Thermal burns and colds Flashcards
Thermal burns most common in who?
Males
2 most severe burns?
- Flame
2. Liquid scald
What degree of burn is caused by sunburn and flashburns?
1st degree
Which degree of burn has no blisters, is red, and painful?
1st degree
Where is the damage in 1st degree burn and how severe?
Minor epithelial damage to dermis
Splash scalds can cause which degree burn?
2nd degree
Two types of 2nd degree burn based on depth?
- Superficial partial thickness
2. Deep partial thickness
Wall thickness of superficial and deep partial thickness burns?
Superficial=Thin-walled
Deep=Thick-walled
How long is healing of 2nd degree superficial partial thickness burns? Scarring?
2-3 weeks. No scarring
How long is healing of 2nd degree deep partial thickness burns? Scarring?
3-6 week heal. Scar likely.
Decreased 2-point discrimination in which type of burn?
2nd degree deep partial thickness
Which degree burn caused by immersion scalds, flame burns, chemical burns, and high voltage ?
3rd degree
Which degree is full thickness of dermis and epidermis?
3rd degree
Which degree burn are white leather appearance with underlying clotted vessels?
3rd degree
Do 3rd degree burns have sensation?
No
A 3rd degree burn >1cm requires what to heal?
Grafting
How does a 4th degree burn occur?
Prolonged exposure to 3rd degree burn cause
Which burn is full-thickness destruction of skin, SC tissue, fascia, muscle, and bone?
4th degree
What does a 4th degree burn require?
Surgical debridment and repair
Which burn is red, blanched white skin?
2nd degree deep partial thickness
Which burn is very tender, thin-walled fluid filled blisters?
2nd degree superficial partial thickness
Relationship between age and survival for burn size?
Inverse relationship between age and survival for any burn size. lower age=better survival
Palm of hand is what percent of Total Body Surface Area?
1%
Which burns not included in TBSA when calculating burn percent?
1st degree not included
Inhalation injury to upper airway can swell within how long?
12-24h after injry
When to intubate upper airway inhalation injury?
Soot around nostrils even if ok now
What is an escarotomy?
Cut down skin until get to non-burned bleeding skin.
What does escarotomy reduce risk of?
Compartment sybdrome in circumferential burns to arms and legs
How many IVs for Moderate Burns (20% TSBA)?
1 large bore IV
How many IVs for Severe Burns?
2 large bore IVs
Maximal Edema occurs when in burns?
24-48h
Kids need what in addition to IV fluids in major burns?
D5W d/t hypoglycemia
What does Over hydration increases risk of 3-5 days postburn?
ARDS
What guides IV fluid resuscitation in burns?
Urine output guides if IV hydration enough or not
Goal urine burns for children and adults?
<2 years= 2ml/kg/hr in children <2 years
Older children=1 ml/kg/hr
Adults=30-40ml/h (0.3-0.5 ml/kg/hr)
Why do kids easily become hypoglycemis with burns?
In a catabolic state and trying to make proteins
Treatment for severe burns?
COLD WATER and keep PT warm
How often change dressings in severe burns
BID
When surgery required in severe burns?
If not healed in 3 weeks
PTs with major burns should be transported where?
Burn center
Do prophylactic abx reduce infection in burns?
No