Burns Quiz Flashcards

1
Q

What are the signs and symptoms of airway burns?

A
  • evidence of burns to upper torso, face and neck
  • facial and upper airway oedema
  • sooty sputum
  • burns that occurred in an enclosed space
  • singed facial hair
  • respiratory distress (dyspnoea, wheeze associated tachycadia + stridor)
  • hypoxia (restlessness, irritability, cyanosis, decreased GCS)
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2
Q

What are AV goals in treating the burns patient?

A
  • Effective cooling of the burn
  • pain management
  • hydration
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3
Q

What are three functions of the skin?

A
  • Fluid retention
  • Protective barrier
  • Temperature regulation
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4
Q

What are the considerations when assessing burn severity?

A
  • depth of burn (classification)
  • cause of the burn
  • percentage of the burn area
  • location of the burn
  • age of the patient
  • patients underlying health
  • other distracting injuries
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5
Q

What are the classifications of burns?

A
  • superficial
  • partial thickness (superficial, mid, deep dermal)
  • full thickness
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6
Q

How long should you cool a burn?

A
  • 20 mins (cooling time prior to AV arrival to be included in the timeframe)
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7
Q

When would you stop cooling?

A
  • when the patient begins to shiver
  • temperature <35 degrees
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8
Q

What are the three zones in the jacksons burn wound model?

A

Zone of hyperaemia (superficial)
- hyperperfused and will recover if no complications

Zone of stasis (partial thickness)
- tissue around burn hypoperfused and may be salvageable

Zone of coagulation (full thickness)
- irreversile damage to cell and coagulation of proteins

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9
Q

Which type of burns do we consider for fluid administration?

A
  • any partial or full thickness burns
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10
Q

What percentage of burns must a patient have to get IV fluids?

A
  • age > 15 yrs x TBSA >15% = (TBSA x pt weight (kg) = volume in ml. To be administered over 2 hours from the time of burn
  • Age 12-15, TBSA > 10% = (3 x TBSA % x pt weight (kg) = volume ml to be given in 24 hours, half to be admin in the first 8 hours
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11
Q

Where would you transport a person ages 12-15 years with 10% burns in metro melbourne?

A
  • RCH
  • highest level of care (rural)
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12
Q

What is the percentage breakdown of the body using the wallace rule of nines?

A
  • head 9%
  • torso 18% front 18% back
  • arm 9% each
  • Leg 18 % each
  • Groin 1%
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13
Q

why is the patient temperature critical in the management of burns?

A
  • hypothermia patients had significantly higher mortality
  • large doses of IV fluids can reduce body temp
  • loss of skin - therefore loss of temperature regulation
  • greater % burn area, greater risk of hypothermia
  • hypothermia = trauma triage of death
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14
Q

List 5 complications of burns

A
  • depth of burn can increase over the first 48 hours
  • hypovolaemia (fluid loss)
  • hyper metabolic state
  • infection/sepsis
  • scarring
  • psychological
  • DVT/PE (prolonged bed rest)
  • Airway burns - aspiration, pneumonia, pulmonary oedema, carbon monoxide poisioning
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15
Q

Calculate the fluid doses for the following:
* Person 1. 24yo (80kg), with 30% full thickness burns
* Person 2. 10yo (33kg) 36% burns
* Person 3. 90yo (50kg) 20% burns
* Person 4. 50yo (60kg) 40% burns
* Person 5. 12yo (50kg) 10% burns
* Person 6. 15yo (70 kg) 15% burns
* Person 7. 34yo (90 kg) 80% burns
* Person 8. 11yo (36kg) 15% burns
* Person 9. 10yo (33kg) 70% burns
* Person 10. 12yo (36kg) 60% burns

A
  • Person 1. 2400mls. = 1200mls per hour. (first 2 hours)
  • Person 2. 3564mls = 222.75mls per hour for the first 8 hours.
  • Person 3. 1000mls = 500mls per hour (first 2 hours)
  • Person 4. 2400mls.= 1200mls per hour (first 2 hours)
  • Person 5. 1500mls = 93 mls per hour for first 8 hours.
  • Person 6. 1050mls = 525 mls per hour (first 2 hours)
  • Person 7. 7200mls = 3600 mls per hour (first 2 hours)
  • Person 8. 1620ml = 101.25 mls per hour for the first 8 hours.
  • Person 9. 6930mls = 433mls per hour for the first 8 hours.
  • Person 10. 6480mls = 405mls per hour for the first 8 hours.
  • Only administer IV fluids for ages 12 and above. Extra calculations here for your maths practise!
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