Flashcards
List the types of burns (5)
- Heat
- Electrical
- Friction
- Chemical
- Radiation
Depth of thermal injury related to? (3)
- Contact temperature
- Duration of contact
- Thickness of skin
Heat burns usually involve which layers of tissue?
epidermis and dermis
Name the 4 most common examples of heat burn
- Flame
- Hot liquid
- Hot solid
- Steam
Electrical energy transformed to heat when current passes through body tissue is classified as what type of burn?
Electrical Burn
Electrical Burns disrupts?
Cell membrane potential
The magnitude of electrical burn damage depends on? (3)
- Pathway of current
- Resistance to current flow
- Strength and duration of current flow
What is the major difference between electrical and thermal burns
Electrical burns often involve cardiac injury
What are friction burns?
Combo of mechanical disruption and heat generated by friction
What are the caustic reactions of chemical burns? (3)
- PH alteration
- Disruption of cell membranes
- Direct toxic effect on metabolic process
The magnitude of chemical burns are related to?
- Duration of exposure
- Nature of agent
Acid causes tissue necrosis via ______.
Alkali causes tissue necrosis via ______
- Coagulation
- Liquefaction
Radiation burns cause what type of damage?
Ionization
Radiation magntiude depends on?
- Dose and time of exposure
- Types of particles
Most common examples of radiation burns? (4)
- Sunburns
- Therapeutic radiation
- Diagnostic procedures
- Nuclear industry workers
Burns take about ____ hours to fully declare themselves
24-48
What age group have deeper burns from less exposure and less intensity due to the thin skin?
- Adults >55
- Kids <5
Describes what degree of burn:
- Involving only the epidermis
- red in color
- dry, no blisters
- hypersensitive
1st degree superficial burn
Superficial 1st Degree Burns heal in approximately how many days?
3-6 days
What are the characteristics of a Superficial Partial Thickness (2nd Degree) Burn?
- Involves the epidermis and part of dermis
- Mottled red color
- Blisters or weeping
- Very painful / nerve endings exposed
- Small burns usually heal in 10 – 14 days
- Minimal scarring
What burn category is not counted in the TBSA (Total Burn Surface Area) ?
1st degree (superficial) burns
What are the characteristics of a Deep Partial Thickness (2nd Degree) Burn?
- Extends more deeply into the dermis
- Decreased moisture
- Destroyed sweat glands + Impaired tissue integrity
- Difficulty regulating body temperature
- Pale in color – Usually a white/pinkish color
- Absent or prolong blanching – No cap refill, stays blanched for quite a while
- Healing in 21-28 days
At what point is skin grafting typically required?
Deep partial thickness burns
What are the characteristics of a Full Thickness (3rd Degree) Burn?
- Dermis and epidermis are destroyed
- Translucent, dry, painless, charred
- Non-blanching
- Requires grafting or amputation
Differences in deep partial and full thickness is subtle and often hard to tell the exact transition areas in early hours.
Compare and Contrast the various degrees of burn injuries.
What is the most painful burn?
Superficial Partial Thickness (2nd Degree Burn)
What is the Rule of nines in adults?
- Head 9% (full head)
- Each arm 9% (4.5% front/back)
- Each leg 18% (9% front/back)
- Ant/Post trunk each 18% (9% upper/lower)
- Perineum 1%
The rule of nines is approximately ________ accurate. Why?
60-70%
D/t varying depths
What is the pediatric version of the rule of nines?
- Head 21%
- Arms 10%
- Back 13%
- Chest 13%
- Legs 13.5%
- Butt 5%
- Perineum 1%
What is the Palmer method?
TBSA used for patient’s palm with fingers together = 1%
Larger burn surface areas are often overestimated. T/F?
False. They are underestimated
Women with large breasts have a _____
larger surface area than what was accounted for and may be disproportionate
Fluid losses secondary to burns are a function of ____ and ____.
- Burn size
- Patient weight
Patients with ____ TBSA will develop burn shock and need IV resuscitation in an ICU.
> 20%
An under fluid resuscitated patient is at risk for what?
↓ perfusion, burn shock, end organ failure
An overly fluid resuscitated patient is at risk for what?
- Abdominal compartment syndrome
- Pulmonary edema/ARDS
List the 5 effects of auto-cannibalism.
- Loss of fat (Lipolysis)
- Loss of lean body mass (proteolysis)
- Gluconeogenesis
- Hypermetabolism
- Insulin resistance
.
The Intensity and duration of auto-cannibalism depends on which two factors?
- Magnitude of injury
- Degree of pain (leads to tachycardia and HTN, thus ↑ metabolism)
What happens to the metabolic rate in a >40% BSA burn?
Metabolic rate doubles.
The effects of auto-cannibalism may last how long?
Months
Immunodepression, recurrent infections, poor wound healing will also be seen
