burn injuries

Question 1

local effects of burns

Answer 1

Pain
Vasodilatation
Increased capillary permeability with loss of albumin into interstitial spaces (ISS)
Loss of fluid and electrolytes into ISS and environment
Loss of heat due to conduction and evaporation
Loss of protective skin barrier

Question 2

types of burns

Answer 2

scalds - most common
flash and flames - clothes involved can led to deeper burns
contact - with metals and plastics
electrical - severe cardio, muscle and skin damage
chemical
radiation - sun, explosion of gas

Question 3

systemic affects of burns

Answer 3

Hypovolaemia
Hypermeability of capillaries - vasodialtion
Hypermetabolic state (release of stress hormones) - glucagon, cortisol, catecholamines
Suppression of insulin, growth hormone & anabolic steroids
Immune response to burn
- Infiltration of tissue with WBC
- Deficiency of neutrophils may cause fatal infections
Loss of GIT barrier function
Stress ulceration
Bone marrow suppression
Widespread whole body changes

Question 4

how to cool burn surface

Answer 4

cold running water for 30mins
10-15 degrees
temps below 5 will worsen burn
wrap patient in clean sheet- stops air getting to damaged tissue
keep patient warm

Question 5

determinants of mortaility

Answer 5

extent of burn
patient age - older aults and kids at risk
burn wound depth

Question 6

zones of jacksons burn wound model

Answer 6

zone of coagulation - central area, no viable tissues
zone of stasis - surronding central area, intial blood flow is here
zone of hyperemia - surrodning the zone of stasis, contains viable tissue

Question 7

what is fluid resuscitaion measured from and calucted by

Answer 7

measured from urine output, and calculated form time of burn and extent of burn

Question 8

what happens if give burn patient NaCl

Answer 8

potential metabolic acidosis

Question 9

why not use dextrose fluid

Answer 9

Does not contain electrolytes

Possibly a large amount of adrenaline in the bloodstream which makes these patients glucose intolerant. Their blood glucose levels will increase, causing their urine output to increase, therefore they won’t be getting resuscitated appropriately

Question 10

goal of IV therapy and how to know if worked

Answer 10

goal is perfusing kidneys
if perfused patient will make enough urine

Question 11

superficial burn

colour, surface, cap refil, sensation, hairs present and healing time

Answer 11

1. pink
2. blisters and moist
3. present
4. present
5. yes
6. < 14 days

Question 12

partial thickness burn

colour, surface, cap refil, sensation, hairs present and healing time

Answer 12

mottled red or white, blisters mostly soft, sluggish or absent, absent or distant, few, > 21 days

Question 13

full thickness burn

colour, surface, cap refil, sensation, hairs present and healing time

Answer 13

white tan fawn black, dry and leathery, absent, absent, no, by 2nd intention

Question 14

superficial thickness attritbutes

Answer 14

very painful, heal rapidly 7-10 days

Question 15

partial thickness attributes

Answer 15

exposed nerve endings so very painful
3 or more weeks to heal
may need skin grafting
extrnsive dressings and pain relief

Question 16

full thickness attritbutes

Answer 16

very deep burns
no pain - no nerves
will need grafting
long time to heal
scarring

Question 17

whats escharotomies

and why

Answer 17

surgery for full thickness burns
reduce pressure inside burned tissue
incision made along the line of burn

Question 18

pros of burn dressings

Answer 18

absorb exudate
prevent infection
ideal wound healing enviroment
reduce pain
cost effective

Question 19

when to graft

Answer 19

if burn isnt healed in 3 weeks
time is 2 weeks for kids

Question 20

scar management

Answer 20

massage, compression, silicone gel sheeting, steriod injection, surgery