SPECONLEC_S1_L2 - 1-36-2 Flashcards
Most common cause of burns in children
Scalds from hot liquids
Most common cause of burns in children AGE
1-5 yo
Most common cause of burns in adolescents and adults
Accidents from hot liquids
Most common cause of burns in adolescents and adults AGE GENDER
Male 16-40
Leading cause of burns in other age groups
Fires in homes and structural dwellings
Burns common cause of death
Inhalation injury
Burns: THREE age groups most commonly involved
<1yr (24%), 2-14yrs(25%), 25-44yrs(25%)
most common type of burn
scale burns
Majority were treated __ hours of the injury (89%)
24
Most common cause of death was ____ (40%)
MOSD
What percent: fatality rate
9%
What percent: Majority were treated 24 hours of the injury
89%
What percent: death by MOSD
40%
What percent: scale burns
43%
3 Significant factors associated with mortality included
1) % TBSA, 2) Inhalation injury, 3) Involvement of head, LE, perineum
3 medical conditions that are risk for burns
epilepsy, peripheral neurophathies, physical and cognitive disabilities
Risk factors for burns
Occupations that increase exposure to fire;
Poverty, overcrowding, and lack of safety measures;
Placement of young girls in household roles;
Underlying medical conditions;
Alcohol abuse and smoking;
Easy access for chemicals used for assault;
Use of kerosene as a fuel source for non-electric domestic appliances;
Inadequate safety measures for liquefied petroleum gas and electricity
Fuel source used for non electric domestic appliances
Kerosene
Risk factor: Inadequate safety measures for liquefied ________ gas and electricity
petroleum
Initial physical finding: direct thermal injury is confined to the ___ & ____
face & upper airway
Initial physical finding: _____ injury is confined to the face & upper airway
direct thermal
3 main INITIAL physical finding
1) facial burns, 2) burned nasal hairs, 3) soot in nares & mouth
Bronchial Cast: Accrued ________ can cause obstruction of distal airways contributing to ventilation perfusion mismatching & secondary infection
endobronchial debris & exudate
Bronchial Cast: Accrued endobronchial debris & exudate can cause obstruction of (proximal OR distal) airways contributing to ventilation perfusion mismatching & secondary infection
distal
Bronchial Cast: Accrued endobronchial debris & exudate can cause obstruction of distal airways contributing to (2)?
ventilation perfusion mismatching & secondary infection
Bronchoscopic view aerosolized chemicals & combustion can deposit through where (2)?
subglottic airways and lungs
Bronchoscopic findings include (4)?
mucosal irritatio, pallor, ulceration, carbonaceous debris
Facial burn (6) contributes to morbidity & mortality?
anoxia, carbon moxodie, cyanide, inflammation, airway obstruction, infection
PH facts: number of fires in 2010-2012
883
PH facts: 43% of fires occurred at what months of the year
first 4 months
PH facts: what time is its highest incidence
12:01-3:00am
PH facts: most common cause (2)
Faulty Electrical Wiring and neglected open flames
PH facts:most common areas affected
residential areas
PH facts: Worst fire in Philippine history
Ozone disco fire
largest organ
skin
4 functions of the skin (PRPS)
1) Protective shield against heat, light, injury, and infection, 2) Regulation of body temperature, 3) Storage of water and fat, 4) Prevents entry of bacteria
The skin serves as a protection for (4)?
heat, light, infection, injury
Skin layer: the surface or outer layer which serves as a barrier between our body and the environment
Epidermis
Epidermis role
serves as a barrier between our body and the environment
5 Layers of the skin
Stratum corneum, lucidum, granulosum, spinosum, germinativum/basale
what layer of the skin is the Stratum corneum
1st
what layer of the skin is the Stratum lucidum
2nd
what layer of the skin is the Stratum granulosum
3rd
what layer of the skin is the Stratum spinosum
4th
what layer of the skin is the Stratum germinativum / basale
5th
EPIDERMIS LAYER: made of keratinocytes & squamous layer
lucidum granulosum
EPIDERMIS LAYER: contains cells that enable epidermis to regenerate
basale
EPIDERMIS LAYER: hardened layer
corneum
EPIDERMIS LAYER:waterproof characteristic
corneum
EPIDERMIS LAYER: contains melanocytes - pigments
basale
EPIDERMIS LAYER:have lamellar granules
granulosum
EPIDERMIS LAYER:dead keratinocytes
corneum
EPIDERMIS LAYER: keratinocytes & langerhans cells
spinosum
EPIDERMIS LAYER: where cell division happens
basale
EPIDERMIS LAYER: helps with production of cells
basale
Layer of skin beneath the epidermis
dermis
dermis is __times thicker
20-30x
Skin layer: Contains epidermal appendages
dermis
Skin layer: Comprised mainly of interwoven collagen and elastin fibers
dermis
dermis contains?
epidermal appendages
dermis is comprised mainly of (2)?
interwoven collagen & elastin fibers
PAPILLARY OR RETICULAR: thin arrangement of collagen fibers
P
PAPILLARY OR RETICULAR: thick arrangement of collagen fibers
R
PAPILLARY OR RETICULAR: denser
R
PAPILLARY OR RETICULAR: supplies nutrients and regulates temperature
P
PAPILLARY OR RETICULAR: strengthens the skin & provides structure, elasticity
R
PAPILLARY OR RETICULAR: has BVs
P
PAPILLARY OR RETICULAR: thin extensive vascular system
P
PAPILLARY OR RETICULAR: supports hair follicles, sweat glands, sebaseous glands
R
PAPILLARY OR RETICULAR: contriction & expansion
P
PAPILLARY OR RETICULAR: arranged parallel
R
(epi/dermi/hypo) BVs, nerves, lymph vessels, hair follicles
Hypodermis/Subdermis
2 layers of dermis
papillary & reticular layer
location & function: free nerve endings
epidermis dermis = pain & itch
location & function: merkerl’s disks
epidermis (s. spinosum) = touch
location & function: meissner’s corpuscles
papillary dermis = touch
what receptor: epidermis dermis = pain & itch
free nerve endings
what receptor: epidermis (s. spinosum) = touch
merkel’s disk
what receptor: papillary dermis = touch
meissner’s corpuscles
location & function: ruffini’s endings
papillary dermis = warm receptors
location & function: krause end bulb
papillary dermis = cold receptors
location & function: pacinian corpuscles
reticular dermis = pressure & vibration
what receptor: papillary dermis = warm receptors
ruffini’s endings
what receptor: papillary dermis = cold receptors
krause end bulbs
what receptor: reticular dermis = pressure & vibration
pacinian corpuscles
Skin layer: Lies below the dermis
Hypodermis/Subdermis
Skin layer: It consists of loose connective tissue and elastin
Hypodermis/Subdermis
Skin layer: Fat serves as padding and insulation for the body
Hypodermis/Subdermis
Hypodermis/Subdermis consists of (2)?
connective tissue & elastin
Hypodermis/Subdermis fat serves as (3)?
padding, shock absorber & insulation for the body
usually injury pattern: Alteration of ______ → Edema → LOM
vascular integrity
MOI: Alteration of vascular integrity → ______→ LOM
Edema
MOI: Alteration of vascular integrity → Edema → _____
LOM
Skin destruction will depend on (4)?
temperature, length of time, type of insult (Flame, liquid, chemical, electrical), extremes of age
4 types of insult in skin destruction
Flame, liquid, chemical, electrical
type of MOI: 70% of burns in children , Spilling hot drinks/liquid, hot water in baths , Cause superficial to superficial dermal burns
Scalds
Scalds __% in children
70
MOI that cause spilling hot drinks/liquid, hot water in baths
Scalds
MOI that cause superficial to superficial dermal burns
Scalds
type of MOI: 50% of adult burns, Associated with inhalation injury and other concomitant trauma, Deep or full thickness
Flame
Flame __% in adults
50
Flame MOI is associated with (2)?
inhalation injury & concomitant trauma
MOI that is associated with inhalation injury & concomitant trauma
flame
MOI that is associated wit deep or full thickness
flame
MOI: The depth of heat injury depends on the degree of heat exposure and depth of heat penetration ; Deep dermal or full thickness
Contact
Thermal burns is divided into (3)
Scalds, flame, contact
contact thermal birns depend on (2)
degree of heat exposure and depth of penetration
most devastating type of MOI
electrical burns
MOI that has an electric current that will travel through the body from one point to another, creating “entry” or “exit” points
electrical burns
MOI that varies according to: (1) Type of current, (2) Intensity of the current, (3) Area of the body that the current passes through
electrical burns
electrical burns vary accordingto (3)?
type of current, intensity of current, area ofbody that current pass through
RANK 1-7: bone
1
RANK 1-7: cartilage
2
RANK 1-7: tendon
3
RANK 1-7: skin
4
RANK 1-7: muscle
5
RANK 1-7: blood
6
RANK 1-7: nerve
7
Two types of electrical burns
low & high voltage electrical burns
type of electrical burn: Exposure to 500-1000 volts of current
low voltage current
type of electrical burn: v fib
low voltage current
type of electrical burn: Greater than 1000 volts
high voltage current
type of electrical burn: Apnea, deep tissue destruction, renal failure
high voltage current
type of electrical burn: divided into true & flash
high voltage current
high voltage current number of volts
> 1000
low voltage current number of volts
500-1000
choose: (flash/true) high tension injury that has current that pass through the patient
TRUE
choose: (flash/true) high tension injury that has current arcs, no current goes through patient
flash
MOI: Extensive muscle and soft tissue necrosis often result in amputation
Electrical burns
electrical burns is most common in (UE/LE) & (Left/Right)
R UE
(High/Low) voltage: PNS and CNS problems may not be present initially but may occur late after
high voltage current
True or False PNS and CNS problems may not be present initially but may occur late after
TRUE
In electrical burns, lightning results to (2)? - pathy
myelopathy & encephalopathy
In electrical burns, lightning results to (2)? - hearing loss
sensorineural & mechanical hearing loss
In electrical burns, (2) ocular complications are?
catarcts & macular holes
type of burn that has 8 cardiac manifestations
Electrical burns
acronym for 8 cardiac manifestations after electrical burns
PMDASINC
8 cardiac manifestations after electrical burns (PMDASINC)
Immediate cardiac arrest,
Pseudo infarction,
Myocardial ischemia without necrosis,
Dysrhythmia ,
Conduction abnormalities,
Acute hypertension,
Nonspecific ECG abnormalities,
Sinus tachycardia
8 other manifestations of electrical burns (DIECBRLI)
Diaphragm paralysis,
Inhibition of the breathing centers in the midbrain,
Extensive fluid loss,
Loss of consciousness,
Impaired recall and PTSD,
Blood clotting ,
Compartment syndrome ,
Rhabdomyolysis
(exit/entry) wound is more devastating in electrical burns
exit
in electrical injury, this is a manifestation where there is degredation of muscles loss
rhabdomyolisis
