Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medcon Rehab IV > Burns: Thermal Injuries Lecture + Burns Quiz > Flashcards

Burns: Thermal Injuries Lecture + Burns Quiz Flashcards

1
Q

How Common?

A

Males>Females until >70yo

*Why??→ Geriatric smoking on O2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are Burns?

5 Categories/Types to discuss:

A
  1. Thermal
  2. Electrical (Entrance/Exit wound)
  3. Chemical
  4. Radiation (think Cx)
  5. Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Classification: Burn Depth

Breaking the components down

A
  • 1st Deg:
    • Superficial Thickness
  • 2nd Deg:
    • Superficial Partial Thickness
    • Deep Partial Thickness
  • 3rd Deg:
    • Full Thickness
  • 4th Deg:
    • Subdermal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Classification: Burn Depth

Breaking it down by Epidermis, Dermis, SubQ Tissues

A
  • Epidermis: SUPERFICIAL BURN: 1st Degree
  • Dermis: PARTIAL-THICKNESS BURN: 2nd Degree
    • Superficial partial thick
    • Deep partial thick
  • SubQ Tissues: FULL-THICKNESS BURN: 3rd or 4th Degree
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Name the 5 Depths of Burns

A
  1. Superficial Thickness→ 1st Degree
    1. Sunburn
  2. Superficial Partial Thickness→ 2nd Degree
    1. Partially thru dermis
  3. Deep Partial Thickness→ 2nd Degree
    1. All way thru dermis
  4. Full (think Fat) Thickness→ 3rd Degree
    1. SubQ fat to bone
  5. Subdermal→ 4th Degree
    1. Bones, ligs, mm’s, tendons
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Burn Descriptions + Pics

Superficial Thickness Burn= 1st Degree Burn

A

“Classic sunburn”

  • Red
  • Dry
  • Painful→ always bc epidermis

*Usually heals w/in 3-4d w/out scar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Burn Descriptions + Pics

Superficial Partial-Thickness Burn= 2nd Degree Burn

A
  • Pink-red
  • Painful
    • bc dermis still intact
  • Blisters*, Moist, Blanching, Edema

*Heals 7-10d w/ min. scarring and min. wound contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Any time you see PARTIAL-THICKNESS you know its __________

A

2nd Degree Burn*****

Then just distinguish bw Superf OR Deep!!!!!!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Burn Descriptions + Pics

Deep Partial Thickness Burn= 2nd Degree Burn

A
  • Pale*
  • Painful→ pot. pain or NO pain, depends on depth*
  • LESS moist
  • Cap refill absent or prolonged
  • Edema
  • Diminished Sensation
    • Deep pressure intact, Pinprick may not be

*May heal 21-35d→ Most likely req grafting, Hypertrophic or keloid scarring w/ pot. sig wound contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Burn Descriptions + Pics

Full Thickness Burn= 3rd Degree Burn

*thru epi and dermis

A

“The black, charred, leathery, waxy eschar one”

  • Black charred, or mottled red/brown, or pale, or waxy white eschar formation
  • Leathery appearance
  • May be insensate
  • NO cap refill
  • Edema
  • NO pain bc vascularization burned

*May heal 4-6wks; grafting req’d, sig hypertrophic scarring and wound contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Burn Descriptions + Pics

Subdermal Burn= 4th Degree Burn

A

MM or bone exposed one

  • Complete destruction: epidermis, dermis, and SubQ tissue
  • DRY
  • Charred appear., mm or bone may be exposed

*Always req’s grafting; poss. mm flap for coverage; definite hypertrophic scarring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Classification: Burn Size

Total Burn Surface Area (TBSA)

3 Methods

A
  1. Rule of Nines→ NPTE*****
  2. Lund & Browder Chart
  3. Palm Method
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Classification: Burn Size

Rule of Nines***

KNOW IT!!!!

100-age-%surf area burned==> chance survival

A

See pics

  • Adult Values
    • Head/Neck= 9%
    • Anterior trunk= 18%*
    • Posterior trunk= 18%
    • Anterior arm, forearm, hand= 9%
    • Genitals= 1%
    • Anterior leg, foot= 18%
    • Posterior leg, foot= 18%
  • Child <1yo
    • Has 9% taken from LE and added to the head/neck region.
      • 1% is distributed back to the LEs for ea yr of life until 9yo→ when head considered same size as adult*
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Classification: Burn Size

MOST ACCURATE MEASURE?

A

Lund and Browder Burn Chart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Classification: Burn Size

Palm Method (exactly what it sounds like)

A
  • The palm of the adult hand (just palm) is Equal to→ .5% TBSA (Total Burn Surface Area)
  • 2 palms= 1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 Classifications of Burns:

A
  1. Burn Depth→ Thickness
  2. Burn Size→ How much surface area
  3. MOI→ How it happened
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Classification: Mech of Injury (MOI)

5 Classes

A
  1. Thermal
  2. Electrical (Enter/Exit wound)
  3. Chemical
  4. Radiation (think Cx)
  5. Other
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Classification: Mech of Injury (MOI)

Thermal Injury

A
  • Flames, hot liquids (scalded), steam, semi-solids, contact w/ hot obj
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Classification: Mech of Injury (MOI)

Electrical Injury

A
  • Pure→ Entrance AND Exit sites
  • Arc→ Electricity flows external to body
  • From→ faulty electrical wiring, high-voltage power lines, lightening
  • **Effects ALL body tissues in its path
    • Nerves→ blood vessels→ Mm→ Skin→ Tendon→ Fat→ Bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Effects ALL body tissue in its path****

Nerves→ blood vessels→ mm→ skin→ tendon→ fat→ bone

A

Electrical Injuries***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Entrance/Exit wounds

A

Electrical Injuries****

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Classification: MOI

Chemical Burn

A
  • Strong Acid
    • Industrial cleaners, household rust removers
  • Alkali (base)
    • Lime, lye, household cleaners, hydroxides
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Classification: Mech of Injury (MOI)

Radiation Burn

A
  • Sunburn**
  • Medical (oncology radiation, excess X-ray exposure, etc.)
  • Nuclear power plant explosions; Atomic bombs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Classification: Mech of Injury (MOI)

Other “Burns”

A
  • Road Rash
    • Need to be cleaned well, debris/foreign bodies removed*
  • Frost Bite
    • Occurs when tissue temp is 35.6*F (2*C)
      • NOTE: W/ frostbite→ body shunts blood to proximal trunk to keep warm, therefore no bloodflow to distal extremities (hence, black frostbitten toes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Systems Affected by Burns:

One she mentions

A

CV, Pulmonary, Renal, Metabolic/GI Tract

26
Q

Classification: Burn Location/Systems Affected by Burns

Location will dictate (is assocd w/) 2 things:

A
  • Location influences severity
  • Location is associated w/ specific complications*
27
Q

Classification: Burn Location/Systems Affected by Burns

Cardiac Systemic Response

*24-48 hr survival link

A
  • 3 in red:
    • Decd blood pressure
    • Decd CO or SV (CO=HR*SV)
    • Incd HR
  • Other:
    • Microvascular fluid shift (fluid TO burn area)
    • Gen impairs in cell memb function
    • Inc in burn tissue osmotic pressure
    • Hypovolemia, edema*
28
Q

Classification: Burn Location/Systems Affected by Burns

Cardiac Systemic Response

Vascular Edema

A
  • Most pronounced first 72hrs
  • *Limits ROM/function
  • Maybe limit venous return
  • Fluid resuscitation INCs edema formation
  • Mgmt of edema is an important role of rehab of burns
29
Q

Classification: Burn Location/Systems Affected by Burns

Pulmonary Systemic Responses

A
  • Injury occurs to lungs in several ways:
    • Direct heat trauma, Lack of O2, Inhaled chemicals
  • Edema→ Obstruction (OLDs common)→ Impaired gas exchange→ ARDS→ Edema (restarts cycle)
30
Q

Classification: Burn Location/Systems Affected by Burns

Pulmonary Systemic Responses

Inhalation Injury

20% of burn mortalities

A
  • Signs of Inhalation Injury:
    • Facial burn, Singed nasal hair
    • Harsh cough, Hoarseness
    • Resp distress, Hypoxemia
31
Q

Classification: Burn Location/Systems Affected by Burns

Renal Systemic Responses

A
  • Hormone secretion:
    • ADH
    • Aldosterone→ vasodilator
      • BOTH= fluid retention
  • Renal failure
32
Q

Classification: Burn Location/Systems Affected by Burns

GI Systemic Response

A
  • HypERmetabolism*
    • 2-3x the BMR*
    • Lasts up to 1yr
    • Greater nutritional needs→ think about it…your metabolism is now TRIPLE to heal the burns… think PRO, Meat!!!
  • Ileus→ blockage in GI system
  • Wt loss—- bc metabolism so HIGH, tough to keep up!!!
33
Q

Classification: Burn Location/Systems Affected by Burns

Bone Fx’s

*think Electrical (bc effects everything in path) or Chemical burns

A
  • Electrical or Chemical burns
  • Can effect any bone in body
    • Vertebral compression fx’s OR Long bone fx’s
34
Q

Burn Sequela from falls or other traumas

Think about it…. if trauma or a fall from high window or anywhere….

A
  • TBI
  • SCI
  • Fx’s

ALL MAKE SENSE!!!

35
Q

Healing Systems with Burns

Those involved in…. OR take these into account as working when we have severe burn

A
  • PNS→ more pain as nerves regen
  • Infx→ extensive burns lead to infx’s
  • Hypertrophic Scar Formation→ scars mean healing
36
Q

Mature Scars

Triple P→ P,P,P

How scars SHOULD BE:

A
  • Pale
  • Planar
  • Pliable
37
Q

Scar Development: Timeline of Scar Tissue Restriction

How quickly will this scar form and restrict indiv?

ALL FIRST

A
  • Burn Scar Contracture→ 1-4d
  • Tendons and Sheaths→ 5-21d
  • Adaptive MM Shortening→ 2-3wks
  • Ligament & Joint Capsule→ 1-3mos

NOTE:** Timing of Scar Mgmt is key to prevention and producing **permanent change*

38
Q

Scar Development: Timeline of Scar Tissue Restriction

How quickly will this scar form and restrict indiv?

Burn Scar Contracture

A

1-4d

39
Q

Scar Development: Timeline of Scar Tissue Restriction

How quickly will this scar form and restrict indiv?

Tendons and Sheaths

A

5-21d

40
Q

Scar Development: Timeline of Scar Tissue Restriction

How quickly will this scar form and restrict indiv?

Adaptive MM Shortening

A

2-3wks

41
Q

Scar Development: Timeline of Scar Tissue Restriction

How quickly will this scar form and restrict indiv?

Ligament & Jt Capsule

A

1-3mos

42
Q

Keloid Scarring

*think “raised up and puffy” one

A

Overgrowth OUTSIDE of wound margin, puffy*

43
Q

Hypertrophic Scarring

*Think “scar tissue” one

A
  • Thick scar tissue, raised from wound surface BUT remains in area of injury, contracts, produces scar bands, painful/itchy
44
Q

Burns and Abuse

Child Abuse w/ Burns

A

see pics but NOTE:

  • Familiar obj patterns→ cigarettes, forks, curling iron, stove top
  • Burns suggestive of forced immersion→ stocking presentation
  • The burns are in isolated areas (see pics) that are in areas where surrounding area is NOT burned, or areas where looks like child was forced to stay in one position while being burned, or cig burns

YOU MUST REPORT!!

45
Q

Sx Mgmt of Burn Wounds

Name all first:

A
  • Autografts (skin from self)
  • Homografts/Allografts (Temporary)
  • Heterografts (Temporary)
  • Free Flap/Free tissue transfer
  • Pedicle graft
  • Skin substitutes
46
Q

Sx Mgmt of Burn Wounds:

Autografts

2 types:

A
  • STSG- Split Thickness Skin Grafts
    • Epi + Part of dermis
  • FTSG- Full Thickness Skin Grafts
    • Epi + ALL of dermis
47
Q

Sx Mgmt of Burn Wounds

Homografts/Allografts (temp)

Heterografts (temp)

A
  • Homo/Allografts (temp)
    • Cadaver
    • Fetal memb’s
  • Hetero (temp)
    • Xenograft (pigskin)
48
Q

Graft Procedure pics

Steps 1-3

A

Note the Mesh-like material

*this allows granulated tissue to come up thru mesh and heal wound

49
Q

Split Thickness Skin Grafts (STSG’s)

Ex’s

A

see pics

Notice the mesh, then they just stitch or staple around edges!!!

50
Q

Mobilization Guidelines AFTER Skin Graft

AKA Protocols

LE Graft Over Joint(s)

POD# 1-4

A
  • POD #1: Lateral move bed to chair, *NO ROM
  • POD #2: Observe graft during dressing change
    • Amb w/ ACE wrap support if no graft shift or bleeding
    • *Limtd AROM only
  • POD #3: Observe graft, Amb w/ ACE, *Full AAROM if graft stable
  • POD #4: Observe graft, *PROM permitted (only NOW can we put hands on them for ROM)
51
Q

Mobilization Guidelines AFTER Skin Graft

AKA Protocols

LE Graft NOT Over Joint(s)

A
  • POD #1: Amb w/ ACE wrap support if no graft shift or bleeding, AROM, AAROM, PROM OK for surrounding joints*
52
Q

Mobilization Guidelines AFTER Skin Graft

AKA Protocols

Buttock Grafts

A

NO OOB Rx until POD #2***

53
Q

PT Wound Care for Grafts

Only 2 dressings used for skin graft:

A

Composite Dressings (big band-aid one)

Foam Dressings

see pics and go back to charts!!!!

54
Q

Characteristics assocd w/ Superficial Thickness Burn (1st Degree Burn)

A

Dry and Painful

Dmg ONLY to epidermis, classic terrible sunburn

55
Q

Characteristics assocd w/ Superficial or Deep Partial Thickness Burn (2nd Degree Burn)?

A

Blisters or Pale and Painful

pain w/ edema

Superf→ wet w/ blisters AND blanchable

Deep→ moist and pale NOT blanchable

56
Q

Characteristics assocd w/ Full Thickness Burn (3rd Degree Burn)?

A

White waxy eschar formation

dry as leather, NOT painful bc insensate, NOT blanchable, w/ edema

common in burn ICU*

57
Q

Characteristics assocd w/ Subdermal Burn (4th Degree Burn)?

A

Charred w/ exposed mm

Destroy epi, dermis, subQ tissue

Charred w/ exposed tendons, mms, bones

*think stage 4 pressure ulcer

58
Q

MOST ACCURATE method of calculating Total Burn Surface Area (TBSA)

A

Lund and Browder Chart

59
Q

Which MOI of a burn can cause bone fx, nerve damage; vascular damage and Exit wounds?

A

Electrical Injury

60
Q

Which terms describe healthy, mature, scar?

Triple-P’s!

A

Pliable, Planar, Pale

61
Q

Correct body pos. for a burn pt in bed w/ shoulder burn is ___________

A

Shoulder ABD 90*

Medcon Rehab IV (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions