MED SURG II: BURNS Flashcards
Examples of Thermal Burns
Flash, Flame, Scaled, Contact with hot objects
What is the most common type of burn?
Thermal
Bed position for burns of the face and head
Elevated HOB 30 degrees
Primary concern with burns of face and head
fluid shift
AIRWAY
Early intubation
What does fluid shifts cause
EDEMA
What causes Chemical Burns
Tissue contact with strong acids, alkalis, or organic compounds
Primary concern with smoke and inhalation burns
AIRWAY
Quick assessments are vital
S/S of Inhalation burns of the upper airway
Blisters, Edema Hoarseness Difficulty Swallowing Copious Secretions Stridor Substernal and Intercostal retractions Total Airway Obstruction
S/S of Inhalation burns below the airway
Chemical usually wheezing hoarsenss altered mental status dyspnea Carbonaceous sputum
What type of inhalation burn is likely if a patient was trapped in a fire or enclosed space?
Lower Airway
Cherry Red Skin Burn tinged Nasal Hairs Dark Sputum Trouble Breathing Hoarseness Facial Burns
S/S of Carbon Monoxide Poisoning
Carbon monoxide displaced O2 on hemoglobin causing _____ which leads to death if carboxyhemoglobin levels >20%
Hypoxemia
Tx for Carbon Monoxide Poisoning
Hyperbaric Oxygenation
Type of Burn: caused by heat generated by electrical energy as it passes through the body
results in internal tissue damage
Electrical
Entry point and Exit point
Entry point gives an idea of how the patient got burned
What is a major concern if there is no exit point?
concerned about internal damage (particularly heart damage and risk for dysrhythmias)
Iceberg Effect
Damage is worse on the inside than on the outside
Complications of Electrical Burns
Dysrhythmias Cardiac Arrest Fractures Fall Injuries Acute Tubular Necrosis
What depth:
(superficial)
Healed ~ 1 week
Partial Thickness
1st degree
What depth:
blisters
mild and moderate swelling
3 weeks to heal (usually on it’s own)
Partial thickness
2nd degree
What depth:
Charred and whitish skin (involving no bone)
Full thickness
3rd degree
What depth:
Charred and whitish sin
Involves bone
Full thickness
4th degree
Methods to measure TBSA
Lund-Browder (more specific)
Role of 9s (quick assessment)
Facial/Respiratory Burn
Airway intubation should occur prior to swelling
What places on the face are hardest to heal
Places filled with cartilage (ears, nose, etc.)
Risks with Circumferential burns
Compartment Syndrome
Check pulses and cap refill
How long should large burns be cooled for?
No longer than 10min (risk for hypothermia)
Should ice be used when treating burns?
NO
What major intervention needs to be done early for a patient experiencing a burn?
begin fluid replacement early
What phase: direct burn injury to vessels increases capillary permeability
onset – time of injury – up to 72 hours
biggest concept: massive fluid shifts
Emergent (resuscitative) phase
when does the emergent resuscitative phase end?
when fluid mobilization and diuresis starts
How is H and H effected by burns
initial increases as a result of plasma
hemodiluted after fluid resuscitation
