Rishavy - Burns Flashcards
How much fluid do you give to a burn victim? (What is the parkland equation?)
4cc/kg/TBSA (total body surface area)
Give the first half of fluids 8 hours post burn,
other half next 16 hours
Inhalation injury add 25%
What is the major cause of organ damage in burn victims? Why is vit C given to burn patients?
Cytokine release of free rad’s.
Vit C is an antioxidant.
What do IVFs do to the “zone of statis” of a burn?
Drives it into the zone of hyperemia, away from the zone of coagulation (dead tissue).
What is the best measure of IVF resuscitation when treating burns? What amount is sufficient?
Measure of urine output
peds 1cc/kg/hr
adult .5cc/kg/hr
Predicted mortality of a burn?
TBSA + age
Which blisters do we pop? Which do we leave alone?
Pop clear blisters (high concentration of inflamm mediators that lead to more dmg)
Leave hemorrhagic blisters (they are protective)
Differences between 1st, 2nd, 3rd, and 4th degree burns.
He said it will be on the test. 1st - sunburn 2nd- blistering 3rd- penetrates subcu, needs grafting, painless 4th- Penetrates deep, bone, organ, etc.
(this stuff all seems pretty basic so far right? It gets better)
The three main types of burn Tx from class
Silvadene, Mafenide acetate (sulfamylon), Silver nitrate.
Silvadene complications
Neutropenia (low amount of neutrofils)
Mafenide acetate (sulfamylon) complications
Carbonic anhydrase inhibitor (cannot convert CO2 + water –> bicarbonate + proton)
i.e. metabolic acidosis.
Silver nitrate complications
leaches Na+, K+, Ca2+, Cl-
Hyponatremia, hypokalemia, hypocalcemia, hypochloremia
Are antibiotics needed in the initial 24-72 hours after a burn?
No.
Escharotomy
“Splitting the hot dog”
Skin cut to releave pressure if a circumferential burn is cutting off circulation.
What urine output do you want with someone suffering an electrical injury?
> 100 cc/hr
What is the type of injury resulting from acid burns?
Coagulation necrosis
