Week 4 Flashcards
How many individuals received medical treatment for burns?
450,000
How many fire/burn/smoke inhalation death per year?
3,400
How many hospitalizations due to burns?
40,000
How many hospital burns gone to burn centers?
30,000
What is the percentage of survival rate?
96.6%
What is the percent of male to female burns?
69% males
31% females
What is the ethnicity breakdown for burns?
59% caucasian
20% African-American
14% Hispanic
7% other
What is the breakdown for burn cause?
43% fire/flame 34% scald 9% contact 4% electrical 3% chemical 7% other
What is the breakdown for place occurence of burns?
72% Home 9% occupational 5% street/highway 5% recreation 9% other
What is a burn?
When the skin comes in contact with something hot resulting in damage and death of skin cells
What determines the depth of injury?
Intensity, heat, duration the skin is exposed
Exposure to certain chemicals
What is BSA?
Body surface area-reference term used when describing the % of the body burnt
What percents for children and adults results in required hospitalization for IV fluid resuscitation?
15% in adults
10% children
What is the Rule of Nine’s for BSA estimation?
Head and Neck 9% Each upper limb 9% Each lower limb 18% -anterior -posterior Torso 36% -anterior 18% -posterior 18% Perineum 1%
What are the four classifications of burns?
1st degree
2nd degree
3rd degree
4th degree
What is a 1st degree burn?
Superficial involvment
Redness of skin without blisters
How are 1st degree burns treated?
Analgesics and pain medications for comfort
Heal within a week
What is a 2nd degree burn?
Partial thickness burns
Blisters
What may occur due to 2nd degree burns?
Excision of damaged skin followed by grafting
What is 2nd degree treatment?
Forearm should be splinted in functional position to prevent later stiffness
Raw surface should be cleaned with frequent dressing changes
Topical antibiotics preformed until wound heals
How long does it take for 2nd degree wounds to heal?
2-3 weeks
What are 3rd degree burns?
Full thickness burns
dead skin will need to be removed and replaced with skin grafts
When is the best time to cast a patient with a 3rd degree burn?
During the bandage change
What is the treatment for 3rd degree burns?
Surgeons remove dead skin and graft immediately
Orthotic treatment till wound heal and mobilization begins
Escharotomy
When is escharotomy indicated?
When a burn is full and the circumference can constrict blood flow.
Large amount of swelling is present
Inelastic burned skin
What is escharotomy?
Release rigid and inelastic burned skin to allow circulation and breathing
What is 4th degree burn?
3rd degree burn with the added damage to deeper structures like the tendons, muscles, joints, and bones
What are the two different scar formations?
Hypertrophic scar
Keloids
What are hypertrophic scars?
Confined scars to the original borders or boundries, regress and flatten in time.
What are keloid scars?
Rising scars that can spread
How can you cleanse the wound?
Maintain temperature of the wound
Use warming cleansing solutions
Warm ambient temperature
Avoid lengthy dressing changes
What is the ideal burn dressing?
Protect the wound from physical damage and micro-organism
Be comfortable, compliant and durable
Be non-toxic, non-adherent, and non-irritant
Allow gaseous exchange
Allow high humidity at the wound
Be compatible with topical therapeutic agents
What are the differences between hypertrophic scars and keloids?
Hypertrophics scars are confined, any location, regress, flatten, appear within 1 month
Keloids extend beyond border; appear on sternum, arms, cheeks, earlobes; thick collagen; remain elevated 4mm; appear 3 month later; worsen with surgery.
What are common issues with burn patients?
Scars to contractures
psychosocial aspects of resultant scarring
Scars become dry and crack (ulceration, skin breakdown)
Scars are sensitive to sun and chemicals
Itching
What should be done to prevent contractures?
Stretching 5-6 times a day
Moisturize the area
Splints with larger area of coverage and special liners
Why are burns itchy?
Burns damage and/or destroy the oil glands
Moisturizer should only be applied to healed scars
pressure garments can decrease itching.
What are the aspects of custom pressure garments?
Worn 23 hours a day
May not improve scar, but can decrease itching and protect the skin from injury
What are the aspects of Silicone gel sheets?
Assist with decreasing itching and moisturizing skin
can be worn alone, or under pressure garments, splints and/or orthoses
Check for skin sensitivities
How much of a barrier should be provided between the fingers and the end of the brace/
1/4-1/2 inch barrier
What orthosis can you use for an anterior burn of arm?
WHO with turn buckle design
What other orthoses can you use for burns?
Total contact
Turn buckle
Soft pro comfy pro
