S1L2: Burns Flashcards
The common deformity of the hand after burn injuries is in the claw hand position or intrinsic plus.
a. True
b. False
b. False
Significant factors involving mortality involvement of the head, upper extremity, and the perineum.
a. True
b. False
b. False
The free nerve endings that are found only in the dermis, convey the sensation of pain and itch to the brain.
a. True
b. False
b. False
Inhalation injuries are the most devastating type of burns.
a. True
b. False
b. False
In electrical burns, PNS and CNS problems may occur
immediately after injury.
a. True
b. False
b. False
In chemical burns, acidic products usually cause more damage compared to alkali products.
a. True
b. False
b. False
Complete healing of superficial thickness burns occurs in 7 to 10 days.
a. True
b. False
a. True
The most common cause of burns in children 1 to 5 years of age is scalding from hot liquids
a. True
b. False
a. True
The tissue with the least resistance to electricity is the blood as it is made up of water.
a. True
b. False
b. False
Inhalation injuries are called carbon monoxide poisoning, heat injuries, or smoke inhalation injuries.
a. True
b. False
a. True
EPIDEMIOLOGY
Most common cause of burns:
○ Children (1 - 5 y.o.) -
○ Adolescent & Adults -
○ Children (1 - 5 y.o.) - scalds from hot liquids
○ Adolescent & Adults - accidents from hot liquids
EPIDEMIOLOGY
Highest injury is found in (gender) between (age)
Males between 16-40
EPIDEMIOLOGY
leading cause
of burns in other age groups
Fires in homes & structural dwellings
EPIDEMIOLOGY
[] injury is common cause of death
Inhalation injury
EPIDEMIOLOGY
Philippines
Most common cause of death:
Multiple Organ Dysfunction Syndrome (MODS)
Significant factors associated with mortality included:
% total body surface area (TBSA) : more dangerous if this is, higher or lower?
higher
Significant factors associated with mortality included:
1.
2.
3.
Head
LE
Perineum
Risk Factors (✅ or ❌)
- Placement of old girls in household roles
- Poverty, overcrowding, & lack of safety measures
- Occupations that increase exposure to fire
- Underlying medical conditions including diarrhea,
fever, physical & cognitive disabilities - Alcohol abuse & Smoking
- Lack of access for chemicals used for assault
- Adequate safety measures for liquefied petroleum gas & electricity
- ❌ (young girls)
- ✅
- ✅
- ❌ (epilepsy, peripheral neuropathies, physical & cognitive disabilities)
- ✅
6.❌
7.❌
Risk factors
Use of [] as a fuel source for non-electric domestic appliances
kerosene
Initial Physical Findings
Direct thermal injury
● Generally confined to the [] & []
face & upper airway
Initial Physical Findings
Direct thermal injury
Physical findings include [] burns, burned [] hairs, and [] in the nares & mouth
Physical findings include facial burns, burned nasal hairs, and soot in the nares & mouth
Initial Physical Findings
Modified T/F:
A. Accrued endobronchial debris & exudate (Bronchial cast) can deposit throughout the subglottic airways & lungs
B. Aerosolized chemicals & incomplete products of combustion contributes to the venti-
lation-perfusion mismatching and secondary infection
FF. A - Aerosolized chemicals & incomplete products of combustion; B - Accrued endobronchial debris & exudate (Bronchial cast)
Initial Physical Findings
Modified T/F:
A. Accrued endobronchial debris & exudate (Bronchial Cast) cause the obstruction of distal airways
B. Aerosolized chemicals & incomplete products of combustion severity depends on both the agents & particle sizes inhaled
TT
Aerosolized chemicals & incomplete products of combustion are seen in []
Bronchoscopic View
T/F: In Bronchoscopic View, findings include mucosal irritation, pallor,
ulceration, & carbonaceous debris
True
Initial Physical Findings
Modified T/F:
A. Anoxia, carbon monoxide, cyanide effects, local & systemic inflammation, airway obstruction,
& infection contribute to morbidity & mortality in patients with inhalation injury
B. These effects are more marked in those with small subcutaneous burns
TF - B. These effects are more marked in
those with large cutaneous burns
Philippines
43% of fires occurred in the first [] mos of the year
4
Highest incidence occurs at [] to [], which
probably is cause d/t accidents as well
12:01-3:00 AM
most common cause of fire in the PH
Faulty Electrical Wiring & Neglected open flames
most commonly affected areas in PH
Residential
Worst fire in Philippine history
Ozone Disco Fire (1996)
MOI
Initial part of injury: Alteration of [] integrity →
[] → []
Alteration of vascular integrity →
Edema → LOM
Skin destruction depend on
Temperature: []the temp → faster degradation of the skin
→ more severe the burn
higher temp
Skin destruction depend on
Length of time: The [] the pt is in contact with the high temp,
worse the burn is
longer
Skin Destruction will depend on:
Age: [] & [] pts are at risk for more
tissue destruction
very young & very old
Modified T/F:
A. Thermal Burns are caused by hot surfaces or hot liquids
B. Scalds, under thermal burns, cause deep dermal or full thickness burns
TF: B - Contact cause deep dermal or full thickness burns
Modified T/F:
A. Scalds are caused by spilling hot drinks/liquid, hot water in baths
B. Flame is associated with inhalation injury and other concomitant trauma
TT
Modified T/F:
A. Both flame and contact can cause deep dermal or full thickness burns
B. The depth of heat injury in both types depends on the degree of heat exposure and depth of heat penetration
TT
Most devastating MOI
Electrical burns
Modified T/F:
An electric current will travel through the body from one point to another, creating “entry” or “exit” points
A. An Open/entry point refers to body part in contact with the
electric current/wire. An exit point is where the current exits
B. Damage is more extensive on the entry points
TF: B - Damage is more extensive on the exit points
Electrical burns vary according to (3)
Type of current
intensity of current
Area of the body that the current passes through
T/F: High frequency alternating current causes more
extensive damage/injury to tissues
False - Low frequency alternating current causes more
extensive damage/injury to tissues
Ranking of the electrical resistance of various tissues (most resistant to least resistant/least conductive to
most conductive)
Skin
Blood
Muscle
Nerve
Tendon
Bone
Cartilage
○ Bone
○ Cartilage
○ Tendon
○ Skin
○ Muscle
○ Blood
○ Nerve
Low vs High voltage electrical burns
- Exposure to 500-1000 volts of current
- Greater than 1000 volts
- Side Effects: apnea, deep tissue destruction, renal failure
- Ventricular Fibrillation (V Fib)
- Low
- High
- High
- Low
Modified T/F:
A. Flash injury refers to the current passes directly through the body
B. True high tension injury refers to the current does not directly pass through the body but its
current arc can still injure the patient
FF -
True high tension injury: the current passes directly through the body
Flash injury: the current does not directly pass through the body but its
current arc can still injure the patient
Modified T/F:
A. Extensive muscle & soft tissue necrosis often result in
amputation
B. The most common extremity affected is the (L) LE
TF: B - (r) UE most common
Modified T/F:
A. Lightning can cause Myelopathy & Encephalopathy
B. Ocular complications includes Sensorineural & Mechanical hearing loss
TF: B - Ocular complications includes Cataracts & Macular holes → blindness
T/F: in a high voltage affectation, PNS & CNS problems may not be present initially but
may occur late after
True
Cardiac manifestations of Electrical Burns (✅ or ❌)
1. Dysrhythmia
2. Sinus tachycardia
3. Blood clotting
4. Rhabdomyolysis
5. Immediate cardiac arrest
- ✅
- ✅
- ❌
- ❌
- ✅
Cardiac manifestations of Electrical Burns (✅ or ❌)
1. Pseudo infarction (affects the muscles of the heart)
2. Myocardial ischemia without necrosis
3. Compartment syndrome
4. Extensive fluid loss
5. Diaphragm paralysis
- ✅
2.✅
3.❌
4.❌
5.❌
Cardiac manifestations of Electrical Burns (✅ or ❌)
1. Conduction abnormalities
2. Acute hypertension
3. Nonspecific ECG abnormalities
all are cardiac manifestations
MOI
It usually as a result of an industrial accident and May occur with household chemical products
Chemical burns
Modified T/F:
A. Acidic products are more injurous than alkali products since they cause irreversible protein & tissue
damage
B. Acidic products cause a severe injury called
liquefactive necrosis, this involves denaturing of the proteins as well as saponification of the adipose tissues
FF
A. Alkali products > Acidic products
B. Alkali products cause a severe injury called
liquefactive necrosis
MOI:
Classified as carbon monoxide poisoning, heat, or smoke
inhalation injuries. It account for more than half of the burn related deaths per
year
Inhalation Injuries
T/F: one of the leading causes of death is inhalation injuries
True
Pathophysiology
Local Response
- Decreased tissue perfusion; Goal: Increase perfusion
- Occurs at the point of maximum damage; Irreversible tissue loss
- Outermost zone; Tissue will recover unless there is severe sepsis
a. Zone of Coagulation
b. Zone of Stasis
c. Zone of Hyperemia
- B
- A
- C
PATHOPHYSIOLOGICAL CHANGES DURING
HYPERMETABOLIC/HYPERDYNAMIC PHASE OF BURN ([] HRS.)
> 48
Match the pathophysiological changes
- High energy expenditure (↑ O2 consumption
& ↑ CO2 production) - ↑ SvO2
- ↑ Pain response
- Bronchospasm, bronchorrhea
- ↓ SVR (systemic vascular resistance)
a. Brain
b. Heart & Circulation
c. Lungs
d. Systematic Inflammatory response
- D
- B
- A
- C
- B
Match the pathophysiological changes
- Insulin resistance - hyperglycemia
- Muscle catabolism
- Altered mental status
- Subclinical myocardial dysfunction
5.Acute respiratory distress syndrome
a. Brain
b. Heart & Circulation
c. Lungs
d. Systematic Inflammatory response
- D
2 D - A
- B
- C
Match the pathophysiological changes
- Albuminemia
- Immunoparesis
- ↑ Glomerular filtration rate
- ↓ Tubular function
- ↑ Gluconeogenesis
a. Liver
b. Kidney
c. Bone Marrow
- A
- C
- B
- B
- A
Match the pathophysiological changes
- Altered metabolic function
- ↓ Hematopoiesis
- Osteoporosis
- Anemia
- Altered drug clearance
- ↓ Coagulation factor
a. Liver
b. Kidney
c. Bone Marrow
- A
- C
- C
- C
- A
- A