Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

POS Flashcards > Purple - Burns > Flashcards

Purple - Burns Flashcards

1
Q

How are burns classified based on depth?

A

1st degree: confined to epidermid

2nd degree:

  • Superficial: superficial dermis
  • Deep: into reticular dermis

3rd degree: full thickness

4th degree: deeper organs/muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

First degree burn is:

A
  • Painful
  • Erythematous
  • Blanch to touch
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Second degree burn (superficial) is:

A
  • Painful
  • Blanch
  • Often blister
  • Re-epithelize from retained epidermal structures in skin ridges, hair follicles, sweat glands
  • Some discolouration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Second degree burn (deep) is:

A
  • Remain painful to pinprick
  • Re-epithelize from sweat gland and hair follicle keratinocytes
  • Severe scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Third degree burn is:

A
  • Hard leathery eschar that is painless

- Heal by re-epithelization from edges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the TBSA for each body compartment?

A
  • Head and neck: 9%
  • Upper extremities = 2 x 9 = 18%
  • Lower extremities = 2 x 18 = 36%
  • Anterior trunk = 18%
  • Posterior trunk = 18%
  • Genitals/perineum = 1%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the initial management for burns?

A
  • Remove sources of continuing heat
  • Douse with room temperature H20
  • Dress with clean dry dressing or sheets
  • NG tube
  • IVF (Parkland Formula)
  • Tetanus prophylaxis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the parkland formula?

A

4ml/kg/%TBSA (excluding 1st degree) of Ringers Lactate within 24 hours

  • 1/2 1st 8 hours
  • 1/2 2nd 16 hours

PLUS maintenance fluid
- 2nd 24h = 20-60% of calc. plasma volume

Timepoint of maximal edema = first 24h, therefore aggressive fluid management first 24-28h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What type of burns require an increase from the Parkland Formula?

A
  • High voltage electrical burns (2cc/kg/hr)
  • Inhalational injuries (add 2xx/kg/%TBSA)
  • Meds burns
  • Major trauma
  • > 80% TBSA
  • 4th degree burns
  • Osmotic diuresis
  • Burn while drunk
  • Delayed resuscitation (6, 7, 8 = b/c behind on fluids)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is important to consider with high voltage burns?

A
  • Most significant injuries are deep and subsequent edema formation can cause distal vascular compromise
  • Need early exploration of affected muscle beds and debridement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should tetanus prophylaxis be considered in burns?

A

> 10%TBSA burns

  • 0.5mL tetanus toxoid
  • 250 unit Ig if immunization status unclear
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the most common infective organisms in burns?

A
  • S. auerus = 85%
  • Enterococcus = 55%
  • E. coli = 40%
  • Candida = 40%
  • Pseudomonas
  • Beta-hemolytic streptococcus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you treat 1st degree burns?

A
  • No dressing
  • Topical salves (gelatinous abs preparations)
  • Mafenide acetate (sulfmylon) salve
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you treat superficial 2nd degree burns?

A
  • Daily dressing changes
  • Topical antibiotics (salves or soaks)
  • Cotton gauze
  • Elastic wraps
  • Temporary biologic or synthetic covering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How do you treat deep 2nd and 3rd degree burns?

A
  • Excision and grafting for sizeable burns
  • Early excision and grafting of thermal injuries: eschars surgically removed within 3-7 days, immediately followed by skin graft/flap
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is silver sulfadiazine?

A
  • Broad spectrum antimicrobial: gram positive, gram negative, some fungi
  • Mild inhibition of epithelization
  • Does not penetrate eschar
  • Transient leukopenia in 3-5 days
17
Q

How do nutrition needs differ for burn patients?

A
  • Thermal injuries cause a hyper metabolic state via increased release of catecholamines
  • Increased caloric need: 25kcal/kg + 40kcal/%TBSA (normal = 35kcal/kg/day)
  • Optimal dietary protein = 1-2g/kg/day
18
Q

When are skin grafts indicated?

A
  • Deep 2nd and 3rd degree burns
  • Improved survival, blood loss, and length of hospital stay
  • Most burns excised in 1st week
19
Q

What are the advantages of full thickness skin grafts?

A

Include entire dermis and epidermis, provide:

  • Diminished contracture
  • Superior cosmesis
  • Better sensation
20
Q

What are the disadvantages of full thickness skin grafts?

A
  • Lower rate of survival (less durable)

- Limited donor sites

21
Q

Why can’t skin grafts be used for tissue infected with beta-hemolytic strep?

A
  • Beta-hemolytic strep produces streptokinase: breaks down fibrin and prevents graft take
22
Q

How do you manage inhalation injuries?

A
  • Mild: warm, humidified O2; incentive spirometry
  • 2cc/kg/%TBSA more on Parkland Formula
  • Prophylactic high frequency ventilation: minimizes airway collapse and atelectasis, reduces pneumonia and mortality

POS Flashcards (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions