Burns

Question 1

what is the most common type of burn?

Answer 1

thermal burns

Question 2

what are the chemical compounds in acids that cause burns?

Answer 2

hydrochloric, sulphuric and hydrofluoric acids

Question 3

what are the chemical compounds in alkalis that cause burns?

Answer 3

hydroxide, ammonia and ammonia hydroxide

Question 4

what are the different types of burn injury?

Answer 4

1) chemical burns
2) smoke and inhalation injury
3) electric burns

Question 5

define smoke and inhalation injury

Answer 5

breathing noxious chemicals or hot air causes damage to tissues of respiratory tract

Question 6

what is a major predictor of mortality in burn patients?

Answer 6

smoke inhalation

Question 7

what are the 3 types of smoke and inhalation injury?

Answer 7

1) carbon monoxide poisoning

2) inhalation injury above the glottis
- thermally produces
- total airway obstruction

3) inhalation injury below the glottis
- chemically produced
- lower airway injury

Question 8

what is the major cause of deaths at fire scenes?

Answer 8

caused by CO and asphyxiation

Question 9

what is the most severe type of burn?

Answer 9

electric

Question 10

define electric burn

Answer 10

intense heat generated from an electric current

Question 11

why system do burns destroy?

Answer 11

integumentary system

Question 12

what are the 3 layers of skin?

Answer 12

1) epidermis
2) dermis
3) subcutaneous tissue

Question 13

what are burns defined by?

Answer 13

1) partial thickness
- epidermal and dermal injuries
- some skin elements viable for regeneration

2) full thickness
- destruction of all skin elements and subcutaneous tissues
- muscles, tendons and bones

Question 14

what are the 2 categories of partial thickness skin destruction?

Answer 14

1) superficial (1st degree) : erythema and blanching. Skin may peel or blister. This is an epidermal burn. tactile and pain sensation is intact

2) deep (2nd degree burn) : fluid filled vesicles that are red and shiny and wet if the vesicle pops. mild to moderate edema
- epidermis and dermis involved. epithet regeneration remains viable

Question 15

what are the 2 categories of full thickness skin destruction?

Answer 15

3rd and 4th degree burns: dry waxy white hard skin. insensitive to pain because of nerve damage as well as muscles and bones
- surgical intervention advisable for healing

Question 16

which chart is used to show which percentage of body is burned and is more accurate to pt’s age to body size area?

Answer 16

adult lund-browder chart.

Question 17

which chart is used for initial assessment to percentage of burns covered?

Answer 17

adult rule of nines

Question 18

what does burns on the face, neck, trunk and back result in?

Answer 18

mechanical obstruction secondary to edema (respiratory obstruction)

Question 19

what does burns to hands, feet, joint and eyes result in?

Answer 19

difficulty with self care and daily life functions

Question 20

what are burns to the ears nose, butt and perineum susceptible to?

Answer 20

infections

Question 21

what are burns to extremities result in?

Answer 21

circulatory compromise and possible euro impairment

Question 22

what are the phases of burn management?

Answer 22

1) prehospital care phase

2) emergent phase

3) Acute phase

4) Rehabilitative phase

Question 23

define the prehospital care phase

Answer 23

• taking the person away from the source of the fire but rescuers must also protect themselves
• if burn is small cooling in a minute interval can help not make the burn go deeper. but if burn is larger, CAB is priority
• never immerse in cold water because it can lead to heat loss aka vasoconstriction

Question 24

define the emergent phase

Answer 24

this is the phase where you need to resolve any life threatening conditions

• primary concerns are onset hypovolemic shock and edema
• phase ends with fluid mobilization and diuresis begin
• dynamic ileus: no or diminished bowel sounds

Question 25

what is the greatest concern for fluid and electrolyte shifts during the emergent phase?

Answer 25

hypovolemic shock; massive shifts of fluid out of the blood vessels which increases capillary permeability

Question 26

what happens to insensible loss?

Answer 26

normally is is 30-50mL but with burns it increases significantly

Question 27

what pressure decreases in the emergent phase?

Answer 27

colloid osmotic pressure resulting in fluid to shift to intravascular depletion resulting in edema and increase BP

Question 28

how is sodium and potassium and album affected in emergent phase?

Answer 28

sodium shifts to interstitial spaces until edema subsides sodium decrease, album decrease, potassium increase

Question 29

how much fluid therapy for burns?

Answer 29

2 large bags

Question 30

define acute phase

Answer 30

1) begins with the mobilization of extracellular subsequent diuresis 2) concluded when the burned area is completely covered by skin grafts or when the wound heals

Question 31

when does healing begin in acute phase?

Answer 31

when WBC surround the burn wound and phagocytosis occurs - granulation tissue forms

Question 32

how do partial thickness and full thickness burns heal in the acute phase?

Answer 32

partial thickness heals from edges full-thickness burns heals from skin grafts

Question 33

what do partial thickness burns form?

Answer 33

eschar and it will need to be removed then re-epithalization will occur

Question 34

what do full thickness burns require to heal?

Answer 34

debriment and skin grafting

Question 35

what is a complication of the acute phase?

Answer 35

insulin increase = hyperglycaemia = high blood glucose because of the high metabolic demand

Question 36

define the rehabilitative phase

Answer 36

begins when burn wound start to heal and when the client is able to resume a level of self care activity

Question 37

what is the common complication in the rehabilitative stage?

Answer 37

skin and joint contractures

Question 38

what are some pathophysiological changes in the rehab phase?

Answer 38

- burn wounds either heal by primary intention or grafting - layers of epithelialization begin to rebuild - collagen fibres add strength to weakened areas

Question 39

what creams are to be used?

Answer 39

an emollient water based cream