Chapter 9- Thermal Injuries Flashcards
What is the difference between other injuries and burn injuries?
The consequences of burns are directly linked to to the extent of inflammatory response to the injury
What are the lifesaving methods in a burn patient?
- Stop the burning process
- Ensure that airway and ventilation are secured
- Ensure circulation with IV fluids
What causes obstruction of airway in burn patients?
The edema that ensues
What are the risks for upper airway obstruction?
- increasing burn size and depth
- burns to the head and face
- Inhalational injury associated with trauma and burns inside the mouth
Do inhalation injury appear in the first 24 hours?
No they do not
What are the indications for early intubation?
- signs of airway ob structure-stridor,hoarsness,sterrnal retraction, use of accessory muscle use
- iF The total body surface is 40-50%
- burns in the mouth
- significant edema or risk for oedema
- difficulty swallowing
- decreased level of consciousness
7.Signs of respiratory distress - Anticipated transfer of an burn patient over long distance
A carboxyhemoglobin level of more than how much shows inhalation injury?
10%
What are the 3 causes of breathing concerns?
- Hypoxia
- carbon monoxide poisoning
- smoke inhalation injury
What percentage of carbon monoxide poisoning doesn’t present with physical symptom?
20%
What are the clinical manifestations of carbon monoxide poisoning of
20-30%
30-40%
>60%
- Nausea and headache
- Confusion
- Coma
- Death
What percentage of affinity does carbon monoxide molecule attach to haemoglobin
?
240 times that of oxygen
What is the half life of CO?
4 hours
How do you manage CO poisoning?
By providing 100% supplemental oxygen with a non-rebreather mask
What size ETT do you use in an adult vs a child?
Adult- 7,5mm
Child-4,u5mm
When should you consider cyanide poisoning?
If there is continual metabolic acidosis
What is the smoke inhalation injury diagnosis?
- Exposure to a combustible agent
2.signs of exposure to smoke in the lower airway below the vocal cords seen on bronchoscopy
When should a patient be intubated that has inhalational injury?
If they are under 10 and above 50 years then 10% TBSA
If they are adults then 20% TBSA
