Ch.29 Burn Emrgencies

Question 1

Skin

Answer 1

• largest and most durable system of the body

- Commonly injured as a result of trauma

Question 2

Most burn patients who die in the prehospital setting die from one of the following

Answer 2

• Airway occlusion
• Toxic inhalation
• Trauma sustained in conjunction with the burn injury

Question 3

Your greatest concerns revolve around these three things

Answer 3

• Airway patency
• Breathing sufficiency
• Circulatory adequacy

Question 4

Severity of a burn is a calculation of?

Answer 4

• Burn type

- Extent of the burn

Question 5

Superficial burns

Answer 5

• First degree
• Involves only the epidermal layer
• Skin tends to present as pink to red, dry in condition, and very painful

Question 6

Where is the burn center in San Diego ?

Answer 6

UCSD

Question 7

SD County Burn center criteria

Answer 7

• greater or equal to 20% 2nd degrees greater or equal to 5% 3rd degree burns
• Suspected Respiratory involvement or significant smoke inhalation (singed facial hair, soot in mouth, wheezing)
• significant injury of the face, hands, feet, perineum, or circumferential burns
• electrical injury greater 110 volts

Question 8

Body Surface Area (BSA) for adults

Answer 8

• Head & Neck- 9%
• Posterior trunk- 18%
• Anterior trunk- 18%
• Each upper extremity- 9%
• External genitalia- 1%
• Each Lower extremity- 18%

Question 9

BSA for pediatrics

Answer 9

• Head & Neck- 18%
• Each Upper extremity- 9%
• Torso- 18%
• Each Lower extremity- 14 %

Question 10

Causes Burns

Answer 10

• Flame burn
• Contact burn
• Scald burn
• Steam burn
• Gas burn
• Electrical burn
• Flash burn

Question 11

S/Sx of an inhalation burn

Answer 11

• Singed nasal hair
• Facial burns
• Carbonaceous sputum
• Smoky odor to breath
• Dyspnea
• Bunred oral mucosa

Question 12

Rx burned pt

Answer 12

• Expose the Byrnes site
• Remove any smoldering clothing
• Loosen/Remove any constrictive items or jewelry
• Cover any burns with a dry sterile dressing
• Keep pt warm
• Treat other injuries
• Transport to an appropriate facility for burned pt

Question 13

DO NOT for burn pt

Answer 13

• Use any material that may become enmeshed in the burn
• Never apply any ointments, lotions, sprays, or antiseptics
• Never break or drain blisters if present
• Do not use wet dressings for major burns

Question 14

Rx eyes

Answer 14

• Do not open eyes if burned
• Flush chemical burns for 20 min
• Dress both eyes with dry, sterile dressings

Question 15

Rx for chemical burns

Answer 15

• Dry chemicals should be brushed off first, then flushed

- Hydrofluoric Acid burn flush minimum 20 min

Question 16

Burns circulatory system

Answer 16

• Increased capillary permeability causes fluid shifting and fluid loss. Speeds up hypoperfusion
• Fluid shifting can occur for up to 24 hours

Question 17

Burns respiratory system

Answer 17

• Hallmarked by Dyspnea and stridorous respirations

- Circumferential thoracic burns

Question 18

Burns renal system

Answer 18

• Can cause the real ease of waste into the blood that can promote renal failure
• Urinary output drops due to circulatory volume and perfusion pressures

Question 19

Burns nervous and musculoskeletal system

Answer 19

-Nerve, Muscle, tendon and skin damage can result I Loss of function to the extremities

Question 20

Burns gastrointestinal system

Answer 20

• diminish perfusion

* diminished absorption and processing of food leading to chemical imbalances in the blood

Question 21

Radiation

Answer 21

Energy in the form of rapidly propagating waves or particles emitted as it changes from a higher energy state to a lower energy states

Question 22

Radiation types

Answer 22

• Alpha -stop with paper
• Beta- stop with thick clothing, 6mm aluminum
• Gamma- lead

Question 23

Radiation protection

Answer 23

• Time
• Distance
• Shielding

Question 24

Tar burns

Answer 24

• Don’t peel

- Cool with water