Thermal Injury Flashcards
1st degree burns are limited to ___ (what skin layer?); heal ___; ___ (do/do not) require medical treatment
1st degree burns are limited to epidermis; heal spontaneously; do not require medical treatment
2nd degree burns–extend to ___; may need ___; aka ___ thickness burns
2nd degree burns–extend to dermis; may need grafting; aka deep, superficial partial thickness burns
3rd degree burns–extend to ___; ___ required; aka ___ thickness burns
3rd degree burns–extend to subcutaneous; skin grafting required; aka full thickness
4th degree burns–extend to ___, ___, ___
muscle, fascia, bone
Mortality estimate for burns = ___ + ___
Mortality estimate for burns = age + TBSA%
> 115 mortality is > 80%
Doubled if inhalation injury
What are (4) etiologies of burns?
- Chemical
- Electrical
- Thermal
- Inhalation
Initial treatment for chemical burns = ___
copious water or saline
Electrical burns can lead to ___ and ___ failure
Electrical burns can lead to myoglobinuria and renal failure
What is the most common type of burn in children?
Thermal burns–2nd leading cause of death for 1-4 year olds
Inhalation burns–UPPER airway can be ___ or ___ burn; LOWER airway usually from ___ or ___ particles
UPPER airway can be thermal (air, steam, smoke) or chemical; LOWER airway usually from chemical or soot particles
What is the first priority of anesthetic management in a burn patient?
Diagnose and treat airway injury
EARLY intubation if necessary–may be extremely difficult, consider awake/fiberoptic, surgical airway, succs?
What is the denervation-like phenomenon that occurs during the resuscitative phase of burn patients?–proliferation of ___ receptors, ___ release
Proliferation of acetylcholine receptors, K+ release
Do NOT give succs to a burn patient after ___ hours
Do NOT give succs to a burn patient after 24 hours
When is it okay to give succs to a burn patient?
When the wound is closed and the patient is gaining weight
If you are using a NDNMB in a burn patient, you have to give ___-___x the ED95 dose for proper intubating conditions
2-3x the ED95 dose
CO has ___x affinity for hemoglobin than O2
CO has 200x affinity for hemoglobin than O2
CO poisoning–tissues are unable to extract ___, leads to metabolic ___osis
CO poisoning–tissues are unable to extract O2, leads to metabolic acidosis
Labs for CO poisoning–SaO2 is ___; ABG has ___ total oxygen
SaO2 is normal; ABG has decreased total oxygen
What device is needed to show true oxygen saturation in a patient with CO poisoning?
Co-oximeter
Treatment of CO poisoning = ___
100% O2–decreases CO half-life from 4 hours to 40 mins
Fluid loss/shifts are greatest in the first ___ hours in burn patients; begin to stabilize after ___ hours
fluid loss/shifts are greatest in the first 12 hours in burn patients; begin to stabilize after 24 hours
Fluid shifts from ___ to ___
Fluid shifts from intravascular to interstitial
Result of fluid shifts in burn patients–severe depletion of ___; marked increase in ___ volume
severe depletion of plasma (hypovolemia); marked increase in extracellular volume (edema)
Parkland formula for burn patients–in the first 24 hours, give ___ ml LR/% burn/kg; give 1/2 in the first ___ hours, give 1/2 in the next ___ hours; ___ (yes/no) colloid
In the first 24 hours, give 4 ml LR/% burn/kg; give 1/2 in the first 8 hours, give 1/2 in the next 16 hours; no colloid
