SPECONLEC_S1_L2 - 2nd (37-72) Flashcards
1
Q
Divides the body into areas of 9%
A
The Rule of 9
2
Q
When is the Rule of 9 more practical?
A
emergent triage of a patient with an acute burn injury
3
Q
Components under total body surface area
A
- Rule of 9
- Modified Lund and Browder Method
4
Q
How many percent is the head?
A
9%
5
Q
How many percent is the entire right (LE)
A
18%
6
Q
How many percent is the entire left (LE)
A
18%
7
Q
How many percent is the entire trunk?
A
36%
8
Q
How many percent is the groin?
A
1%
9
Q
How many percent is the entire right arm?
A
9%
10
Q
How many percent is the entire left arm?
A
9%
11
Q
Tool divides the body into much smaller areas and gives you sizes that are associated with differently aged patients
A
Modified Lund and Browder Method
12
Q
T or F: Modified Lund and Browder Method is a more accurate means to determine the extent of burns
A
T
13
Q
Modified Lund and Browder Method modified the percentages of body surface area to account for a ___ and to accommodate for ___ of different body segments
A
continuum age; growth
14
Q
When is it considered a minor injury when in children and elderly
A
<10% TBSA
15
Q
When is it considered a moderate injury when in children and elderly
A
20% TBSA
16
Q
When is it considered a major injury when in children and elderly
A
> 20% TBSA
17
Q
When is is considered a Minor injury in partial thickness burn?
A
N/A, also moderate and major are N/A
18
Q
When is it considered to be a minor injury in adult?
A
<15% TBSA
19
Q
When is it considered to be a moderate injury in adult?
A
15-25%
20
Q
When is it considered to be a major injury in adult?
A
> 25%
21
Q
When is it considered to be a minor injury in full thickness burn?
A
2% not involving the EEHFP
22
Q
When is it considered to be a major injury in full thickness burn?
A
> 10%, except EEHFP, electrical or inhalation
23
Q
When is it considered to be a moderate injury in full thickness burn?
A
2-10%, except EEHFP, electrical or inhalation
24
Q
Inhalation injury is suspected in what type of injury?
A
moderate
25
Inhalation injury is known in what type of injury?
major
26
An electrical burn is a __
major injury
27
A burn injury in the eyes, ears, face, perineum and hands is a __
major injury
28
Co-morbid factors and premorbid illness in major injury
/ fracture and trauma
29
Co-morbid factors and premorbid illness in moderate injury
/ predisposing patient to infection (DM, SCD)
30
Criteria for admission: Partial and full thickness burns in pts under 10 and over 50
>10% TBSA
31
Criteria for admission: Partial and full thickness burns in other age groups
>20% TBSA
32
Criteria for admission: full thickness burns in other age groups
>5% TBSA
33
Criteria for admission: Partial and full thickness burns involving the __, _, _, _, _
hand, feet, face, perineum, or skin overlying major joints
34
Criteria for admission: other conditions which will warrant admission
Electrical burns and lightning injuries
Chemical burns
Patient with inhalation injury
35
Complications of Burns
Infections
Pulmonary Complications
Metabolic Complications
Cardiovascular complications
Heterotrophic ossification
Neuropathy
Pathologic Scar
Complications of electrical burns
36
Complication that is a leading cause of mortality
Infections
37
Agents causing infection
Pseudomonas aeruginosa and Staphylococcus aureus
38
Suspected in patients burned in a close space
pulmonary complications
39
injury that can happen in pulmonary complication
inhalation injury
40
Primary complications of pulmonary complications (5)
carbon monoxide poisoning, tracheal damage, upper airway obstruction, pulmonary edema, pneumonia
41
Damage to the lungs = __
lethal
42
rapid decrease in body weight and decrease in energy stores that are vital to the healing process
metabolic complications
43
__ injuries cause a great metabolic and catabolic change to the body
thermal
44
Severe burns where there are hemodynamic changes from the loss/shifting of fluids
cardiovascular complications
45
Cardiovascular complications will have __% decrease in __
15%; cardiac output
46
heterotrophic ossification happens in __%TBSA
20%
47
HO occurs in areas of (superficial partial/full/deep) thickness or sites that remain unhealed for a prolonged period of time
full thickness burn
48
causes of HO (4)
Immobilization, microtrauma, high protein intake, sepsis
49
areas affected by HO
elbow, hips, shoulders
50
most common area affected by HO
elbow
51
Complication that is due to compression bandages applied to tight, poorly fitted splints, inappropriate positioning
neuropathy
52
Neuropathy can occur where? (3) sites
Brachial plexus, ulnar, common peroneal
53
Pathologic scar include ___ burns allowed to heal
Deep partial thickness
54
Pathologic scar includes __, __, or __
hypertrophy, contracture, or both
55
Pathologic scar include ___burns that have been skin grafted
full thickness burns
56
Type of scar: more on cosmetic problem (2)
keloid & hypertrophic
57
Type of scar: considered problem since it limits movement
contracture scars
58
Kinds of Wound Healing
Epidermal Healing
Dermal Healing
59
(2) to tak enote in Edpidermal healing
epithelial lining & contact inhibition
60
Healing that occurs when there are viable cells lining the skin appendages
epithelial healing
61
Epidermal healing will undergo ___ which means u cannot disturb/move area while healing
contact inhibition
62
Epithelial healing is most clinically evident in (partial/full/deep) thickness wounds that have intact hair follicles and glands
partial thickness wounds
63
in epidermal healinh, damage in ____ may cause dryness and itching of wounds
sebaceous glands
64
Phases under dermal healing
Inflammatory
Proliferative
Maturation
65
Wound healing phase: 3-5 days
Inflammatory
66
Wound healing phase: Fibroblast formation
Proliferative
67
Wound healing phase: Characterized by redness, edema, warmth, pain, and decreased ROM
Inflammatory
68
Wound healing phase: Wound contraction
Proliferative
69
Wound healing phase: = or slightly > than collagen breakdown
Maturation
70
Wound healing phase: >collagen breakdown
Maturation
71
Wound healing phase: Platelets aggregate, & fibrin is deposited to form a clot over the area
inflammatory
72
Wound healing phase: A wound is considered closed at the time epithelium covers the surface; however, wound healing involves remodeling of the scar tissue
maturation
73
Wound healing phase: at deep, fibroblasts are migrating & proliferating; superficial, re-epitheliazation
proliferative
74
Wound healing phase: there is a reduction in the number of fibroblasts, a decrease in vascularity d/t a lesser metabolic demand,
maturation
75
Wound healing phase: Leukocytes infiltrate the area & behin to rid the site of contamination
inflammatory
76
Wound healing phase: remodeling of collagen, which becomes more parallel in arrangement & forms stronger bonds
maturation
77
Wound healing phase: re-epithelialization
Proliferative
78
Wound healing phase: Ratio of collagen breakdown to production determines the type of scar that forms equal or slightly greater than collagen breakdown
maturation
79
Wound healing phase: If there are other parts of the dermis nearby, they produce epithelium,
proliferative
80
Wound healing phase: There is increased permeability of the blood vessels, with leaking of plasma, into the interstitial space & subsequent edema formation.
inflammatory
81
what type of scar we want after wound healing
flat, pale, pliable
82
re-epitheliazation occurs at what layer of epidermis
stratum basale
83
this ceases when (1) the edges of the wound meet, or (2) tension in the surrounding skin equals or exceeds the force of contraction
wound healing
84
these are the cells that synthesize scar tissue, which is composed of collages & protein ppolysaccharides in the form of a viscous ground substance that surrounds the collagen strands
fibroblasts
85
Transient vasoconstriction in inflammatory phase of healing lasts for _ to _ mins
5-10
86
In proliferative phase, where is re-epithelialization occurring in which fibroblasts are migrating and proliferating?
surface of the wound, while deep within the wound,
87
In maturation phase, the ratio of ___ to __ determines the type of scar that forms
collagen breakdown; production
88
an = or slightly > than collagen breakdown leads to what scar?
pale, flat, pliable scar
89
a >collagen breakdown leads to what scar?
hypertophic scarring
90
Types of burn scars
hypertrophic scars
keloid scars
contracture scars
91
type of scars: characterized by extremely tight skin that can restrict your ability to move
contracture scars
92
type of scars: excessive collagen deposits appear raised, but not to the degree super observable
hypertrophic scars
93
type of scars: can appear as a firm, rubbery lesion or shiny, fibrous nodules
keloid scars
94
type of scars: Distinct pattern of collagen
keloid scars
95
type of scars: They come out on the usual wound bed
keloid scars
96
type of scars: Contained in the site of injury & may regress over time
hypertrophic scars
97
type of scars: On histological examination, tends to have regularly
patterned collagen
hypertrophic scars
98
type of scars: Spread beyond the borders of the initial injury & do not regress
keloid scars
