week 10 - Burns

Question 1

4 causes of burn injury

Answer 1

• chemical
• temperature (flame, hot object, cold object, hot liquid)
• electrical (includes lightening burns)
• radiation (sun burn)N

Question 2

classification of burns?

Answer 2

burns classified in 2 ways:

• the depth of the injury
• extent of the injury (expressed as a % of TBSA)

Question 3

how is burn depth further classified?

Answer 3

• superficial
• partial
• full thickness

Question 4

Superficial burn

Answer 4

• involves only the
• bright pink, dry and red
• blanches to pressure
• no blisters
• may be painful
• healing time = within 7 days

Question 5

partial burn

* check 2447 notes for this

Answer 5

• involves epidermis and upper dermis
• pale pink, fine blisters
• very painful
• healing time <14 days

Question 6

full thickness burns

Answer 6

• involes epidermis and dermis
• white waxy/ lethery charred skin
• no sensation
• no circulation
• will not heal without skin graft

Question 7

how to classify the extent (%) of TBSA burned?

Answer 7

rule of 9’s:

• face and scalp 9%
• front 18%
• back 18%
• arm each 9%
• upper leg each 9%
• lower leg each 9%

Question 8

Burn management

Answer 8

• running water for upto 20 minutes
• do not use ice
• burn gel

Question 9

Burns assessment

Answer 9

Danger:
- remove source of burn (chemicals etc..)

Response:
- AVPU

Airway:

• may be suffering from smoke inhalation
• observe for stridor, wheezing, hoarse voice/ loss of voice, cough

Breathing:

• WOB, RR etc..
• auscultate chest

Circulation:

• pts with severe burns may develop severe hypovalemic shock within 3-4 hours
• need to replace fluid loss

Disabilty:
- normal

Question 10

Fluid loss =

Answer 10

Heat loss!

Question 11

when will fluid resuscitation be needed?

Answer 11

• adults (>15% TBSA burn)

- children ( >10% TBSA burn)

Question 12

Parkland formula

Answer 12

volume = weight x percentage burn x 4ml

eg pt weighs 80kg, 30% TBSA burn
- how much fluid should we give?

80kg x 30% x 4ml = 9600ml

• first 8hours five half of total required
• next 16hours give remainder
• adjust volume according to urine output (0.5mg/kg/hr min)

Question 13

what fluid to give?

Answer 13

• NaCI

- hartmans solution ig using parkland formula

Question 14

dressing of burns

Answer 14

superficial = melonin

partial thickness & full thickness = non stick dressing with absorptive qualities to soak up excess exudate

Question 15

burns complications

Answer 15

• infection
• decreased perfusion
• psychological trauma
• respiratory damage