EM Burn and Wound Management Flashcards
what is ABCDE
Airway
Breathing
Circulation
Disability/Deformity
Exposure/Environment
when do you intubate
4
airway protection
cant oxygenate
cant ventilate
expected clinical course
What are the three rules of determining body surface burns
Lund-Browder
Rule of 9’s
Plam Rule
What is Lund-Browder
used by burn centers to assess the burned body surface area
What is the Rule of 9’s
entire head and neck = 9%
each arm = 9%
entire anterior torso = 18%
entire posterior torso = 18%
entire R leg = 18% (9% front and back)
entire L leg = 18% (9% front and back)
What is the Parkland Formula
4mL LR x weight in kg x % TBSA burned = total amount of fluid pt should recieve in first 24 hours or 1/2 given over first 8 hours
What is the Modified Brooke Formula
2mL LR x Weight in Kg x % TBSA = total amount of fluid pt should recieve in first 24 hrs or 1/2 given over first 8 hours
What is an escharotomy
opens burned tissue to remove the contractures forming if evidence of compartment syndrome
what does cyanide decrease
oxygenation utilization
assume toxic exposure if pt has lactic acidosis
what types of shock can come from a severe burn
hypovolemic and distributive
usually multiple
What is superficial thickness burn
1st degree, sunburn
not included on TBSA calculations
apply moisturizing lotion +/- NSAIDs
What type of burns go into the papillary dermis
superficial partial thickness (2nd degree)
pink, moist, blisters
heals over 2-3 weeks w/o scarring or disfunction
What type of burn goes into the reticular dermis
deep partial thickness (2nd degree)
white/lethargy skin, insensate
develops contractures
need debridement and grafting
what is exposed in a full thickness burn
(third degree)
fat exposed
insensate burned areas
what is the treatment for full thickness burn
needs excision and grafting
