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