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AHIV - ch 23
| Question | Answer |
|---|---|
| Outermost to innermost layers of the skin | Epidermis -> dermis -> subcutaneous tissue |
| Functions of the skin | Protective barrier, maintains normal body temp, activates vitamin D when exposed to the sun, maintains fluid & electrolyte balance, & sensory perception |
| Rule of nines | Method for calculating the size of a burn injury, see powerpoint or pg. 461 |
| Superficial | Top layers - epidermis & dermis; 1st & 2nd ( superficial partial-thickness) degree burns; painful, red, blanching, & blisters |
| Deep | Deeper into dermis to fat to muscle, tendon, & bone; 2nd (deep partial-thickness), 3rd (full-thickness), & 4th degree burns; no pain, more swelling the deeper you go, & any color (black, red, yellow, brown, white) |
| Chemical burns | Can occur in homes, in manufacturing industries, or as the result of assault |
| Electrical injury | Occurs when an electrical current enters the body; “iceburg effect” - the surface injuries may look small, but the associated internal injuries can be significant |
| Radiation burns | Occur with prolonged exposure to the sun or to sources of such as x-rays or therapeutic radiation treatment |
| Smoke-related burns | Can occur on inhalation; **even if you believe the patient has experienced only a minor burn, it is critical to assess the mouth, throat, & nose for signs of soot** |
| Thermal burns | Dry heat - caused by contact with flames Moist (scald) burns - hot liquids Contact burns - hot objects or substances |
| Handling chemical burns | Decontamination is priority -> contaminated clothing is removed & chemicals in powder form are brushed off then the burn is cautiously irrigated with large amounts of water |
| Emergent (resuscitation) phase | Begins at onset of injury & continues for about 24 to 48 hours; the injury is evaluated & priorities of care are determined based on extent & severity of the burn |
| Priorities of care during the emergent phase | 1) securing the airway 2) supporting circulation & perfusion 3) maintaining body temp 4) keeping pt. comfy with analgesics 5) providing emotional support |
| Acute (healing) phase | 36 - 48 hours after injury, when the fluid shift resolves, & lasts until wound closure is complete; continued assessment & maintenance |
| Rehabilitative (restorative) phase | Begins with wound closure & ends when pt. achieves his or her highest level of functioning; the emphasis is on the psychosocial adjustment of the pt, the prevention of scars & contractures, & the resumption of preburn activity |
| Physical assessment/S&S | Assessment of the respiratory system is most critical to prevent life-threatening complications for those with inhalation injuries!!! |
| The size of the burn injury… | …not only important for the diagnosis & prognosis, but also for calculating drug doses, fluid replacement volumes, & caloric needs |
| Carbon monoxide poisoning levels | Normal -> 1 - 10% Mild -> 11% - 20% Moderate -> 21% - 40% Severe -> 41% - 60% Fatal -> 61% - 80% See chart on pg. 466 |
| Interventions | Pain management (ibuprofen, acetaminophen, or opioids), infection (dressing changes & antibiotics), & compression garments to prevent contractures & tight hypertrophic scars |
| Escharotomy vs. fasciotomy | Surgical management; determined based on depth |
Created by:
tatianalopez03
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