EM Burns
Help!
|
|
||||
|---|---|---|---|---|---|
| Most common burn cause in adults | flame burns adn ignition of clothing
🗑
|
||||
| Most common burn cause in children | scald burns
🗑
|
||||
| Depth classifications | superficial, partial thickness, deep partial thickness, full thickness
🗑
|
||||
| First Degree burns | epidermal only, caused by sun or minor flash, no metabolic alteration or edema, skin is pink or red and is dry or has only small blisters, hypersensitivity, rapid healing: 3-6 days
🗑
|
||||
| Second degree burns | Involves dermis, superficial or deep, appearance and healing time vary on severity of burn
🗑
|
||||
| Superficial Second Degree burns | flame, scalding, chemicals. Minimal damage to skin appendages, edema formation, skin is pink or red & often blisters. Hypersensitivity, healing: 10-21 days
🗑
|
||||
| Deep Second Degree burns are dermal, but more destruction and involves some skin appendages (follicles). Caused by | scalds, longer exposure to flame or chemical. Moderate edema. Large blisters or bulle, often ruptured, skin may be red or pale. Decreased sensation and circulation. Healing takes longer than 21 days
🗑
|
||||
| Start losing sensation with which burn? | deep second degree burn
🗑
|
||||
| Third degree burns: full thickness destruction of epidermal and dermal layers. Caused by | prolonged exposure to heat or severe exposure. Edxtensive edema, skin often moist and weeping, charred skin or pale. NO sensation, circulation. will not heal spontaneously, requires grafting
🗑
|
||||
| Blister formation not found in | full-thickness burns.
🗑
|
||||
| Pre-Hospital Management: First Aid | Remove causative agent, cool the burn surface (not with ice b/c it can cause ischemia; can use wet sheets/towel) cover/protect burn wound to prevent heat loss and keep clean
🗑
|
||||
| Airway assessment | assess for patency, smoke inhalation injury, constantly reassess for upper airway edema (develops as fluid resuscitation progresses). Intubate preemptively, anticipate need for surgical airway
🗑
|
||||
| Breathing assessment | for spontaneous respiration, for bilateral airflow
🗑
|
||||
| Circulation assessment | assess circulatory status, establish IV access
🗑
|
||||
| Adding fluid to someone with airway inflammation/damage | will incresae airway edema. May want to intube prophylactically
🗑
|
||||
| Go to pain med in burn patients | Morphine
🗑
|
||||
| Secondary Survey | Nasogastric decompression, urinary catheter to monitor fluid output
🗑
|
||||
| Labs in burn | Obtain 02 sat, calculate weight for resuscitation volumes, ABG, CBC, electrolytes, glucose, urinalysis, carbon monoxide level, tetanus booster or Ig and immunization
🗑
|
||||
| Calculation of 9's | Percentage of body surface affected by 2nd and 3rd (1st don't count) degree burns. each thigh -9, each arm-9, bilateral chest - 18, whole leg -18%
🗑
|
||||
| Palm is approximately what % of BSA? | 1%
🗑
|
||||
| Major Burns | Partial thickness>25% BSA, Full thickness>10% BSA, Specialized tissue. Transfer to nearest Burn Center (UNC)
🗑
|
||||
| Moderate Burns | Partial thickness 15-25%, full thickness 2-10% (unless special tissues). This excludes high voltage electrical injury, inhalation, high risk , or multi-trauma. Admit, but not necessarily to burn unit
🗑
|
||||
| Parkland Formular for fluid | 4cc of LR x wt in Kg x %BSA = total volume over first 24 hours. monitor urine output, pulmonary status, BP and pulse
🗑
|
||||
| ____ is the most common cause of morbidity in smoke inhalation patients | pneumonia
🗑
|
||||
| Tx of Smoke inhalation injury | humidified O2, Pulmonary physiotherapy, mucolytic agents and bronchodilators
🗑
|
||||
| MOA of CO | displaces O2 from hemoglobin. PaO2 remains normal. MUST check the CO level for diagnosis. O2 sat will be reduced. Tx by administering 100% O2
🗑
|
||||
| The most commonly utilized and most accurate method to diagnose smoke inhalation injury is: | Fiberoptic bronchoscopy of upper airway and trancheobronchial tree
🗑
|
||||
| Concern with Electrical Injury | extensive muscle damage. Fasciotomy may be warranted. Compartment syndrome (do a frequent neuro exam! and monitor circulation: appearance, pulses)
🗑
|
||||
| Patients with electrical burns should be closely monitored with: | Observation for myoglobinuria
🗑
|
||||
| Escharatomy | An escharotomy is a surgical procedure used to treat full thickness (third-degree) circumferential burns.
🗑
|
||||
| Which is better to be burned with? Acid or Alkali? | acid. (severe occular injury from alkali will cause conjunctival pallor)
🗑
|
||||
| Most common burn injury to the eyes | chemical burn
🗑
|
||||
| Assessment of all burn pts should include | an eye exam with flourescein exam of cornea if indicated
🗑
|
||||
| Blisters on the palms or the soles are | left alone. Anywhere else are typically broken and drained. Topical abx, vasoline gauze dressing AFTER exudative phase (for minor burns)
🗑
|
||||
| Most common pathogens post burns | S. aureus and Pseudomonas.
🗑
|
||||
| Colonization | all burn wounds will become colonized. Difference between colonization and infection. Topical abx prevent invasion. Usually apply BID
🗑
|
||||
| Which Abx is used to penetrate an eschar? | Mafenide Acetate
🗑
|
||||
| ABX | Routine systemic antibiotics use is controversial and not indicated as part of routine, emergency care. If indicated, use broad spectrum with Gram positive activity: PCN, Cephalosporins, Macrolides
🗑
|
||||
| What kinds of burns may skin grafting be indicated for? | deep second degree or third degree
🗑
|
||||
| Biological dressings | Gold Standard: human allograft: lasts 2-3 weeks until rejection. Porcine xenografts (cheap, available, lasts about 1 week), Synthetic skin substitutes
🗑
|
||||
| coagulative necrosis involving the subcutaneous blood vessels is pathognomonic for | third degree burns/full-thickness injury
🗑
|
||||
| incision through the burn wound is termed | escharatomy; may be required to relieve this compression and restore distal circulation
🗑
|
||||
| Special tissue that requires burn center tx | face, eyes, ears, hands, feet, or perineum
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
ltm12