Schwartz Flashcards
4 crucial assessments of burn patients
Airway, other injuries, burn size, CO and cyanide poisoning
Potentially lethal effect of direct thermal injury to the upper airway or smoke inhalation
Airway edema
Signs of impending respiratory compromise in burn patients
Hoarseness, wheezing, stridor
(“the HWS of lungs”)
Other signs but not an indication: perioral burns and singed nasal
At what TBSA do you usually don’t consider IV resuscitation?
Less than 15%
Common prehospital complication resulting to resuscitation failure
Hypothermia
Effects of prophylactic antibiotics in acute burn injuries?
Promote fungal infections and resistant organisms
TBSA for referral to a burn center
Partial thickness greater than 10% TBSA
Used a quick referance for estimating patient’s burn size
Rule of nines
Should not be included when calculating burn size
Superficial burns
Three burn classifications
Thermal, Electrical, Chemical
(Thermal: flame, contact, scald)
Special concerns related to electrical burns?
Cardiac arrhythmia and compartment syndrome
Acid chemical burns result in?
Coagulation necrosis
Alkali chemical burns cause?
Liquefactive necrosis
Hydrofluoric acid causes?
Hypocalcemia
(Calcium based therapies are mainstay of treating hydrfluoric acid burns)
Most severely burned portion and typically in the center of the wound?
Zone of coagulation
Zone of burn injury with variable degrees of vasoconstriction and resultant ischemia?
Zone of stasis
Zone of burn which will heal with minimal or no scarring
Zone of hyperremia
(Mostly partial thickness or 1st degree burn)
Burn wounds evolve over the __ to __ hours after injury
48 to 72 hours
One of the most effective ways to determine burn depth is __?
Full thickness biopsy
(Painful, scarring, specialized pathologist dapat)
Other modalities to predict burn depth include _ and _?
Laser doppler and noncontact ultrasound
(Laser doppler: sensi 83%, speci 97%)
(Noncontact US: painless modality for nonhealing wound)
SERIAL EXAMINATION BY BURN SURGEONS PA RIN ANG BEST
Used to predict mortality in burn patients
Baux score
Most robust indicators for burn mortality
Age, burn size, inhalation injury
(ABI Baux)
Target MAP for critically ill burn patients?
60
TBSA for referral to a burn patient
More than 10% TBSA partial thickness burns
Most important component of initial therapy. (2)
- Careful removal of the toxic substance
- Irrigation of the affected area with water for a minimum of 30 minutes
Formula of Baux Score
Mortality risk = Age + %TBSA
* but no longer accurate
Goal for UO in resuscitation among adults and pediatrics?
30ml/hr (adults)
1 to 1.5 mg/kg/hr (pedia)
