CHP 33: BURNS Flashcards
the eye is more sensitive to what kind of chemical
alkali (basic - higher pH)
why do burns cause hypovolemic shock
fluid loss from damaged skin and volume shifts within body
thermal burns occur when skin is exposed to what temp or higher
118
what state of matter causes more significant burns
solids over gases
what type of burns do lightning strikes cause
flash burn
zone of coagulation
area that sustains most damage, little to no blood flow
zone of stasis
peripheral area surrounding zone of coagulation that has decreased blood flow and inflammation
zone of hyperemia
area least effected by thermal injury
superficial burn
1st degree - epidermis only, skin is red and swollen
partial-thickness burn
2nd degree - epidermis and dermis - blisters and moisture present
full-thickness burn
3rd degree - destroys epidermis and dermis - no pain
subdermal burns
4, 5, and 6th degree - all layers of skin damaged and layers of fat, muscle, bone, or internal organs
infraglottic and lower airway damage is associated with ___ and supraglottic airway damage is associated with ______
steam
superheated gases
treatment for airway burns
humidified oxygen and nebulized epi
what toxic gas is present in fires
hydrogen cyanide
what does hydrogen cyanide smell like
bitter almonds
how much easier does CO bind to hemoglobin than oxygen
250x
what is an escharotomy
surgical cut through burned tissues to allow for swelling
what burns to include in TBSA
partial and full-thickness burns (not superficial ones)
rule of 9’s for adult
head: 9
back: 18
chest: 18
arms: 9 each
legs: 18 each
genitals: 1
rule of 9’s for infant
head: 18
back: 18
chest: 18
arms: 9 each
legs: 13.5 each
genitals: 1
rule of 9’s for child
head: 12
back: 18
chest: 18
arms: 9 each
legs: 16.5 each
genitals: 1
major burn criteria
hands/feet, face, circumferential burns
full-thickness covering more than 10% of TBSA
partial-thickness burns covering 25% of TBSA between 10-50 years old and 20% under 10 years or over 50 years
inhalation burns
electrical or chemical burns
Parkland formula
4mL x body weight (kg) x %TBSA burned
give one half of that amount in first 8 hours and other half over next 16 hours
1% TBSA equals how long of inpatient treatment
1 day
what type of injury do acid chemicals create
coagulation necrosis
what type of injury do bases and alkalis create
liquefaction necrosis
what type of injury do vesicants create
blister agents
what to do with powder chemical exposure
brush off, do NOT use water
treatment for sodium metal contact
cover will oil
treatment for hydrofluoric acid exposure
calcium gluconate topical gel
highly water soluble vs slightly water soluble irritant gases effects
high: immediate
slightly: hours or days later
management for inhaled gases
O2 and nebbed beta agonists
low vs high voltage patterns in body
low: path of least resistance along blood vessels and muscles
high: shortest path
what type of current is most likely to induce vfib
alternating
what is alternating current so dangerous
causes muscle contractions, causing patient to freeze to electrocution source
at what milliamps is cardiac arrest and death probable
10,000
at what milliamps does the patient “freeze”
9-30
what is Ohm’s law
current = voltage / resistance
what is Joule’s law
one joule is generated when 1 amp flows through 1 ohm of resistance for 1 second
what’s the amp that can provoke vfib
0.1 amp from hand to hand
how many amps does a taser produce
3 milliamps
what type of electricity does lightning carry
30,000 amps of direct current
what stops alpha particles
skin
what stops beta particles
clothing
what stops gamma radiation
several inches of lead or concrete
what is ARS
acute radiation syndrome - exposed to very high levels of radiation for brief period
what is a predictor of poor outcomes with radiation sickness
onset of vomiting soon after exposure
a burn and radiation affecting more than what percent of TBSA should affect your triage decisions
30
what drug protects thyroid against radioactive isotopes and how soon must it be given
potassium iodide within 6 hours of exposure
what is the inverse square law
exposure drops as distance from source increases
