Wk 4 Burns Flashcards
What are the 6 types of burns?
Thermal
Chemical
Inhalation
Electrical
Radiation
Extreme temperature
What is the most common type of burn?
Thermal
What is a chemical burn?
Exposed to acid, alkaline, or chemicals
What happens during an inhalation burn?
Causes oral/nasal, esophageal, and direct parenchymal lung injury
Who is at risk for extreme temperature burns?
Children and the elderly due to their reduced ability to generate heat
What 5 factors influence severity of a burn?
Depth
% of body covered
Location
Age of patient
Health of patient
If the burn is severe enough the patient will be transferred to..
a burn center
What is a second degree burn?
Includes epidermis and dermis
What is another name for a second degree burn?
Deep partial thickness
What is a third degree burn?
Full thickness, includes all layers
What is a 1st degree burn called?
Superficial partial thickness
A third and fourth degree burn, a patient may not…
feel because the nerves are destroyed
% of body burned
Rule of Nines
The head accounts for __% of rule of nines
4.5% (on one side)
The torso accounts for __% of rule of nines
18% (on one side)
The legs account for __% of rule of nines
9% each, on one side
The arms account for _% of rule of nines
4.5% each, on one side
The groin area accounts for __% of rule of nines
1%
What are the 3 phases of burn management
Emergent/Resuscitative Phase
Acute Phase
Rehabilitative Phase
How long does the emergent phase last for?
Up tp 72 hours from the time the burn occurred
What are the main concerns in the emergent phase of burns?
Hypovolemic shock
Edema formation
When does the emergent phase end?
Fluid mobilization and diuresis begins
What is the pathophysiology (general) of the emergent phase of a burn?
Massive fluid and electrolyte shift related to massive increase in capillary permeability
What is the primary concern with the emergent phase?
Hypovolemic shock
What is a circumferential burn?
A burn that goes all the way around the extremity
What are thew 2 major concerns of the cardiovascular system during the emergent phase of a burn?
Shock and increased blood viscosity, + VTE
Circumferential burns and edema impair circulation
What might a provider need to do to restore circulation during the emergent phase of a burn?
Escharotomy
What is an escharotomy?
full-thickness incision through the eschar, exposing the subcutaneous fat
This is an example of a…
Escharotomy
What are we concerned about with the pulmonary system during the emergent phase of a burn?
upper and lower airway
What is the concern with the urinary system during the emergent phase of a burn?
Acute renal failure
Why do the kidneys shut down during the emergent phase of a burn?
Decreased blood flow (from hypovolemic shock)
Excessive myoglobin and hemoglobin released can block renal tubules
What is the number 1 nursing management during the emergent phase of a burn?
Airway management
What is the number 2 nursing management of the emergent phase of a burn?
Fluid therapy
A patient in the emergent phase of a burn will have have type of IV/fluids
2 large bore IV’s or CVAD
Fluid resuscitation
What are the IV fluids that are typically used during an emergeny phase of a burn? (2)
Crystalloids (Lactated Ringers)
Colloids (Albumin)
or both
What is the reason behind infusing large amounts of fluid into a patient in the emergent phase of a burn?
Increase blood volume to increase cardiac output
What is a fasciotomy?
a surgery to relieve swelling and pressure in a compartment of the body, cut into the fascia
When burn wounds are exposed, you must
PPE (hat, mask, gown, gloves)
Sterile gloves to apply ointments/dressings
How warm should a burn patient’s room be in the emergent phase of a burn?
85 degrees
Drug therapy for burns includes…
Opiods
Sedatives
Tetanus immunization
Topical antimicrobials
VTE Prophylaxis
What is a topical antimicrobial agent used in burns?
Silver sulfadiazine
What is the name brand for silver sulfadiazine?
Silvadene
When are systemic antibiotics used in burn patients?
Concerns regarding sepsis
What is the leading cause of death in burns?
Sepsis
What type of feeding would a burn patient be on?
Enteral to treat extreme hypermetabolic state
When does the acute phase of a burn begin?
With mobilization of extracellular fluid and subsequent diuresis
When does the actue phase end?
When partial-thickness wounds are healed and full-thickness are covered by skin grafts
How long is the acute phase?
Takes weeks to months
With partial thickness, there is eschar formation, it is then…
Removed for regeneration of epithelium
With full thickness burns, the eschar takes longer…
to separate. Surgical debridement and skin grafting is common
A burn patient may need what types of therapy?
PT
OT
Psychiatry
What are the 2 goals of the rehabilitation phase?
Working toward resuming functional role in society
Rehabilitate from any reconstructive surgery that may be needed
What do you want to avoid during the rehabilitation phase?
Contractures and hypertrophic scarring
What helps keep scars flat?
Pressure garments
What else might a patient need to do in the rehabilitation phase?
Schedule ROM
