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Burns 7-21-11
| Question | Answer |
|---|---|
| Burns are direct contact with or exposure to any. | Thermal, Chemical, Electrical or Radiation |
| Severity Of Burns | Risk of Infection, Mortality, And cosmetic or functional disability. |
| Factors that Influence Severity | depth, %TBSA, Location, age, general Health, Mechanism of injury |
| Burn Size | %TBSA, est. helps predict the severity of physiological response |
| Rule of Nines | (burn size) divides body into 11 segments.. Each 9% and 1% for genitals |
| Lund & Browder | Standard table based on the parts of body burned according to age |
| Incidence | Males more than females, except of 70 years |
| Thermal | Flames, Hot liquids, Steams semisolid, hot objects. |
| Chemical | contact with or ingestion, inhalation or injection |
| electrical | electrical energy as it passes through the body |
| radiation | least common, caused by radioactive source |
| Risk Factors for Burns | 75% result from actions of injured person usually in home |
| Who is at highest risk? | Children under 3 years, and elderly over 70years. |
| Other Risk factors | rural location, mobile home, occupation, lack of smoke detectors, fireworks, and misuse of cig smoking |
| Amount of skin destructed depends on. | temp to which skin exposed, length of time of exposure, and type of injury |
| A tremendous amount of heat is not required to cause.. | Damage |
| below 111*F (44*c) | no damage, unless prolonged exposure |
| 111*F-124*F (44*C-51*C) | Rate of cellular death doubles with each degree in temp rise. |
| >124*F (51*C) | exposure time is brief for damage |
| SUPERFICIAL (1ST DEGREE) | Epidermal Burn, Cell damage only to the epidermis skin, mild-severe erythema, blanching, surface is dry, no blisters, minor swelling, painful, skin will heal with out scaring, 3-7days |
| PARTIAL THICKNESS (2nd DEGREE) | Superficial Partial Thickness & Deep Partial Thickness |
| SUPERFICIAL PARTIAL THICKNESS | VERY PAINFUL, INTACT BLISTERS(COMMON SIGN), EPIDERMIS IS DESTROYED, SUPERFICIAL DERMIS MIN DAMAGE, MODERATE EDEMA, BLANCHING, HAIR & SWEAT GLANDS PRESERVED, COMPLETE HEAL 14-21 DAYS, LITTLE OR NO SCARING |
| DEEP PARTIAL THICKNESS | DESTRUCTION OF EPIDERMIS & DOWN TO RETICULAR LAYER OF DERMIS, INJURY TO NERVE ENDINGS, HAIR FOLLICLES, AND SWEAT DUCTS; SENSITIVE TO COLD AIR, MIXED RED OR WAXY WHITE; WET SHINY AND WEEPING BROKEN BLISTERS; EDEMA; MAY REQUIRE SKIN GRAFT; HEAL 27+DAY |
| DEEP PARTIAL THICKNESS-- 2 SCARS | HYPERTROPHIC & KELOID SCAR |
| FULL THICKNESS BURN (3RD DEGREE) | ALL EPIDERMAL AND DERMAL LAYERS ARE DESTROYED, SUBCUTANEOUS FAT LAYER DAMAGED |
| ESCHAR | DEVITALIZED TISSUE CONSISTING OF DRIED COAGULUM OF PLASMA AND NECROTIC CELLS -FEELS DRY, LEATHERY, & RIGID --TAN OR YELLOWISH-BROWN COLOR OR BLACK |
| FULL THICKNESS BURN (CONT) | NO BLANCHING, DESTRUCTION OF HAIR FOLLICLES AND NERVE ENDINGS (NO PAIN), DECREASED SENSATION, DAMAGE TO PERIPHERAL VASCULAR SYSTEM, SKIN GRAFT |
| ZONE OF COAGULATION | IRREVERSIBLE DAMAGE, SKIN DEATH!, SKIN GRAFT NEEDED TO HEAL, INCREASED RISK OF INFECTION |
| ZONE OF STASIS | INJURED CELLS (DILIGENT TREATMENT OR CELL DEATH WITHIN 24-48HOURS) TOO TIGHT SPLINTS/COMPRESSION BANDAGES WILL DAMAGE |
| ZONE OF HYPEREMIA | MINIMAL CELL DAMAGE |
| CLINICAL MANIFESTATIONS | LOCATION INFLUENCES SEVERITY |
| PULMONARY COMPLICATIONS | HEAD, NECK & CHEST |
| CORNEAL ABRASIONS | fACE |
| PERMANENT PHYSICAL/VOCATIONAL DISABILITY | HANDS/JOINTS |
| EMERGENT | TIME OF INJURY UNTIL RESTORATION OF CAPILLARY PERMEABILITY |
| RESUSCITATION PERIOD | INITIATION OF FLUIDS AND ENDS WHEN CAPILLARY INTEGRITY RETURNS TO NEAR-NORMAL & LARGE SHIFTS HAVE DECREASED |
| ACUTE PHASE OF RECOVERY | HEMODYNAMICALLY STABLE, CAPILLARY PERMEABILITY RESTORED & DIURESIS BEGINS |
| REHABILITATION PHASE | FINAL PHASE- MAX FUNCTIONAL RECOVERY |
| MOST COMMON AND LIFE THREATENING COMPLICATION | INFECTION |
| OFTEN FATAL COMPLICATION | INHALATION INJURY WITH MAJOR BURNS AND STAPHYLOCOCCAL SEPTICEMIA |
| COMPLICATIONS OF CARDIOVASCULAR & PULMONARY | MULTIPLE ORGAN DYSFUNCTION SYNDROME AND DEATH |
| WOUND CLEANING GOALS | REMOVE DEAD TISSUE, PREVENT INFECTION (STERILE), PROMOTE REVASCULARIZATION &/OR EPITHELIZATION |
| DEBRIDEMENT | REMOVAL OF DEAD TISSUE |
| SHARP DEBRIDEMENT | USE OF SURGICAL SCISSORS OR SCALPEL & FORCEPS; BLEEDING KEPT TO MINIMAL |
| HYDROTHERAPY WITH DISINFECTANT IN WATER | TEMP 98*f -102*F, TOPICAL MEDS OR DRESSING APPLIED |
| PRIMARY EXCISION | REMOVAL OF ESCHAR |
| AUTOGRAFT | PTS ON SKIN USED TO COVER A BURNED AREA, PERMANENT COVERAGE |
| ALLOGRAFT (HOMOGRAFT) | SKIN TAKEN FROM AN INDIVIDUAL OF THE SAME SPECIES; USUALLY CADAVER SKIN, TEMPORARY |
| XENOGRAFT (HETEROGRAFT) | SKIN FROM ANOTHER SPECIES, USUALLY A PIG, TEMPORARY |
| BIO SYNTHETIC GRAFTS (SKIN SUBSTITUTIONS) | CULTURED AUTOLOGOUS SKIN, GROWN IN A LAB, HIGHLY SUSCEPTIBLE TO INFECTION |
| DERMATOME | INSTRUMENT FOR REMOVAL OF SKIN FOR GRAFTING |
| SPLIT-THICKNESS | CONTAINS EPIDERMIS & ONLY SUPERFICIAL LAYERS OF DERMIS, ADHERES BETTER |
| FULL-THICKNESS | CONSIST OF FULL DERMAL THICKNESS, LOOKS BETTER |
| DONOR SITE | SITE FROM WHICH SKIN GRAFT IS TAKEN, THIGHS, BUTTOCKS AND BACK |
| SHEET GRAFT | WITHOUT ALTERATIONS, FOR FACE, NECK AND HANDS |
| MESH GRAFT | ABLE TO EXPAND BEFORE APPLICATION |
| PROCEDURES TO ELIMINATE SCAR CONTRACTURES | SKIN GRAFTS, Z-PLASTY (LEGTHENS SCAR Y INTERPOSING NORMAL TISSUE IN LINE OF SCAR) |
| POSITIONING | DECREASE EDEMA, PREVENT TISSUE DESTRUCTION, MAINTAIN SOFT TISSUE IN AN ELONGATED STATE |
| SPLINTING | PREVENT CONTRACTURES, MAINTAINANCE OF ROM, CORRECTION OF CONTRACTURES, PROTECTION OF JOINT OR TENDON |
| ACTIVE OR PASSIVE EX | PROGRESS 2 STRENGTHENING |
| AMBULATION | AS EARLY AS POSSIBLE |
| SCAR MANAGEMENT | PRESSURE DRESSING, VASCULAR SUPPORT OF SKIN GRAFTS/DONOR SITES, TO CONTROL EDEMA AND SCARRING; MASSAGE TO ASSIST WITH ROM EX. |
| HIGHER MORTALITY RATE | FOR CHILDREN 4 & UNDER AND ELDERLY OVER 65YEARS |
| SURVIVAL RATE FOR ELDERLY | 70% |
| FACTORS THAT INCREASE COMPLICATIONS & MORTALITY IN ADULTS | OBESITY, ALCOHOLISM, CARDIAC DISORDERS (PVD) |
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1215657031
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