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Burns

QuestionAnswer
Layers of skin Epidermis. Dermis. Subcutaneous.
Function of the skin Protection from infection. Sensory organ. Temperature regulation. Pain. Controls loss and movement of fluids. Flexible to accommodate movement of the body.
Types of burns Thermal. Electrical. Chemical. Radiation
Voltage Difference of electrical potential between 2 points, different concentration of electrons.
Types of chemical burns Acids-form a thick, insoluble mass where they contact tissue. Necrosis. Limits burn damage. Alkali-destroys cell membrane thru liquefaction necrosis. Deeper tissue penetration and deeper burns. (Worse)
Transmission of energy Radiation
Types of radiation Nuclear energy. Ultraviolet light. Visible light. Heat. Sound. X-rays.
Gamma Rays Highly energized. Penetrate deeper than alpha or beta. EXTREMELY DANGEROUS. Pass thru thick shielding, clothes, body. Extensive cell damage
Airway Thermal Burn. Supraglottic structures absorb heat and prevent lower airway burns. Injury is common from superheated stream.
Red skin. Pain at site. Involves only epidermis. Superficial Burn. 1rst degree
Intense pain. White to red skin. Blisters. Involves epidermis and dermis. Partial Thickness. 2nd degree
Dry leathery skin. (White,dark brown or charred) loss of sensation. All dermal layers and tissues may be involved. Full Thickness. 3rd Degree Burn.
Treatment for local and minor burns Local cooling. Remove clothing. Cold water immersion. Analgesics.
Treatment of moderate to severe burns Dry sterile dressing. Maintain warmth. Prevent hypothermia. Consider aggressive fluid therapy. Burns over IV sites then you may place IV in partial Thickness burn site.
Parkland Burn Formula 4ml X pt weight in kg X %BSA= amount of fluid. Pt should receive half this amount during the first 8 hrs. Remainder in 16. Caution for fluid overload.
Management of inhalation injury High flow O2 by NRB. Consider intubation if swelling. Hyperbaric oxygen therapy.
Management of Cyanide exposure Sodium nitrate, amyl nitrate, sodium thiosulfate. Forms methemoglobin binds to cyanide. Non toxic substance secreted in urine. Inhale 1 amp Amyl Nitrate, 300mg Sodium Nitrate over 2-4mins. 12.5gm of sodium thiosulfate.
Management of electrical injuries Safety. Turn off power. Energized lines act as whips. Est safety zone. Assess pt. Entrance and exit wounds. Remove clothing, jewelry, and leather items. Treat visible injuries. ECG. Treat cardiac and resp arrest. Sodium bicarb 1 mEq/kg. Mannitol 10g
Management of chemical burns Scene size up. Hazmat team. Est hot,warm and cold zones. Treat each chemical agent according to protocol.
Dry Lime - strong corrosive that reacts with water. Brush off dry substance. Irrigate with copious amounts of water.
Sodium: unstable metal, reacts vigorously with water, releases extreme heat, hydrogen gas, ignition. Brush off dry chemical. Cover wound with oil substance.
Radiation burns. Notify hazmat. Est safety zone. Hot, warm and cold zones. Personnel positioned upwind and uphill. Decontaminate ALL rescuers, equipment and pt's.
Created by: Mistymedic