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Complex Med Surg
Week 10
| Question | Answer |
|---|---|
| What are the four types of burns one could get? | Thermal Burns, Chemical Burns, Electrical Burns, Radiation Burns |
| Alkaline burns penetrate deeper than what kind of burns? | Acid burns |
| Severity of electrical burns depend on what two things? | Type of duration of current, Amount of voltage |
| Electrical burns take a path of ______ ___________ | least resistance (muscles, bones, vessels, nerves) |
| In electrical burns, what leads to tissue necrosis? | Blood coagulates at the site of injury |
| What must be done when a person is experiencing contractions (clamping down) on an electrical source? | You must shut off the power |
| Definition of flashover? | Current travels over moist areas rather than deeper structures below the skin |
| What is the usual cause of death from lightening? | Cardiopulmonary arrest |
| Superficial burns involve only the ____________ layer of the _____________ | Superficial burns involve only the OUTERMOST layer of the EPIDERMIS |
| What are the three classifications of burns? | Depth, Extent, Severity |
| The depth of a burn depends on what two things? | Temperature of burning agent, Length of contact |
| Partial Thickness is a result of what? | Brief exposure to flame, hot surface or dilute chemical |
| Superficial Partial = ? | Blisters (detachment of epidermis and dermis, causing collections of secretions between these two layers) |
| Other than superficial partial, the other partial thickness is what? :) | Deep Partial Thickness |
| Full thickness is a result of what? | Prolonged contact with flames, steam, chemicals, or high voltage current. |
| Extent of burns is always a what? | A percentage |
| What are the two Total Body Surface Area assessments? | Rule of Nines (rapid), Lund and Browder Method (more accurate) |
| Rule of nines is based on what? | A man's hand is 9% of his body surface area |
| Special care areas for burns? (7 of them) | Eyes, Ears, Face, Hands, Feet, Joints, Perineum |
| Major burns are treated where? | At a Burn Center |
| Why don't burns bleed? | The process of platelets aggregating, fibrin trapping more platelets to form a thrombus, and local vasoconstriction makes it possible to WALL OFF WOUND FROM THE SYSTEMIC CIRCULATION. |
| Leaking fluid into tissues surrounding burn, and fluid leaks into the burn (and then evaporated) leads to what? | Hypovolemia: BURN SHOCK |
| The bigger the _____ the more fluid is lost to ________ and ________________ | The bigger the BURN the more fluid is lost to EDEMA and EVAPORATION. |
| Inflammatory Stage happens when? | At the time of the injury. |
| Proliferation happens when? | 2-3 days post burn. |
| Proliferation lasts until the wound is completely ____-______________ | Re-epithelialized (which means covered) |
| What cells stretch and try to cover the wound by joining with others on the other side? | Epithelial cells |
| Another way to help cover a wound (other than epithelial cells) is what? | Skin grafting. |
| Remodeling may last how long? | Years |
| What is a hypertrophic scar? | Overgrowth of skin that remains in the wound boundaries |
| What is a keloid? | A scar that extends beyond the wound boundaries |
| What are the three risks with having an open wound? | Risk for fluid volume deficit, Risk for Infection, Risk for Hypothermia |
| The deepest part of a wound is where? | In the center |
| What is eschar? | Hard black crust over the wound in initial stage, harbors necrotic tissue. |
| What must be done with eschar? | It must come off! |
| Due to constriction, eschar can stop what below the injury? | Circulation |
| Management of burns? | Debride, Cover, Prevent Infection |
| How does a major burn effect the cardiovascular system? | Hypovolemic Shock, Cardiac Dysrhythmias, Peripheral Vascular Compromise (Compartment Syndrome) |
| What is Compartment Syndrome? | Compartment syndrome is the compression of nerves and blood vesselswithin an enclosed space. This leads to muscle and nerve damage andproblems with blood flow. |
| If a major burn might have any effect on the respiratory system, what should be done early? | INTUBATE EARLY! "once edema starts, you will NOT get on in later!" |
| What should be done before a patient with a major burn starts to show ominous signs: hoarsness, labored breathing, and stridor. | Intubation |
| Myoglobulins are from the break down of what? | Muscle |
| Renal failure and Myoglobulinuria produce what color of urine? | Dark brown urine (also tea, coke, mohaggany) |
| Myoglobins occlude the renal tubules leading to what? | Renal Failure |
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