Ch.29 Burn Emrgencies Flashcards
Skin
- largest and most durable system of the body
- Commonly injured as a result of trauma
Most burn patients who die in the prehospital setting die from one of the following
- Airway occlusion
- Toxic inhalation
- Trauma sustained in conjunction with the burn injury
Your greatest concerns revolve around these three things
- Airway patency
- Breathing sufficiency
- Circulatory adequacy
Severity of a burn is a calculation of?
- Burn type
- Extent of the burn
Superficial burns
- First degree
- Involves only the epidermal layer
- Skin tends to present as pink to red, dry in condition, and very painful
Where is the burn center in San Diego ?
UCSD
SD County Burn center criteria
- greater or equal to 20% 2nd degrees greater or equal to 5% 3rd degree burns
- Suspected Respiratory involvement or significant smoke inhalation (singed facial hair, soot in mouth, wheezing)
- significant injury of the face, hands, feet, perineum, or circumferential burns
- electrical injury greater 110 volts
Body Surface Area (BSA) for adults
- Head & Neck- 9%
- Posterior trunk- 18%
- Anterior trunk- 18%
- Each upper extremity- 9%
- External genitalia- 1%
- Each Lower extremity- 18%
BSA for pediatrics
- Head & Neck- 18%
- Each Upper extremity- 9%
- Torso- 18%
- Each Lower extremity- 14 %
Causes Burns
- Flame burn
- Contact burn
- Scald burn
- Steam burn
- Gas burn
- Electrical burn
- Flash burn
S/Sx of an inhalation burn
- Singed nasal hair
- Facial burns
- Carbonaceous sputum
- Smoky odor to breath
- Dyspnea
- Bunred oral mucosa
Rx burned pt
- Expose the Byrnes site
- Remove any smoldering clothing
- Loosen/Remove any constrictive items or jewelry
- Cover any burns with a dry sterile dressing
- Keep pt warm
- Treat other injuries
- Transport to an appropriate facility for burned pt
DO NOT for burn pt
- Use any material that may become enmeshed in the burn
- Never apply any ointments, lotions, sprays, or antiseptics
- Never break or drain blisters if present
- Do not use wet dressings for major burns
Rx eyes
- Do not open eyes if burned
- Flush chemical burns for 20 min
- Dress both eyes with dry, sterile dressings
Rx for chemical burns
- Dry chemicals should be brushed off first, then flushed
- Hydrofluoric Acid burn flush minimum 20 min
Burns circulatory system
- Increased capillary permeability causes fluid shifting and fluid loss. Speeds up hypoperfusion
- Fluid shifting can occur for up to 24 hours
Burns respiratory system
- Hallmarked by Dyspnea and stridorous respirations
- Circumferential thoracic burns
Burns renal system
- Can cause the real ease of waste into the blood that can promote renal failure
- Urinary output drops due to circulatory volume and perfusion pressures
Burns nervous and musculoskeletal system
-Nerve, Muscle, tendon and skin damage can result I Loss of function to the extremities
Burns gastrointestinal system
- diminish perfusion
* diminished absorption and processing of food leading to chemical imbalances in the blood
Radiation
Energy in the form of rapidly propagating waves or particles emitted as it changes from a higher energy state to a lower energy states
Radiation types
- Alpha -stop with paper
- Beta- stop with thick clothing, 6mm aluminum
- Gamma- lead
Radiation protection
- Time
- Distance
- Shielding
Tar burns
- Don’t peel
- Cool with water
