Paediatric burns and trauma Flashcards

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1
Q

what type of burn is not painful?

A

full thickness burns as the nerve endings are burnt off

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2
Q

what is an escharatomy

A

escharatomy is a surgical procedure used to treat full-thickness (third-degree) circumferential burns. In full-thickness burns, both the epidermis and the dermis are destroyed along with sensory nerves in the dermis. The tough leathery tissue remaining after a full-thickness burn has been termed eschar.

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3
Q

what type of burn is sunburn

A

epidermal burn (superficial)

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4
Q

what burns are counted in calculating body surface area of burns?

A

superficial dermal burn
mid dermal burn
deep dermal burn
full thickness burn

(NOT epidermal burns)

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5
Q

First aid management of burns?

A

call for ambulance

for at least 20 minutes- cold running water over burns

cling wrap over burn area

warm the child

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6
Q

what are the components of a burn wound assessment?

A

Determining the depth of the burn
Is it circumferential?
What is the %TBSA

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7
Q

what might you do for a circumferential SUPERFICIAL burn?

A

always elevate the limb if possible

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8
Q

how might you calculate the %TBSA of burns?

A

discount simple erythema (epidermal burn)

Rules of 9s
or
Palmar method
or
Lund and Browder chart (most accurate)
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9
Q

describe the rule of 9s for TBSA?

A

Think of the person in anatomical position

Adult:
whole head = 10%
whole arm = 9%
Front of chest= 18%
Back= 18%
whole leg=18%

Child:
Bigger head= 18%
smaller legs= 14%

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10
Q

why is TBSA% important for burns patient?

A

guides fluid resuscitation requirements

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11
Q

what are the x-rays we order for trauma?

A

lateral C-spine
CXR
pelvic x-ray

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12
Q

what consists of a secondary survey for a burns patient?

A

head to toe examination

  1. AMPLE history
  2. Tetanus status
  3. Wound care
  4. Reassess need for primary survey
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13
Q

why are children more susceptible for abdominal trauma?

A

Kids ribs are very compliant and so more vulnerable to abdominal injury

More force going through a smaller body- hence more prone to abdominal trauma

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14
Q

why is a child’s airway more likely to obstruct than an adults?

A
  • the child’s airway is smaller
  • relatively larger tongue and smaller oral cavity
  • cartilaginous nature of a child’s airway is more collapsable
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15
Q

what are some reasons why intubation may be difficult in a child?

A
  • smaller airway and oral cavity
  • may have enlarged tonsils
  • larynx is higher and more anterior than in adults
  • larger head, particularly occiput region
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16
Q

how might you check capillary refill in a child? what are the normal values?

A

CRT= press for 5 seconds, and make sure you lift the limb above the level of the heart! Normal is less than 2 secs. Delayed is greater than 3 or more seconds

17
Q

what are some adjunct management things you need to consider in a burns patient?

A
  • warming the patient as they are often hypothermic
  • fluid resuscitation!!
  • analgesia (usually opiate)
  • gastric tube (NGT may not be possible)
  • IDC
18
Q

what are the organs we need to consider in a paediatric abdominal injury?

A

spleen, kidney, liver as they make up 75% of intra-abdominal injuries

other= bowel/pancreas etc

19
Q

what is a common mechanism for causing abdominal injuries in a child?

A

blunt force at high velocity e.g. seatbelt injury

20
Q

what are some adjunct management procedures to consider in a child with an abdominal injury

A

Gastric decompression tube

IDC

21
Q

why do we use a gastric decompression tube in a child with an abdominal injury?

A

prevents gastric dilation
prevents vomiting
improves image quality
improves ventilation

22
Q

what is the admission criteria for a child with a burn to hospital?

A

Criteria for Admission

  • Partial thickness (superficial) burns with a surface area greater than 10%, except very superficial burns.
  • All full thickness burns, except those that are extremely small.
  • All burns to face, ears, eyes, hands, feet, genitalia, perineum or a major joint, even if less than 5‐10%.
  • Circumferential burns.
  • Chemical burns.
  • Electrical burns (including lightening). Extensive tissue damage can occur to underlying structures.
  • Burns associated with significant fractures or other major injury.
  • All inhalation burns.
  • Burns in children under the age of 12 months.
  • Small burns in patients with social problems, including children at risk.
23
Q

which fractures are suspicious of non-accidental injury?

A

spiral fractures of the humerus
posterior rib fractures
bucket handle/corner fractures of metaphysis of long bones
skull fracture