Test 1 - Burn Injuries Flashcards
Skin Function
Protective Barrier
Thermoregulation (controlled by brain) - sweating, vasoconstriction/dilation
Fluid/Electrolyte Balance (sweat glands)
What is a burn?
Break in barrier
What are the risk factors with burns?
Infection
F/E imbalance
Hypothermia
Burn Chain of Events
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
What is leaked when fluid moves into 3rd space/interstitial space?
Potassium
Sodium
Water
Plasma
Where is fluid shifting to and from?
Shifts from vascular space to third space
Rate of Evaporation
1 Depth of Injury
Assess by:
#2 Event of injury (Total Body Surface Area/TBSA)
Rule of 9s required to assess ROE
Electrical Burn
Entrance/exit wound
“Grand masquerade” of burns
Cause dysrhythmias - need EKG
Radiation Burns
Chemo
UV
Contact Burns
Tar
Asphalt
Friction
Hot Metal
Thermal Burns
2 Types:
Moist - steam/scald
Dry - fire explosion
Cold Burn
Frost Bite
Types of Burns
Electrical
Chemical
Radiation
Contact
Thermal
Cold
Inhalation
1st Degree Burn: Example, S/Sx, Treatment, Healing Time
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
2nd Degree Burns: Types, S/Sx, Treatment, Healing
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
3rd Degree Burn: Examples, S/Sx, Treatment
Full Thickness Burn
S/Sx:
hard
dry
leathering skin
Eschar (sticky, coagulated skin) = differentiator
Eschar requires emergent eschiotomy
4th Degree Burn: Examples, S/Sx, Treatment, Healing
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
How do we describe burns?
Minor
Moderate
Major
All depend on depth, extent, location
Parkland Formula
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
