Chemical, Electrical, Hypo, Hyper Flashcards
What is occurring to the tissue in an Acid chemical burn?
- Coagulation
- Formation of touch eschar (dark scab, or flailing of dead skin), this may limit further damage
What is occurring to the tissue in an Alkalis burn?
- Liquefactive necrosis; the transformation of tissue into a liquid mass
- Will have deeper penetration
What are some factors that may alter signs and symptoms of a chemical burn?
- pH
- Concentration of agent
- Contact time
- TBSA
- Physical form of the agent
- Ingestion/inhalation/absorption
What considerations need to be made for the ingestion/inhalation of a chemical agent?
- Dysphagia, stridor, wheezing, dyspnea, tachypnea
- Abdominal tenderness guarding, subcutaneous air
What forms of chemical burns should not be water irrigated?
- Calcium
- Metallic lithium
- Potassium
- Sodium
- Magnesium
Do chemical burns receive the same fluid therapy as thermal burns?
- Yes
Why does IOP ↑ in eye related chemical injuries?
- Due to collagen hydration and inflammatory mediators
What are alkali chemical burns to the eye more detrimental?
- Because alkali are lipophilic and can penetrate the eye structure.
What is the most dangerous acid known and why?
- Hydrofluoric acid
- It contains fluoride ion that readily penetrates the skin causing destruction of deep tissue layers.
Can burns from Hydrofluoric acid be painless?
- Yes
Why is the fluoride in HF so concerning?
- Because fluoride has a high affinity to calcium, this results in the bones being attacked and causing hypocalcaemia.
What may fluoride poisoning cause?
- Hypocalcaemia
- Hyperkalaemia
- Hypomagnesia
- Death
What will retard diffusion of fluoride ion?
- Ice pack
What are the categories of electrical burns?
- Low voltage <1000v
- High voltage >1000v
- Lightning strike
What are the voltage distances that high voltage electricity will discharge through air?
- 1000v – will clear a few millimetres
- 5000v – will bridge 10mm
- 40,000v – will clear 130mm
What is the largest risk group for electrical burns?
- Toddlers
- Teenagers
- Those who work with electricity
What may help determine the severity of electrical burns?
- Current type – AC/DC
- Volts
- Intensity
- Resistance
- Area
- Duration of contact
- Environmental factors
What are the symptoms of electrical burns?
- Contact burns
- Thermal heating
- Flash arc and flame burns
- Blunt trauma
- Prolonged muscle tetany
What typed of voltage will cause what rhythms?
- Low V = VF
- High V = AF
What potential damage can domestic AC voltage cause?
- Significant contact wounds
- Cardiac arrest
- But will not cause deep tissue contact
What injuries can occur from high tension cables?
- Flash burns – the significant electrical charge will cause combustible substances to ignite → burns.
- Deep muscle damage may occur under apparently normal skin and may be life threatening.
How does the pathway of damage appear in lightning strikes?
- Over the skin, rather than through.
- Pt will have significant exit burns on their feet.
What are treatment management of electrical burns?
- 12 lead – assess for arrhythmia
- IV fluids to maintain renal perfusion
- Manage entry and exit burns as per thermal burns
- Pain relief
- Manage arrhythmias accordingly
What are causes of cryogenic burns?
- Coolants such as, liquid nitrogen, methane and propane
