Thermal Injuries Flashcards
In Thermal ijuries what are indications for early intubation
40-50% TBSA
extensive and deep facial burns
burns to mouth or circumferential neck burns
burns in children
prolonged estimated transport time
What is one simple BLS manouver that you can do to minimise risk of glottal oedema in burns victims
elevate to 30’
If you suspect someone has inhalation injury what is the management of this
intubaion with a size 7.5-8ET tube to facilitate bronchoscopy
what investigations should always be performed in someone with ?inhalation injuries
CXR + ABG
When is BURNS fluid resus needed inburns
If there are any Partial (deep) -> full thickness burns or >20% TBSA
What is the fluid resus equation for adults in burns
2ml x kg x %TBSA
What is the fluid resus equation for paeds in burns
what about if theyre under 30 kg?
3 ml x Kg x %TBSA
add maintenence fluids of 5% dex
what is the equation for maintenence fluids in paeds
0-10 KG:
10ml xkg x hr
11-20kg
1000 + 50ml x kg x hr (for every kilo over 10)
> 20Kg
2000 + 20ml x kg x hr (every kilo oer 20)
How does fluid resus change in electric burns in adults and children over 30kg
in adults and children over 30kg
4ml x kg x hr to mainatin UO 100ml/hr
How does fluid resus change in electrical burns in children under 30kg
1-1.5ml x kg x hr
what should a carboxyhaemoglobin level of >10 be a warning of
inhalation injury
when should you think about CO exposure
fires in enclosed spaces
what are 2 imprtan steps in co exposure
100% O2
carbxyhaemoglobin levels
what should you be wary of in circumferential burns, limbs or abdomen/pelvis
compartment syndrome may occur needing escharoomy / fasciotomy
how would you manage patient who is suffering from 30% partial burns, tachy, no airway issues
O2 as needed
IVF burns resus fluids
NGT in anyone with burns >20% TBSA
clean skin and cover burns do not break blisters
if a burns pt has dark urine and minimal UO what may be occuring
how do you treat
rhabdomylosis
IVF until 100ml x hr urine
mannitol
why is mannitol useful in rhabdomylosis
mops up free radicals and an osmotic diuretic
how to treat frost bite
moist air rewarming
what is the pathophysiology of frost bite
ice crystalisation f cell membrane causing microvascular occlusion and anoxia
what is the pathophysiology of non freezing cold injuries
long exposure to wet/cold conditions abd teps just above freezing causing stasis and vascular occlusion with alternating vasospasm to dilation (numb to painful)
how do you treat non freezing ocld injury
blankets
circulating war, water of 40’
po hot fluids
what happens in reperfusion syndrome
hyperkal
high lactate
what is classed as severe hypothermia
T < 32
