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z Su15 HEHI 3 > burn > Flashcards

burn Flashcards

1
Q

leading cause of burn deaths

A

residential fires

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2
Q

leading cause of burn-related injury resulting in death

A

inhalation

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3
Q

percentage of burns in children that are life-threatening

A

~3-5%

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4
Q

chemical burn irrigation: how long?

A

2-3 hours

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5
Q

normal pH of effluent

A

4.5 - 6.5

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6
Q

carboxyhemoglobin

A

carbon monoxide on oxygen binding sites of hemoglobin

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7
Q

carboxyhemoglobin normal levels

A

3%

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8
Q

carboxyhemoglobin levels in smokers

A

up to 15%

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9
Q

treatment to clear CO2 from inhalation injury

A

100% FiO2 4-6 hours (gets carbon monoxide out of blood)

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10
Q

cyanokit nota bene x2

A

must administer by itself
will make secretions pink
for inhalation injury removal of cyanide

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11
Q

most electrical burn deaths due to ? voltage

A

low

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12
Q

high voltage patterns

A

current enters body through relatively small opening, travels deep through body, exits through a small opening (look for exit wounds!)

  • entrance typically symmetrical
  • exit more dramatic
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13
Q

flash injury

A

arc of high tension voltage, burn is from heat

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14
Q

1st degree burn: quick description

A

superficial

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15
Q

2nd degree burn: quick description

A

partial thickness

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16
Q

3rd degree burn: quick description

A

full thickness

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17
Q

4th degree burn: quick description

A

muscle, bone, black and charred

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18
Q

1st degree burn: characteristics

A 
-epidermis only
local pain, redness
spontaneously heals 2-5 days
resembles bad sunburn
not included when calculating % total bsa
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19
Q

2nd degree burn: characteristics

A

-epidermis, dermis
very painful

concerns
infection
may evolve to 3rd degree

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20
Q

3rd degree burn: characteristics

A

full thickness! epidermis, dermis, subcutaneous tissue
- white, waxy, red, brown, leathery, no blanching

will need surgical intervention!!! remove necrotic tissue to prevent sepsis

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21
Q

4th degree burn: characteristics

A

include muscle, bone; black, charred

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22
Q

partial thickness burn: type & description

A

pink, beefy red, blistered

type of 2nd degree burn

23
Q

deep partial thickness burn: type & description

A

pale, mottled

24
Q

highest risk factor for 3rd degree burn

A

infection

25
Q

burn that will require surgical intervention

A

3rd degree - remove necrotic tissue to prevent sepsis

26
Q

4th degree burn causes

A

very prolonged exposure to flame, chemicals, high voltage

27
Q

4th degree burn concerns x3

A

loss of function
may require amputation
may require escharotomy, fasiotomy

28
Q

zone of coagulation

A

white; max amount of damage that can be done to skin

irreversible tissue loss due to coagulation of constituent proteins

29
Q

zone of stasis

A

may be lighter; decreased tissue perfusion

potentially salvageable - focus on preventing damage here from becoming irreversible

30
Q

zone of hyperemia

A

red; outermost, will probably heal/partial thickness burns (unless sepsis, prolonged hypoperfusion)

31
Q

reason for hypercatabolism in burn patients

A

metabolic rate due to no skin, unable to thermoregulate → protein wasting

32
Q

reason for delirium in burn patients

A

pts can’t sleep, can’t regulate cycles

  • develop routine, lights on and ambulate during the day, no wound care during night
33
Q

hyponatremia in burn patients

A

seizures! give salt tabs

34
Q

how do large burns lead to myocardial depression?

A

initial decrease in cardiac output and metabolic rate

in successfully resuscitated → “flow phase” (?) stereotypical hypermetabolic state (near doubling cardiac output, resting energy is huge) - may be hypertensive, common in peds

35
Q

compartment syndrome in burn patients

A

from wound itself OR from fluid being pumped into patient

36
Q

compartment syndrome

A

increased tissue pressure in a confined anatomic space causes decreased blood flow to the area, leading to hypoxia and pain.

37
Q

peripheral ischemia in burn patients can result from

A

edema

38
Q

ileus and stomach ulceration in burn patients

A

risk decreased with histamine blockers

39
Q

first sign of acute renal failure in burn patients

A

decreased urinary output

40
Q

ideal pressure in abdomen

A

10 - 13

41
Q

increased abdominal pressure in burn patients

A

20+: vital organs not perfused, urine output drops off

42
Q

dysrhythmias common in electrical burn injuries

A

v tach, v fib

43
Q

total body surface area calculated when

A

2nd and 3rd degree burns

44
Q

parkland formula & what to do with calculation

A

4mL * weight (kg) * tbsa %
fluid replacement calculation (just a guideline!)
- first half over 8 hours
- second half over 16 hours

psst peds 3 to 4 mL

45
Q

resuscitation fluid of choice in burn patients

+ peds change

A

lactated ringer

+ dextrose 5% maintenance rate for peds

46
Q

how long does burn injury take to fully develop?

A

24 to 48 hours

47
Q

most useful index of adequate intravascular fluid replacement

A

urine output

48
Q

expected uop for adults & peds

A

adult: 30 to 50 mL/hour (0.5 ml/kg/hr)
peds: 1ml/kg/hr (typically

49
Q

sheer graft

A

whole graft laid intact on wound

  • used in cosmetic areas of body
  • requires meticulous care to prevent accumulation of fluid beneath
50
Q

split thickness sheet graft

A

skin passed through machine which creates slits, can be expanded to cover larger wound

often wrapped and protected 3-5 days while graft adheres to wound bed

51
Q

split thickness sheet graft side effects

A

infection, area may progress to full thickness wound

52
Q

escharotomy

A

Incision made through tight eschar to relieve pressure and allow normal blood flow and breathing

  • full thickness circumferential burns
  • loss of circulation or movement
  • performed on the medial and lateral
  • relieves pressure: pulse returns
53
Q

steven johnson syndrome aka

A

toxic epidermal necrolysis (tens)

  • not a burn but treated like one
  • hypersensitivity reaction specific to skin, mucous membranes

z Su15 HEHI 3 (4 decks)

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