Burn Injuries

Question 1

Type of burns

Answer 1

Thermal
Chemical
Electrical
Smoke and inhalation
Cold thermal injury or frostbite

Question 2

Thermal burn causes

Answer 2

Flame, flash of heat, scold , coming into contact with something hot

Question 3

Chemical burn causes

Answer 3

Acid, alkali, or organic compounds

Question 4

Electrical burn causes

Answer 4

Electricity

Question 5

Superficial burns

Answer 5

Involves just the skin
Burns like sunburn

Question 6

Deep partial thickness

Answer 6

Down to your fat layer, takes hair follicle and sweat gland

Question 7

Full thickness

Answer 7

Down to fat , muscle and bone

Question 8

With facial burns
We should always be prepared to

Answer 8

Intubate them

Question 9

Fluid resuscitation for a burn

Answer 9

Weight in KG , x Tbsa burned x4mL

Give half the first 8 hours
The half of the half the next 8 hours
And the last half the last 8 hours

Question 10

Treatment for edema after the fluid resuscitation after a burn

Answer 10

Lightweight diuretic
Turn the fluid down that we are giving

Question 11

Why are we giving so much fluid resuscitation

Answer 11

To correct the volume loss
Capillary bed last about 24 hours
So we are fighting the loss of fluid for the first 24 hours

Question 12

When can we have insensible fluid loss

Answer 12

While breathing ( we can lose 30 -50 mL in a burn pt)
Blister formation

Question 13

How can we minimize insensible fluid loss

Answer 13

Intubate and humidified warm air to cut down the loss

Question 14

Classifications of burn injury

Answer 14

Superficial partial thickness
Deep partial thickness
Full thickness

Question 15

Superficial partial thickness

Answer 15

Can heal w/o intervention
Pink to red
Painful to touch
Involves only the epidermal layer

Like our sun burns or heat flash

Question 16

Deep partial thickness

Answer 16

Epidermal and dermal layer
Red,mottled, pink, edges
Very painful
Blisters right away
Sensitive to cold air, hot air and touch

2-4wks to heal

Question 17

Full thickness

Answer 17

Full dermal layer involved
White , dry , leather like texture

No clear pain (nerve ending is gone)

Question 18

What meds do we give for burns

Answer 18

Tetanus shot
And analgesic for pain

Question 19

What is contraindicated for burns

Answer 19

Showers

Question 20

When a pt comes in with signs of inhalation burn .. what should we do immediately

Answer 20

Intubate and dont wait any longer

Question 21

Why do inhalation burns cause mechanical obstruction

Answer 21

Burn skin on The mucosa becomes tight

Question 22

A pt comes into covenant with an obvious inhalation injury.. we know we must transfer them to a burn unit but what must we do first

Answer 22

Stabilize the pt

Question 23

Electrical injury

Answer 23

Takes the path of least resistance and does damage inside tearing up muscles, fat cells

Grafting may be necessarily for muscles , fat , vessels , skin

Monitor pt for dysrhythmias

Question 24

Rule of 9s

Answer 24

Arms post and ant - 4.5%
Chest and abd- 9%+9%
Head-4.5%
Legs post and ant-9%
Genitals -1%

Question 25

Palmar method

Answer 25

Used to measure splatter burns with the pt palm 1%

Question 26

Referral criteria

Answer 26

Partial thickness >10% of total body surface area Burns of face, hands,feet,genitalia , perineium , major joints Third degree burns in any age group Electrical burns including lightening injury

Question 27

Burns and inhalation injury frequently mask other injures such as

Answer 27

Fractures, spinal cord injury and other trauma

Question 28

With associated trauma we should look out for

Answer 28

Any hidden trauma on a burn pt

Question 29

Why is there decrease vascular volume in a burn pt

Answer 29

The capillary beds become permeable causing third spacing

Question 30

Emergent phase

Answer 30

Airway management Fluid therapy Wound care Emotional support Teaching

Question 31

In the emergent phase emotional support is important for

Answer 31

Patient and staff Staff may be traumatized

Question 32

What do we teach in the emergent phase

Answer 32

How to care for burn Avoid future burns And when to go to doc And how to take their medications

Question 33

Fluid resuscitation formula

Answer 33

Weight in kg x tbsax4ml

Question 34

A pt comes into the ED 7 hours later after a burn .. what is important to note when it comes to calculating their fluid resuscitation?

Answer 34

We would give the whole amount in that hour

Question 35

Treatment for edema after fluid resuscitation

Answer 35

Light weight diuretic Turn the fluid down that we are giving

Question 36

Insensible fluid loss

Answer 36

Lost in breathing ( 30-50mL ) And blistering formation

Question 37

How to minimize insensible fluid loss

Answer 37

Intubate , humidified warmed air to cut down the loss of

Question 38

Reparative phase

Answer 38

Wound care ** Nutritional support Management of pain ** Prevention of contractures Wound management Psychosocial issues

Question 39

In the reparative phase what can help with psychosocial issues

Answer 39

Encourage physician to consult counselor , antidepressants ( staff may also need)

Question 40

Since in the reparative phase we manage the womb by scrubbing and Debridement of scabs..what is important to keep in mind

Answer 40

Pain management is huge

Question 41

Rehab and reconstruction phase

Answer 41

Ongoing skin needs Activity needs Self concept and depression Noncompliance w care

Question 42

Jopst garment

Answer 42

Looks like a wet suit Must be worn all the time , can’t be tooken off for a long period of time

Question 43

Burns in a nutshell

Answer 43

Ventilate ABCCCC Fluid resusitation Control pain Transfer to burn center

Question 44

Short term burn healing

Answer 44

7-8 mo it will start to want to repair things after