Thermal Injuries Flashcards
2 major conditions that can bee seen in electrical burns
rhabdo and cadiac arrhythmias
clinical indications of inhalation injury
face/ neck burns singing of eyebrows/ nasal vibrissae carbon deposits in mouth/ nose acute inflammatory changes in oropharynx hoarseness impaired mentation/ confinement in burning buildings
Who requires fluid resuscitation with burns
> 20% total body surface area
what type solution is preferred in resuscitation
lactated Ringer’s
the palmar surface (including fingers) of the patient’s hand represents approx. ___ percent of the patient’s body surface
one percent
burn with erythema, pain and no blisters. epidermis remains intact
first degree burn
are first degree burns included in estimate of burn size
no
burn that is dark and leathery, painless and dry. May be red and doesn’t blanch w/ pressure.
full thickness burn
red or mottled burn with swelling and blisters. may be weeping or wet looking
partial- thickness burns
patients with CO levels
20
when should you assume CO exposure with a burn
when it happens in an enclosed area
what is the half life of CO
4 hours (only 40 minutes with 100% oxygen)
fluid needs for burn patients
2-4 mL of Ringer’s lactate x kg of body weight x percentage BSA of deep partial thickness and full thickness burns during first 24 hours (1/2 of this in the first 8 hours after burn injury)
what is the target UOP fluids should be titrated to for burn patients
0.5mL/kg/hour in adults
1 ml/kg/hour for children
for small children (
glucose to avoid hypoglycemia
what is a naturally occurring toxin that may be inhaled in confined space fires
cyanide
in burn patients what may be the first sign of hypoxia and electrolyte/ acid-base abnormalitites
cardiac dysrhythmias
baseline labs for burn patients
CBC, type and cross match/ screen
ABGs w/ HbCO
serum glycose, electrolytes
preggo test
a compartment pressure above what indicates escharotomy is needed
> 30 mm Hg
if burns involve >20% BSA what should be inserted
gastric tube
what type burns are painful when air currents pass over them
partial thickness.
cover the burn with clean sheets to relieve the pain
what should you NOT do to burns
break blisters or appy antiseptic agents or apply cold compresses
no cold water if (>10% BSA)
is there any indication for prophylactic antibiotics in the early post-burn period
No
what type chemical burns are more serious
alkali because they penetrate more deeply
tx for chemical burn
flush away the chemical with large amounts of water for at least 20-30 minutes
how long doe alkali burns to the eye require continuous irrigation for
the first 8 hours after the burn
criteria for transfer to burn center
partial/ full thickness burns >10% BSA
burns on face, eyes, ears, feet, genitals, perineum, over joints
any full thickness
inhalation injury, electrical, chemical burns (significant)
mild cold injury. pain, pallor and numbness. is reversible w/ rewarming and no tissue loss
frostnip
freezing of the tissue w/ intracellular ice crystal formation, microvascular occlusion and subsequent tissue anoia
forstbite
degree of frostbite- full-thickness and subq tissue necrosis. commonly w/ hemorrhage vesicle formation
third degree
degree of frostbite with hyperemia and edema. no skin necrosis
1st degree
frost bite degree with large, clear vesicle formation that accompanies hyperemia and edema. partial thickness skin necrosis
2nd degree
frost bite degree that has skin necrosis and includes muscle and bone w/ gangrene
4th degree
tx for cold injury
replace damp clothing w/ warm blankets give hot fluids by mouth place injured part in circulating water at 104 degrees until pink color returns do NOT rub or massage give adequate analgesia and rewarm
what constitutes hypothermia
core temp
