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bi240 burns

grcc bi240 burns

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