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PARASCI_LE11
Burns
| Question | Answer |
|---|---|
| most common burn, heat or fire including scald injuries, be sure to ask mechanism of injury, consider child abuse | thermal burn |
| typically on face, eyes, arms and legs, contact, ingestion, inhalation, injection,. some agent cause deep tissue damage not readily apparent when first sighted | chemical burn |
| uncommon 0.8% of paeds burns, 2.4% in adults, current passage through body may cause extensive damage | electrical burn |
| hand to hand shock, 60% mortality | transthoracic shock |
| 20% mortality | head to foot passage shock |
| includes sunburn and radiation therapy, cancer patients typically | radiation burn |
| outer layers of epidermis | superficial partial thickness |
| involves epidermis & various degrees of dermis | partial thickness and deep partial thickness |
| involves epidermis, dermis and subcutaneous tissue, may involve muscle and bone | full thickness |
| redness, blistering, skin maintains function as water vapour and and bacterial barrier, oedema lifts necrotic tissue away from recovering tissue | superficial partial thickness burn |
| fluid vesicles, shiny, moist, severe pain, weeping, bright pink/red skin, sensitive to temp, air exposure & touch, barrier function lost | partial thickness burn |
| very painful as pain sensors remain intact, tactile sensation may be absent, mottled red, pink waxy, white areas with vesicles & oedema, flat dry tissue paper | deep partial thickness burn |
| dry, waxy, white/yellow/tan/brown/black leathery/hard skin oedema extensive in surrounding tissues, no pain as nerves have been burned, | full thickness burn |
| devitalised, necrotic, white, no circulation | zone of coagulation |
| may convert to full thickness, mottled red | zone of stasis |
| outer rim, good blood flow, red | zone of hyperemia |
| age, location, other injuries, & pre existing conditions, | may increase assessed burn severity |
| calculation of total body surface area | Rule of nines |
| head & neck/ L arm/ R arm | 9% |
| anterior trunk/ posterior trunk/ L leg/ R leg/ | 18% |
| genitalia | 1% |
| cellular injury causes inflammatory mediator release -> hypovolaemia -> organ hypoperfusion -> | haemodynamic instability |
| TBSA (%) . weight (kg) . 4ml = | replacement fluid volume for 24hrs (Parkland's Formula) |
| length of cooling for irrigation and chemical burns | 1 hr |
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