Thermal Burns Flashcards
Soft tissue is typically burned when it is exposed to temperatures above ______
115 F
Thermal burns can be caused by?
flame
contact
scalding
heat
thermal energy denatures & coagulates protein causing what?
irreversible tissue destruction
What are released from damaged tissue immediately following the burn injury?
vasoactive mediators
What results in extravasation of fluid into the interstitial space around the burn?
increased capillary permeability
What can occur in patients with burns 40% ore more TBSA?
myocardial supression
What is burn severity based on?
depth
extent
location
What is the treatment for minor burns?
cool burns imediately
pain management (NSAIDS, opioids)
clean burns with mild soap & water
topical antibiotic ointments should be applied (silver slufadiazine, bacitracin, triple antibiotic ointment, or honey)
What is the approach to patients w/ moderate or severe burns?
initial management focuses on ABC’s
evaluate cardiovascular status
determining the depth & extent of burns
trauma/surgical consul
wound care
anitbiotics
transfer is imminent
tetanus booster or Ig
The rule of nines is used for what type of burns?
ONLY for burns more severe than superficial
involves only the epidermis
skin is red, dry, painful
no blisters, blanches w/ pressure
heals in 4-7 days without scarring
superficial burn
(aka 1st degree burn)
involves epidermis & extends into dermis
skin is red, moist, painful, blisters may be present
blanching is still present
heals in 14-21 days without scarring
superficial partial thickness burn
(2nd degree burn)
involves epidermis AND deeper into dermis
skin is whitis or yellowish
pressure can be felt there is usually no overt pain
blanching is absent, 2-point discrimination is diminished
healing may take 21 days to 3 months
scaring is common
deep partial thickness burn
charred & black to pale & waxy white, leather, painless (except in surroudning area of more superficial burns)
will not heal spontaneously- skin grafting is required
full thickness burn
parital thickness < 10% of BSA in patients 10-50 years old
partial thickness < 5% of BSA in patients < 10 years old or over 50
full thickness burns < 2% BSA in any patient without other injury
isolated injury
may NOT involve face, hands, feet, perineum or genitalia
may NOT cross major joints
may NOT be circumferential
minor burn
10-20% TBSA burn in adults
5-10% TBSA burn in young or old
2-5% full thickness burn
high voltage injury
suspected inhalation injury
circumferential burn
medical problem predisposing to infection (DM, sickle cell)
moderate burn
> 20% TBSA burn in adults
> 10% TBSA burn in young or old
>5% full thickness burn
high voltage burn
known inhalation injury
any significant burn to face, eyes, ears, genitalia, or joints
significant associated injuries
major burn
What is the disposition for a minor burn?
outpatient
What is the disposition for a moderate burn?
admit to hospital
What are some signs of smoke inhalation injury?
carbonaceous (black) sputum
signed facial or nasal hairs
facial burns
oropharyngeal edema
voice changes
assume injury in any person confined in a fire environment
What is the disposition for a major burn?
refer to burn center
What can smoke inhalation rapidly lead to?
airway edema
intubate as needed
What is the name of the formula used to determine how much fluid an adult burn patient needs?
Parkland Formula
(renamed Consensus Formula)
What formula is used to determine the amount of fluid needed for a pediatric burn patient?
What is different in this formula?
Galveston Formula
uses total body surface area instead of weight (kg)
