trauma and burns Flashcards
What are thermal burns due to?
Heat
fire
scoldings
flash
direct contact with hot object
Which is thr most powerful UV rays?
a)UVA
b) UVB
c) UVC
a
Through what mechanism does radiation burn occur?
contact with radioactive sources found in commercial and industrial settings
What are the three types of rays that a patient could be exposed to with radiation burn?
alpha, beta, gamma
what is the most dangerous ray a patient can be exposed to? alpha, beta or gamma?
gamma
In chemical burns, there is potential for acid or alkali exposure. Which exposure is most severe?
alkali exposure
What is the result in the body when exposed to acid?
produces coagulation necrosis by denaturing proteins, forming eschar which limits the penetration of the acid
what is the result in the body of exposure to alkali?
liquifaction necrosis involves denaturing of proteins which does NOT limit tissue penetration.
more severe injury
parkland formula
4cc x kg x %TBSA burned
fluid administered over 24 hours
1/2 over 8 hours,2nd half over remaining 16 hours
Rule of 9s - what are the percentages of parts of body?
head I clouding neck- 4.5% front. 4.5% back
chest - 9% front and 9% back
and abdomen- 9% front and 9% back
upper back - 9% front 9% back
lower back- 9% front and 9% back
upper limb (1)-4.5% front, 4.5% back
lower limb (1)- 9% front and 9% back
genitalia - 1%
What are the 3 classifications of burns
superficial burn
partial thickness burn
full thickness burn
there are 3 categories of burns. what are the requirements for a MAJOR burn?
25% BSA
Involvement of hands, feet, face, perineum
electrical or inhalation injury
what are the four categories of shock?
hypovolemic
distributive
obstructive
cardiogenic
causes of hypovolemic shock?
hemorrhage
fluid loss
third spacing of fluid
causes of distributive shock
sepsis,neurogenic causes,anaphylaxis, adrenal crisis
what are some causes of obstructive shock
pulmonary embolism
tension pneumothorax
cardiac tamponade
what are some causes of cardiogenic shock
myocardial infarction, arrhythmia, valvular defects, cardiomyopathy
a hypotensive patient in shock may have a reduction in one of 2 things
reduction in stroke volume (low output state )
reduction in systemic vascular resistance (vasodilatory state)
what is the trauma triad of death
hypothermia
metabolic acidosis
coagulopathy
equation for MAP
MAP= DBP + 1/3 (SBP - DBP)
Why are burn patients prone to hypothermia after being cooled?
The skin aids in thermoregulation, and so they lose ability to thermoregulate due to damage to the skin
What is the significance of vomiting within 10 mins after radiation exposure?
they will not survive
Those with radiation exposure who exhibit vomiting within 1 hour have _______radiation exposure and a ____% to _____% survival
severe
30
80
how long do you cool a burn for?
15-20min,
the burn wound has 3 zones/ degrees of injury. what are they?
zone of coagulation
zone of stasis
zone of hyperemia
You are caring for a patient who was involved in a MVI. You notice a clear fluid coming from the ear, as well as ecchymosis behind the ear. What type of skull injury to you suspect?
basilar skull fracture
what is the definition of primary brain injury?
the injury to the brain and it’s associated structures that results immediately from impact to head
what are the processes that occur in a secondary brain injury ?
cerebral edema, intracranial hemorrhage, increased ICP, cerebral ischemia, hypoxia, hypoglycemia, hypotension
Also decrease in ATP, and switch to anaerobic metabolism
The normal CPP in an adult is 60mmHg. A _______ drop in CPP ______ the chances of death in patient eith brain injury
single
doubles
Why does BP go up and HR go down in brain injury?
when brain injured, body’s autoregulatory mechanism shunts more blood to brain, increasing systemic arterial BP and reflex bradycardia.
what is myocardial contusion?
-may be minor or asymptomatic
-tachycardia may be present
– sone pts develop conduction abnormalities and/or arrhythmias
true or false: ventricular rupture is a form of blunt cardiac injury, and is usually asymptomatic
false! it is usually rapidly fatal.
true or false: valve disruption is a form of blunt cardiac injury and my cause heart murmur and manifestations of heart failure
true
what is becks triad?
hypotension
jugular vein distention
muffled heart sounds
what pathology is becks triad associated with?
acute cardiac tamponade
true or false: pericardial effusion is a slow build up of fluid so pericardium can stretch co accommodate fluid, whereas cardiac tamponadr is a sudden accumulation of fluid in the pericardium and it doesn’t have time to stretch
true
symptoms of pericardial effusion include:
chest pain
shortness of breathe
compression of nearby structures
causes of cardiac tamponade include:
chest trauma - stab wound
ruptured aorta
future of ventricle adapter myocardial infarction
what is pulsus paradoxus
exaggerated drop in a patients blood pressure by more than 10mmHg during INSPIRATION
