Test 1 - Burn Injuries

Question 1

Skin Function

Answer 1

Protective Barrier
Thermoregulation (controlled by brain) - sweating, vasoconstriction/dilation
Fluid/Electrolyte Balance (sweat glands)

Question 2

What is a burn?

Answer 2

Break in barrier

Question 3

What are the risk factors with burns?

Answer 3

Infection
F/E imbalance
Hypothermia

Question 4

Burn Chain of Events

Answer 4

Burn
Massive Evaporation due to cap leak (fluid to 3rd space)
Edema/vasodilation
Decrease Map ( Decrease BV, BP, BF, Increase HR)
Tissue Ischemia/Hypoxia
Tissue Necrosis
Cell Death
Organ Failure

Question 5

What is leaked when fluid moves into 3rd space/interstitial space?

Answer 5

Potassium
Sodium
Water
Plasma

Question 6

Where is fluid shifting to and from?

Answer 6

Shifts from vascular space to third space

Question 7

Rate of Evaporation

Answer 7

1 Depth of Injury

Assess by:

#2 Event of injury (Total Body Surface Area/TBSA)

Rule of 9s required to assess ROE

Question 8

Electrical Burn

Answer 8

Entrance/exit wound
“Grand masquerade” of burns
Cause dysrhythmias - need EKG

Question 9

Radiation Burns

Answer 9

Chemo
UV

Question 10

Contact Burns

Answer 10

Tar
Asphalt
Friction
Hot Metal

Question 11

Thermal Burns

Answer 11

2 Types:

Moist - steam/scald
Dry - fire explosion

Question 12

Cold Burn

Answer 12

Frost Bite

Question 13

Types of Burns

Answer 13

Electrical
Chemical
Radiation
Contact
Thermal
Cold
Inhalation

Question 14

1st Degree Burn: Example, S/Sx, Treatment, Healing Time

Answer 14

Superficial Burns, Affect epidermal layer

Example: Sunburn

S/Sx: NO BLISTERING, red, dry, hot to touch, pain to touch, desquamation (peeling)

Treatment: Aloe, cool compress, stay out of sun

Healing: 3 days - 1 week

Question 15

2nd Degree Burns: Types, S/Sx, Treatment, Healing

Answer 15

Partial Thickness Burns
Affects dermal layer

2 Types:

Superficial partial (top 1/3 dermal layer)
- blistering
- moist wound bed w/ weeping of red/pink fluid
- vascular bed intact

Deep partial (bottom 1/3)
- white patches w/ some red/pink weeping
- burn exists through capillary bed

Treatment/Healing
- None b/c vascular bed intact
- 10-21 days

Question 16

3rd Degree Burn: Examples, S/Sx, Treatment

Answer 16

Full Thickness Burn

S/Sx:

hard
dry
leathering skin
Eschar (sticky, coagulated skin) = differentiator

Eschar requires emergent eschiotomy

Question 17

4th Degree Burn: Examples, S/Sx, Treatment, Healing

Answer 17

Deep Full Thickness

S/Sx:

Hard
Dry
Leathery skin
BURNED THROUGH ALL LAYERS
POSSIBLE BONE/Muscle Exposure

Healing:

Based on early: eschiotomy, skin graft (xeno or auto), fasciotomy

Question 18

How do we describe burns?

Answer 18

Minor
Moderate
Major

All depend on depth, extent, location

Question 19

Parkland Formula

Answer 19

Calculates TOTAL VOLUME of fluids (mL) that patient needs 24-hours AFTER burn

2nd and 3rd degree burns ONLY

Total mL Needed = 4ML x TBSA (%) x Body Weight (Kg)

• Give FIRST 1/2 of solution during 1st 8 hours
• Give SECOND 1/2 of solution over next 16 hours