Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Critical Care > Burns > Flashcards

Burns Flashcards

1
Q

What are the 3 types of burns?

A

Thermal (contact with flame, heat, liquids)
Electrical (energy converted to heat)
Chemical (contact, inhalation, ingestion, injection)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

*First degree burn symptoms

A

Involves only epidermis

Reddened skin
Pain at burn site
No blistering

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Second degree burn symptoms

A

Epidermis and dermis

Red
Painful
Blistered
Pale areas
Mottled areas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Third degree burn symptoms

A

Involves epidermis, dermis, subcutaneous tissue

Dry, leathery skin (white, dark brown, or charred)
Loss of sensation (little pain)
All dermal layers/tissue may be involved

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Forth degree burn symptoms

A

Includes involvement of muscle and bone

Loss of function
Painlessness
Black, charred appearance
May require amputation, escharotomy, fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How long does it take first degree burns to heal?

A

2-5 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How long does it take for second degree burns to heal?

A

10 days to 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Which layers of skin do blisters occur between?
Why shouldn’t burn blisters be popped?

A

Occurs at dermal-epidermal junction

Fluid filled with inflammatory mediators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Properties of burn eschar

A

Occurs with full thickness burn
Dead and has no normal function
Must be removed through debridement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why are circumferential burns a surgical emergency?

A

They are limb threatening or threat to internal organs if burns to trunk

Veins collapse due to edema
Need to do fasciotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Reasons to suspect inhalation injury

A

Closed space incident
Presence of heavy smoke
History of unconsciousness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Symptoms of inhalation injury

A

Facial burns
Profuse secretions
Carbonaceous sputum
Lacrimination
Singed nasal hair
Hoarseness
Wheezing
Stridor
Edema
Hypoxemia
Tachycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What lab is drawn immediately if carbon monoxide inhalation is suspected?

A

COHb

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment for carbon monoxide inhalation

A

100% oxygen via non-rebreather mask

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S/s of CO poisoning

A

*Majority of pts are asymptomatic
50% have cherry red color
Possible HA
Possible confusion
Possible coma
No tachypnea or cyanosis - CO2 not affected
PaO2 normal
SaO2 normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Symptoms of inhalation injury above glottis

A

Hoarseness
Dry cough
Labored breathing
Stridor
Difficulty swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment for inhalation injury above glottis

A

Intubate b/c edema = airway obstruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Symptoms of inhalation injury below glottis

A

*Carbonaceous sputum
Bronchospasm
Wheezing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Consequences of electrical injuries:

A

*Cardiac arrhythmias (b/c of shock)
Cardiac and pulmonary arrest
Intracranial bleeding
Decreased LOC (d/t ammonia build up from protein breakdown)
Paralysis of extremity
Loss of peripheral pulses and limbs
*Myoglobinuria
Serum CK > 1000 IU (troponin = muscle breakdown)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Why might higher fluid volumes need to be given electrical injuries?
Goal for UOP
What else should we be looking for?

A

*to adequately resuscitate the d/t muscle damage and myoglobinuria

*Urine output should be 75-100 mL/hr

Assess carefully for compartment syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What occurs during stage 1 of burns: emergent phase
And what symptoms will the patient experience

A

First 12-24 hours

Pain response
Catecholamine release (pt feeling anxious)
Tachycardia, tachypnea, mild HTN, mild anxiety

22
Q

What occurs during stage 2 of burn: diuresis phase how long does this phase last?

A

Lasts 18-24 hours (reaches peak in 8 hours)

Damaged cells initiate *inflammatory response
- increased blood flow to cells
- shift of fluid from intravascular to extravascular (3rd spacing)
- MASSIVE EDEMA d/t “leaky capillaries”

23
Q

Treatment for stage 2 of burn (diuresis phase)

A

Pt has no BP b/c fluid in wrong place (distributive shock) so need to constrict vessels

*Give dopamine/dobutamine

24
Q

What occurs with stage 3 of burns: hypermetabolic phase how long does it last?

A

Lasts for days to weeks

Large increase in body’s need for nutrients as it repairs itself
Need protein

25
Q

What occurs with stage 4 of burns: resolution phase

A

Scar formation
General rehabilitation and progression to normal function

26
Q

Effect of burns on cardiac system

A

Myocardial depression
Fluid shift causing distributive shock:
- hypovolemia
- decreased CO
- edema
Peripheral ischemia
- burn shock (distributive & hypovolemic)

27
Q

Burn effects on lungs

A

Smoke inhalation cause pneumonia = most common cause of death

28
Q

Effect of burns on GI system

A

Ileus if > 20% TBSA burn (NG tube needed)
Malabsorption
Ischemia
Curling’s ulcers
Hypercatabolism

29
Q

Burns effect on the hematopoietic system

A

RBCs consumed or damaged
Platelets destroyed
Granulocytosis
Huge stimulation of bone marrow to reproduce blood cells

30
Q

Effect of burns on the renal system

A

Decreased perfusion (pre renal)

31
Q

Effect of burns on the immune system

A

Immune suppression
More susceptible to bacteria, viruses, fungi
Failure to reject cadaver skin or mesh

32
Q

*Pre hospital treatment of burns

A

**Occurs out in the field, before pt is in nurses’ care

Extricate pt / stop the burn
Remove clothing/jewelry
Primary survey ABC / brief D-I
Give 100% O2
Cover burn with sterile white sheet
Cover pt to prevent hypothermia
Irrigate chemical burns
Transport to a burn center

*Decontamination prior to transport
*Cool the burn within 30 minutes (to cool down inflammatory response)

33
Q

What are we assessing for during assessment of airway / breathing on intake of burn patient?

A

Assess for:
*change in voice
* hoarseness
obstruction
emesis
edema
blood
*facial burns with singed hair
* stridor

34
Q

Initial treatment for airway of burn patient

A

100% O2 on all patients
Consider intubation d/t likelihood of impending airway obstruction: *tube them if any question

35
Q

Initial treatment for circulation of burn patient

A
  • Insert 2 large bore IVs
    *LR = fluid of choice b/c extra nutrients

Obtain labs:
- CBC
- BMP
- Mg and phos
- ABG
- CO
- PT/PTT

36
Q

Initial assessment for disability on burn pt

A

Check neuro status

37
Q

What does expose mean for a burn pt?

A

*Remove all clothing and jewelry
Assess entire body for acute injuries

38
Q

What does environment mean for a burn pt?

A

Cover pt to prevent hypothermia
Control family and room

39
Q

What does estimate mean for a burn pt?

A

*Estimate the burn injury

40
Q

3 ways to estimate % of TBSA burned

A

Rule of palms
Rule of nines
Lund & browder chart

41
Q

When is rule of nines used to measure area of burn?

A

*for large surface areas quickly

42
Q

What are the percentages for each body part when measuring BSA for rule of nines

A

Head = 9%
Arms = 9%
Anterior torso = 18%
Back = 18%
Legs = 18%
Groin = 1%

43
Q

Measurement best used when burn is < 10% of BSA

A

Rule of palms

44
Q

*What is the rule for fluid resuscitation called?

A

*Parkland Formula

45
Q

What need to be in place to be able to use the Parkland Formula?

A

2 large bore IVs
Foley catheter

46
Q

Crystalloid of choice for fluid resuscitation

A

*LR
(Blood administration not recommended for fluid replacement)

47
Q

Guidelines for fluid resuscitation for UOP

A

*Goal = 0.5 mL/kg/hr
(No more and no less, to prevent adverse effects)

48
Q

*Parkland formula

A

*2-4 mL x weight in kg x % TBSA burned = amt to infuse over 24 hours

49
Q

*What is are the guidelines for resuscitation using the parkland formula after amt to be infused is determined?

A

Give 1st half over first 8 hours *from time of incident
Give 2nd half over second 16 hours

Used for 2nd and 3rd degree burns only

50
Q

Drug of choice for comfort for burns

A

*Morphine

51
Q

Treatment of GI after burn

A

*NPO until transfer to burn center
*NG tube for all pts who have 20 or greater TBSA to prevent ileus

52
Q

Tules for wound care for a burn *Prior to transfer to a burn center

A

Transfer in dry sterile sheet or kerlex
Do not use NS
Do not place topical medication
Do not debridement the patient prior to transport
Give morphine

Critical Care (35 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions