Complex: Burns

Question 1

Burns: Describe the risks for a patient with burns in areas such as the arms, legs, or torso and risk prevention

Answer 1

Burns that occur around arms, legs, or torso can cause problems with circulation d/t swelling and rigid skin. This can cause compartment syndrome. Escharotomy is used to prevent this from occurring

Question 2

Burns: Understand the rule of 9’s and what it is used for

Answer 2

Rule of 9’s is used to determine TBSA of burns. (Refer to lecture/text)

Question 3

Burns: Understand the Parkland Formula and how to use it

Answer 3

The Parkland Burn Formula is used to determine fluid replacement for burns. (Refer to lecture/text)

Question 4

Burns: Describe how burns on different parts of the body determine nursing priorities.

Answer 4

Nursing priorities are determined based on location of burns and consideration of airway, breathing, circulation.

Question 5

Burns: Explain the purpose of an escharotomy for a patient with burns

Answer 5

An escharotomy is a surgical incision made to release pressure and improve circulation in a part of the body that has a deep burn and is experiencing excessive swelling. Burn injuries that encircle a body part, such as an arm or the chest, can cause swelling and tightness in the affected area, resulting in reduced circulation. Making surgical incisions into the burned tissue allows the skin to expand, reduces tightness and pressure, and improves circulation.

Question 6

Burns: Describe the rule of 9’s for estimating total body surface area of burns

Answer 6

Identify the areas of the body that are burned and then apply the following:

Head 9%
Torso 36% (front 18% and back 18%)
Arm 9% each
Leg 18% each
Perineum 1%

Question 7

Burns: Classify the depth of burns from Superficial to Full-thickness

Answer 7

Superficial: redness and sensitivity; heals on it’s own

Superficial partial-thickness: redness but blanches; pain; blisters; heals on it’s own

Deep partial-thickness: eschar; red, painful; mild to moderate edema; heals w/ scarring

Full-thickness: involves skin into the bone; eschar; no pain; surgical intervention required

Question 8

Burns: Describe the use of the Parkland Burn Formula when calculating fluid needs for a patient with greater than 20% TBSA burns

Answer 8

Purpose:
 To calculate the IV fluids needed for the first 24 hours after a burn
injury > 20% of TBSA

Formula:
 4 mL x Patient weight in kg x % of TBSA burned = 24hour volume of IV
fluid
 First 8 hours give half of the 24 total volume of fluid
 Second 8 hours give one-fourth of the total volume
 Third 8 hours give one-fourth of the total volume

Question 9

Burns: Describe why airway management is the priority for a patient with burns involving the head, neck, and chest

Answer 9

This is as simple as ABC (don’t over think it). When a patient has burns anywhere near the head and neck area, there should always FIRST be the airway consideration.