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3512 > wk 12 flash > Flashcards

wk 12 flash Flashcards

1
Q

what are the three types of burn

A

thermal, chemical and electrical

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2
Q

what are the characteristic of a first degree burn

A
  • red, minimal swelling, moderate to severe tenderness
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3
Q

what are the characteristics of a deep partial thickness (second degree) `

A

miderate to severe pain
no debridement if its small enough

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4
Q

what are the characteristics of a third degree (full thickness) burn

A

leathery, white and dark brown
no pain in area, only in the edges
if not derided within 24 hours they’ll be septic

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5
Q

how long does a third degree burn have to be derided before the patient goes septic

A

24 hours

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6
Q

how do we calculate TBSA

A

rule of 9s
only for people who have average height and weight proportions

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7
Q

how can you tell if a burn patient needs a respiratory assessment

A
  • burned hair, soot on face, wheezing, SOB
    or any burns on the face, neck and chest
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8
Q

what do we have to focus on if a patient has a burn on their bum or perineum

A
  • worry about BM, diarrhoea, and infection from diarrhoea
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9
Q

what is a circumferential burn

A

skin around the trunk
its bad because skin will get so tight you won’t be able to breathe

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10
Q

what is an escharotomy and why would one need it

A
  • basically you cut through burn tissue and let the skin expand
    you need it for a bad circumferential burn
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11
Q

what constitutes a minor burn

A

<10% TBSA partial thickness
<2% full thickness
no burns on face, eyes, hands, ears, or perineum
no electrical or chemical burns
no inhalation injury
< 60 years of age with no chronic disorders

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12
Q

what constitutes a moderate burn

A

partial thickness less than 10 % TBSA
full thickness 2-10% TBSA

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13
Q

what constitutes a severe burn

A

partial thickness> 10% TBSA
3 degree burn
inhalation burn
electric/ chemical burn
burn on the face, hands, feet, perineum, joints, etc.
children in hospitals where they dont have supplies for pets

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14
Q

what is the Manitoba burn unit

A

HSC H5

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15
Q

in the emergency phase of smoke inhalation, what are your 3 main priorities

A

Airway: protect the airway, intubate early
Breathing: stand beside patient with 15L of oxygen ready
C: give IV fluid because the patient will be hypovolemic (NS or ringers usually)

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16
Q

should you prioritise wound care in the emergent phase of a burn?

A

no, wait until airway is protected and BP is stable

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17
Q

what are signs that there is a burn in the upper airway

A
  • hoarseness/stridor
  • difficulty swallowing
  • lots of secretions
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18
Q

what is the main focus of the acute phase of a burn

A
  • patient will be hypervolemic and diuressing a lot
  • mainly focus on wounds and preventing sepsis
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19
Q

what is a patients metabolism like in the acute phase of a burn

A

patients will be hyper metabolic, they’ll likely need a tube feed

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20
Q

what do you give for antianxiety in a burn patient

A

Ativan

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21
Q

what do you give for pruritis in a burn patient

A

Benadryl

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22
Q

what type of infusion should you give during burn dressing change

A

ketamine continuous

23
Q

what is the main thing with silver/acticoat

A

it kills bacteria, activate it by getting it wet

24
Q

what is an autograft

A

patients own skin

25
Q

what is a cultured epithelial autograft

A

take skin and grow in lab (fragile)

26
Q

what is an allgraft/homograft

A

another persons skin

27
Q

what is a heterosexual/xenograft

A

different species skin graft

28
Q

what is biobrane

A

manufactured skin (product)

29
Q

how long do people need to wear compression garments during the recovery phase of a burn

A
  • 1-2 years
  • 24 hours a day
30
Q

why do you need to wear compression garments after a burn

A

to prevent hypertrophic scar

31
Q

which grades of frostbite need to be hospitalised

A

grades 3 and 4

32
Q

how long does it take to demarcate

A

2 weeks - 5 months

33
Q

what is demarcation

A

divides between injured and normal skin, you can see the full extent of the damage

34
Q

what are the main things we do for frostbite care

A

handle area carefully
soak with warm water
take off jewellery
do NOT squeeze

35
Q

what does a grade 1 frostbite look like

A

decreased blood flow (hyperaemia) and edema

36
Q

what does a grade 2 frostbite look like

A

large, clear milky blisters

37
Q

what does a grade 3 frostbite look like

A

small, dark blisters
cool dumb and blue non-blandkking

38
Q

what does a grade 4 frostbite look like

A

blisters all over, part is cold and bloodless
necrosis extends to bone

39
Q

what is the treatment for a grade 3 frostbite

A

debridement

40
Q

what is the treatment for a grade 4 frostbite

A

amputaiton

41
Q

what is the priority for sepsis

A

early identification and antibiotics

42
Q

what is the priority for septic shock

A

treat BP

43
Q

what will lactic acid levels look like for a patient with sepsis

A

they will be high

44
Q

what will BUN and Cr levels look like for a patient with sepsis

A

they will be high

45
Q

what are the main early shock symptoms

A
  • change in VS
  • low BP, high HR
  • narrow pulse pressure
  • warm and flushed skin
46
Q

what do late shock symptoms look like with sepsis

A
  • cold and clammy
    very low BP
    narrow pulse pressure
    mottled skin
    increase in lactic acid
47
Q

what are the 6 main priorities for sepsis

A
  1. give O2
  2. IV fluid to raise BP
  3. draw cultures
  4. give IV abx (broad spectrum until culture comes back
  5. baseline bloodworm
  6. put foley in for accurate i/o
48
Q

what are three types of opportunistic infection someone who is HIV positive could have

A

thrush, shingles, pneumonia, yeast

49
Q

what do pupils look like in late stage shock

A

unreactive and dilated

50
Q

what are the main 2 reasons someone dies in the emergent phase of a burn

A

airway obstruction
CV collapse (high pulse, low BP)

51
Q

what is the main big thing we should monitor for if a patient has stridor from an inhalation burn

A

if the stridor stops that’s BAD

52
Q

what are the four main priorities in a patient with a possible inhalation burn in the emergent phase in ER

A

1) High fowlers
2) O2 mask on
3) constant oxygen sat probe
4) continually listen to chest sounds (nurse will be assigned to monitor breathing)

53
Q

what vital signs indicate hypovolemic shock

A

SBP < 90
HR > 120

3512 (19 decks)

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