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bi240 burns
grcc bi240 burns
| Question | Answer |
|---|---|
| Electrical burns are always serious because | currents travel thru path of least resistance, blood vessels coagulate and obstruct blood supply leading to cardiac arrest |
| First degree burn | partial thickness to epidermis only; NO blisters...usually a sunburn |
| 2nd degree burn | superficial partial thickness including epidermis and part of dermis |
| Blisters, pain and minimal scarring happens with this type of burn | 2nd degree burn |
| Deep partial thickness | 2nd degree burn that effects epidermis and dermis; hair follicles and sweat glands are spared |
| Waxy white & hair reappears after 7 to 10 days | deep partial thickness |
| 3rd degree burn is full-thickness | from epidermis, dermis and hypodermis is destroyed |
| 3rd degree burn forms eschar which shrinks leading to pressure | inflammation delivers chemicals to wound area but it has not where to go, so it compresses underneath the eschar |
| 3rd degree burn may need an Escharotomy on a circumferential burn | may need to cut through damaged skin to relieve pressure allowing ciruculation/expansion |
| 3rd degree burns require skin grafts because | there are no viable cells to help with healing. |
| 4th degree burns involve | the deeper tissues, including subq tissues, tendons & bones. |
| What is the priority with someone with 4th degree burn? | Cardio needs to survive first, before anything else. |
| BSA provides what | the guidelines for fluid replacement |
| What are the effects of burns | both local and systemic |
| with burns you do not see the blood because | tissue and blood have coagulated, forming charred dry surface called eschar. |
| If circumferntial burn you'll need to do an | escharotomoy to relieve the pressure allowing circulation and expansion. |
| With large burns, there is a large fluid shift into the tissue that includes | water, protein and electrolytes |
| A large fluid shift after a large burn leads to | edema and decreased intravascular volume = hypovolemic shock |
| Decreased osmotic pressure in blood is due to | loss of protein resulting in the difficulty in maintaining blood volume until inflammation subsides |
| Continue Lower BP leads to | acuterenal failure |
| Treatment for local and system shock | IV fluids, electrolytes, volume expanders (sub for loss proteins) using burn formulas |
| Other complications due to burns | respiratory problems |
| Respiratory problems: Inhalation of toxic fumes/smoke | damage the respiratory tract |
| Respiratory problems: Carbon Monoxide (CO) | Perferentially binds with Hgb, replacing oxygen leading to hypoxemia. |
| what is an indicator of CO poisoining? | Bright red cheek and lips |
| Respiratory problems: eschar, inflammation, a pain may | limit ventilation leading to pneumonia. |
| Burns and pains | very painful and needs to be managed carefully. |
| Burns and infections is a major concern b/c microbes are present in glands and hair follicles and | opportunistic bacteria easily invade open areas. |
| what are common microbes that lead to infection? | psuedomonas aeurginos staphlyococcus aureus, and klebsiella and candida |
| Before giving abx what would you expect the doc to order? | Wound cultures to help ID microbes and give proper abx & to help reduce development drug resistant organisms. |
| Septic shock | serious infection where microbes/toxins spread throughout body |
| how to treat septic shock | aggressive treatment with fluids & abx |
| BMR increases because | of heat loss, protein loss in exudate, stress response, anemia |
| BMR increases: anemia | due to RBC destruction and or decreased hematopoiesis |
| BMR increases: Tissue | body's need to replace tissue. |
| What happens to metabolic system following severe burn? | Hypermetabolism |
| How to treat hypermetabolism | increase dietary intake of protein and carbs required. |
Created by:
Wends1984
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