Thermal Injuries Flashcards
A burn patient becomes stridorous. What do you do?
Stridor is an immediate indication for endotracheal intubation
After establishing the airway and stopping the burning what is your next step in mgmt of the burn patient?
Gain IV access
Approximately what percent of BSA does the head make up for a child and adult?
Child: 18%
Adult: 9%
What BSA does the palmar surface of hands include?
1%
How do partial thickness (2nd degree) and full thickness (3rd degree) burns differ in appearance?
2nd degree are red, weeping, mottled, and hypersensitive to pain
3rd degree are darker, leathery, dry, and with limited sensation
What are symptoms of CO poisoning?
Headache, nausea, confusion, coma, death
How do you determine the amount of fluids to provide and the rate in 2nd and 3rd degree burn patients?
2-4 mL Ringer’s solution per kg body weight per percent body surface area burned
Half of the above calculated volume is given in the first 8 hrs and the remainder is given over the subsequent 16 hrs
After starting fluid resuscitation what should be the target UOP in adults and children?
- 5 mL/kg/hr in adults
1. 0 mL/kg/hr in children
2nd degree burns hurt when air flows above them. What do you do to alleviate this?
Dry sheets over them
Should you apply cold water to a patient with 20% BSA?
No. Don’t apply cold water to patients with BSA burns >10%
Is there an indication for prophylactic antibiotics in burn patients?
No, only for actual treatment
Patient presents with chemical burn and dry powder still on leg. What do you do?
Gently brush powder off leg and then irrigate with water copiously, 20-30 mins (longer for alkali solutions)
In patient with electric burns what should you monitor?
Heart for arrhythmia
Urine for dark color/myoglobulinuria
Spine and muscular damage
Define first-degree frostbite
Hyperemia and edema without skin necrosis
Define second-degree frostbite
Large, clear vesicle formation accompanies hyperemia and edema; partial-thickness skin necrosis
Define third-degree frostbite
Full-thickness and sub-cutaneous tissue necrosis; hemorrhagic vesicle formation
Define fourth-degree frostbite
Full-thickness skin necrosis which includes muscle and bone with gangrene
Give an example of non-freezing cold injury
Immersion injuries of extremities in temperatures slightly above freezing for long periods of time
How are frostbite and nonfreezing cold injuries managed?
Remove damp clothes and replace with warm blankets, promote drinking hot liquids, place body part in hot circulating water (40 deg C; 104 deg F)
Ensure adequate analgesia since rewarming can be painful
