FINALS: Burns Flashcards
What are the components of the skin and its appendages?
Hair, nails, sebaceous glands, sweat glands. Skin thickness ranges from 0.5 to 6.0 mm.
Name the five layers of the epidermis.
Corneum: Dead cells
Lucedum
Granulosum: Contains keratin
Spinosum: Provides flexibility and strength
Basale: Site of cell division
Describe the hypodermis.
Not a true skin layer; composed of fat and connective tissues. It functions in shock absorption.
What are the two layers of the dermis and their functions?
Papillary Dermis: Made of loose connective tissue, highly vascularized.
Reticular Dermis: Made of dense connective tissue, provides strength and elasticity.
What are the 7 major functions of the skin?
Temperature regulation
Protection
Sensation
Excretion
Immunity
Blood reservoir
Vitamin D synthesis
What causes electrical burns, and what factors affect severity?
Caused by exposure to low or high voltage.
Severity factors: Contact duration, voltage, current type/path, and tissue resistance.
What are UV burns, and what causes them?
Overexposure to UV radiation, typically from the sun.
What is the focus of emergency management in burn care?
Systemic stabilization and burn care to improve survival
What are some clinical variations in skin structure?
Men have thicker skin than women.
Young and elderly individuals have thinner skin compared to adults.
Skin thickness varies depending on body location.
What are the three burn wound zones?
Zone of Hyperemia: Outermost area; least damage; heals rapidly.
Zone of Stasis: Salvageable tissue; viable but at risk.
Zone of Coagulation: Non-viable tissue; eschar; greatest damage.
Describe ionizing radiation burns.
Caused by exposure to electromagnetic or particulate radiation, creating free radicals in tissue.
Describe the types of wounds from electrical burns.
Entrance wound: Necrotic, depressed
Exit wound: May be single or multiple
Arc wounds: Occur between joints
What immediate physiological effects occur after a burn injury?
Release of vasoactive substances, increased vessel permeability, and cell damage.
Edema from fluid leakage, electrolyte imbalance (low K+, altered Na+ and Cl-), and increased BUN.
Hematologic changes: Increased Hct, RBCs, and WBCs; decreased platelets.
Increased blood viscosity, reduced blood volume, kidney impact, and risk of organ failure.
What are the systemic effects of chemical burns?
Alters tissue pH and metabolism, can cause pulmonary and metabolic complications.
What causes chemical burns, and what factors determine their severity?
Caused by reduction, oxidation, or corrosion of tissue.
Factors: Type/concentration of the chemical, contact duration, and mechanism of action.
Cardiac arrest, arrhythmias, myocardial damage
Headache, seizures, nerve injury, spinal paralysis
Dislocations, fractures, visceral damage, cataracts, hearing issues
Result from conduction/convection (hot objects, liquids, flames). Types:
Scalds: Hot liquid or steam
Flame burns: Open flames
Flash burns: Intense heat exposure
Contact burns: Hot solid objects
How do deep partial-thickness (second-degree) burns differ from moderate ones?
Appearance: Pink to pale ivory, dry blisters, slow capillary refill. Healing: 2-3 weeks, often grafted if >3 weeks. Pain: Decreases with depth.
What are common complications from electrical burns?
What is used to assess the extent of burns, and why is it important?
Total Body Surface Area (TBSA); it’s essential for calculating fluid therapy needs and predicting morbidity.
What factors affect the severity of thermal burns?
Location, temperature source, and contact duration.
What are signs of inhalation injury?
Altered mental status, burns on the face/neck/chest, singed nasal hair, laryngeal edema, hypoxia, and soot in mouth/sputum.
What is the Rule of Nines used for?
Calculating the TBSA affected by burns.
What are the characteristics of moderate partial-thickness (second-degree) burns?
Appearance: Pink to red, moist blisters, blanches with capillary refill. Healing: 1-2 weeks. Pain: Very painful.
What factors determine the severity of a burn?
The extent and depth of the burn, which influence the severity and guide acute care management.
Describe the appearance, healing time, and pain level of superficial (first-degree) burns.
Appearance: Pink to red, may have edema, intact skin. Healing: 3-5 days. Pain: Tender or painful.
What are common goals of physical therapy for burn patients?
Improve ROM, manage pain, prevent scar contractures, enhance functional mobility, and promote overall functional outcomes.
List key components of systemic stabilization.
Assess inhalation injury & CO poisoning, fluid resuscitation, pain management, and treatment of secondary injuries.
: Describe full-thickness (third-/fourth-degree) burns.
Appearance: White, red, brown, or black, dry with possible blisters. Healing: >3 weeks, usually needs surgery. Pain: Insensate.
What are some admission guidelines for burn injuries?
Partial-thickness burns >10% TBSA, burns on face/hands/feet/genitalia, 3rd-degree burns, electrical/chemical burns, inhalation injuries, and burns with preexisting conditions.
How is body temperature maintained in burn patients?
Use dry dressings, warm environments, radiant heat panels, and warmed IV fluids to prevent hypothermia.
What causes inhalation injury and increases its mortality risk?
Inhaling superheated gases, steam, or fumes, leading to asphyxia or direct cellular injury.
What relevant history is needed for a burn patient evaluation?
Burn incident details, inhalation injuries, secondary injuries, and psychosocial considerations.
What is a cultured epidermal autograft (CEA)?
Lab-cultured epidermal cells transplanted to the wound.
Differentiate between STSG and FTSG.
STSG: Thin layer of skin (epidermis + part of dermis). FTSG: Full thickness of skin (epidermis + dermis).
What are escharotomy and fasciotomy, and when are they needed?
Escharotomy: Incision through eschar for decompression. Fasciotomy: Incision through fascia to relieve compartment pressure. Needed for neurovascular/respiratory complications.
What additional medications are used for pain control?
NSAIDs, mild analgesics, anesthetics, and anxiolytics.
What are the initial steps in burn care?
Neutralize burn source, remove clothing/jewelry, rinse the burn, ensure medical stability, debride, clean, and dress with topical antimicrobial agents.
What factors should be assessed during inspection and palpation?
Consciousness level, pain, location of burns/grafts, dressings, splints, and lines/tubes.
