Trauma Part 3

Question 1

epidural or superficial burns

Answer 1

• epidermis
• appear red
• no blistering, brisk cap refill and normal sensation
• rapidly heal

Question 2

superficial dermal or superficial partial thickness

Answer 2

• dermal: damage to epidermis and papillary dermis
• pale pink
• painful
• blistering is common and cap refill normal
• heal in 7-10d (adults) 5-7d (child)
• tx: fluid resus, analgesia, moist wound healing environment and protection from infection

Question 3

deep dermal burns

Answer 3

• Extend into reticular layer of dermis
• blotchy red with variable sensation.
• Non-blanching
• Epidermis/dermis is destroyed so healing depends on epidermal migration from peri-burn area.
• Long healing duration- scarring and changes in pigmentation occur.
• Tx: surgical excision/skin grafting

Question 4

full thickness burns

Answer 4

• Damage extending through all the skin structures.
• white and waxy(scalds) or charred(flame)
• Can extend to subcutaneous tissue, muscle or bone.
• complx: septicemia, hypovolaemia, excess catabolism or chronic illness.
• Reassessment of injury at 24-48 hours

Question 5

inhalation burns

Answer 5

Inhalation burns:

• Phase 1 (0-36 hours post exposure) acute pulmonary insufficiency
• Phase 2 (6-72 hours post exposure): pulmonary edema
• Phase 3 (3-10 days post exposure): bronchopneumonia

Question 6

upper airway burn

Answer 6

direct thermal burn, edema appears fast

Question 7

lower airway burn

Answer 7

toxins, ARDS, edema appears later

Question 8

management of burns

Answer 8

• wash with warm water and soap or NaCl
• blisters less than 1cm are left intact; others are de-roofed
• dressings assessed after 24-72hrs
• pain
• managing post-surgery site (debridement)
• fluid resus
• nutritional status (high protein, high cal)

Question 9

which type of burn is the most acute?

Answer 9

inhaled; damage to lungs