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WVSOM skin System 2012

What is the role of the skin? Prevents heat and water loss as well as invasion by bacteria
What is the result of a burn? Loss of vascular integrity, increased capillary permeability, increased interstitial volume, diminution of blood volume
What is the rule about fluid loss? It is proportional to the depth of the burn
what is the result of fluid loss? Hypovolemia, hypotension, tachycardia, decreased CO, vasoconstriction, Kindey ischemia
What are the most common burns in the following age groups? 3-14 15-60 60 3-14: flame burns 15-60: industrial accidents 60: Accidents
What is burn severity dependant on? Temperature, Duration, Conduction
What is a first degree burn? Epidermal involvement ONLY
What is a second degree burn? Partial thickness into dermis
What is a third degree burn? Dermis though to adipose
What is a fourth degree burn? Passes into muscle
treatment of first degree burns remove clothing, apply cool compress and soothing lotion
how do you treat a second degree burn? cool compress, leave blisters intact, cleanse wounds, occulsive dressing
what is the purpose of occlusive dressings? Absorptive, bulky, eliminate dead space, give vascular support, splinting effect
How do we treat a third degree burn? remove dead tissue, cleanse the burn area, grafting if bigger 3-4cm
Skin grafting is priority for what areas? Face, neck, hands and flexion creases
what does ABCDE Airway Breathing Circulation Disability Exposure
When would you send a patient to a burn unit? If they had facial burns, singed eyebrows or nasal hairs, confinement in a burning building, impaired mentation, explosion, or CO levels greater than 10%
how do we evaluate breathing? 100% O2 and tension pneumothorax, or flail chest
How do we evaluate circulation? 16 gauge catheter in a peripheral vein
How do we evaluate Disability? AVPU
How do we replace lost fluid? 2-4ml IV/kg/%BSA in 24 hrs 1/2 in 8hrs, then second half in 16hrs
What is the secondary survey? A- allergies M- medications P- past history L-last meal E-event
Rules of nine each leg is 9%, each arm is 4.5%, torso is 18%, head is 4.5 %, genitalia is 1%
How can you estimate BSA? anterior surface of palm of the hand= 1% BSA
How do we Assess Peripheral Circulation Capillary refill,cyanosis, doppler
What do we look for in the blood work of a burn victim? CBC, CO levels, electrolytes, ABG, prothrombin, carboxyhemoglobin, pregnancy test in females of childbearing age
what other labs would you order? Chest-Xray not before 48hrs, NG if 25% BSA, Urinary cath X 72hrs,
criteria for hospitalization full thickness (3-4 degree) >2% BSA Partial thickness (2 degree) >10% BSA
Criteria for Burn Unit full thickness >5% BSA Partial thickness >20%BSA or 10% if under 10 or over 50 high voltage electrical burn significant chemical burn inhalation injury
What complications should you be aware of for a burn victim? Infection, gastric distention, paralytic ileus, fecal impaction, curlingulcer, URI obstruction.
which is worse: Alkali burn or acid burn? ALKALI
How do you irrigate chemical burns Acid: neutral solution for 20-30 minutes Alkali- irrigate for 8 hrs
how do you deal with electrical burns? make sure urine is clear if not increase fluids to 100ml per hour and add 25 gms of mannitol then 12.5 gms to each liter of fluid
Created by: Bwest8