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HCPAR6002 Exam Revision > Burns > Flashcards

Burns Flashcards

1
Q

What is the pathophysiology of burns and the different types

A
  • A burn occurs as a result of excess heat effecting the body
  • when the body cannot dissipate the heat then it causes burns
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2
Q

What are the immediate complications of a burn

A
  • the depth of burns can increase over the first 48 hours
  • hypovolaemia from fluid loss
  • increased fluid requirements
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3
Q

What are the long term complications of a burn

A
  • infection
  • scarring
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4
Q

Describe the Jackson Burn Wound Model

A
  • Hyperaemia
  • Stasis
  • Coagulation
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5
Q

Explain the Wallace rule of nines

A
  • Head 9%
  • Torso 18% front and 18% back
  • Arm 9% each
  • Leg 18% each
  • Groin 1%
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6
Q

What is the burns calculation formula for adults?

A

> 15 years with TBSA > 15%

% TBSA x weight (kg) = vol (ml)

administer over 2 hours since time of burn

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7
Q

What is the burns calculation for paeds 12-15?

A

12 - 15 yo with TBSA >10%

3 x TBSA % x weight (kg) = vol (ml)

Give over 24 hours from time of burn
Administer half of the volume in the first 8 hours

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8
Q

Recite the Burns CPG

A
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9
Q

How do you assess for airway burns?

A
  • facial and upper airway oedema
  • sooty sputum
  • burns to upper torse, neck and face
  • burns that occured in an enclosed space
  • singed facial hair
  • Respiratory distress +/- wheeze and associated tachycardia, stridor
  • Hypoxia (restlessness, irritability, cyanosis, decreased GCS)
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10
Q

What is the epidermis and what is it made up of?

A
  • the epidermis is the outermost layer of skin
  • it is made up of two different types of cells - squamous and basal cells
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11
Q

What is the dermis and what does it contain?

A
  • the layer of skin below the epidermis
  • it contains blood and lymphatic vessels, sebaceous and sweat glands - which are responsible for maintaining the moisture and temperature of the skin
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12
Q

How do you assess the severity of a burn injury?

A
  1. the depth
  2. the cause of the burn
  3. the TBSA %
  4. the location of the burn
  5. the age of the patient
  6. patients underlying health
  7. other injuries
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13
Q

What are the three different types of burns?

A
  • superficial
  • partial thickness (superficial, mid, deep dermal)
  • full thickness
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14
Q

What are the three different types of burns?

A
  • superficial
  • partial thickness (superficial, mid, deep dermal)
  • full thickness
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15
Q

Describe the zone of stasis

A
  • partial thickness
  • tissue directly surrounding the burn that is hypo perfused. This may be salvageable with appropriate treatment
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16
Q

Describe the zone of coagulation

A
  • Full thickness
  • irreversible damage to cell and coagulation of proteins
17
Q

What are first degree burns

A
  • Superficial
  • Involve the epidermis layer. causing erythema and is painful. This is often caused by sunburn or exposure to moderately hot liquids or radiant heat
  • There is no interruption to normal blood flow and healing usually occurs within a few days
  • painful up to 72 hours
18
Q

What are second degree burns?

A
  • Partial thickness
  • Can be described as superficial, mid or deep dermal

Superficial (dermal)
- involves the epidermis and upper dermis
- it is characterised by erythema and increased blood flow
- it will blister after some hours and is very painful
- usually takes 2 weeks to heal if uncomplicated

Mid dermal
- involve the epidermis and some of the dermal layer
- results in blotchy red and pink skin with extensive blisters and may be very painful
- there are areas of viable and non viable tissue
- appropriate care can have a large impact on saving viable tissue

Deep dermal
- large blisters from early and usually break within hours causing fluid to leak out
- characterised by decreased capillary return
- usually takes longer than 2-3 weeks to heal and will cause permanent scarring
- large area of tissue is unviable

19
Q

Describe third degree burns

A
  • full thickness
  • epidermis, dermis and possibly the subcutaneous and muscle and bone
  • these are generally charred and black, or waxy looking
  • they can be painless
  • decreased/absent blood flow
  • they will not heal without intervention
  • excision and skin grafting is required
20
Q

What are the mechanism of burn injury?

A
  • Scald - contact with a hot liquid
  • Contact burns - contact with a hot object e.g. touching a heater
  • Chemical burns - contact with skin or ingestion of a chemical (acid/base)
  • Radiation burn - contact with radiant heat e.g. sunburn
  • Electrical burns - contact with a source of electrical energy e.g. lightening strike
21
Q

What are the complications of airway burns?

A
  • oedema leading to airway compromise
  • may not occur until 12-18 hours post injury
  • fluid therapy increases oedema
21
Q

What are the complications of airway burns?

A
  • oedema leading to airway compromise
  • may not occur until 12-18 hours post injury
  • fluid therapy increases oedema
22
Q

What is the surgical intervention for burns called and what does it do?

A
  • Escharotomy
  • releases pressure
23
Q

What are some important factors about electrical burns?

A
  • they can be more severe than they appear
  • they will often have entry and exit points
  • These patients are at risk of compartment syndrome and cardiac arrythmias
24
Q

What are circumferential burns?

A
  • burns to the chest, limb or abdomen
  • act.as a tourniquet resulting in impeded distal blood flow or impeded respiratory function
  • decreases blood flow can result in ischaemia
  • Surgical intervention (escharotomy) is required
24
Q

What are circumferential burns?

A
  • burns to the chest, limb or abdomen
  • act.as a tourniquet resulting in impeded distal blood flow or impeded respiratory function
  • decreases blood flow can result in ischaemia
  • Surgical intervention (escharotomy) is required
25
Q

When assessing the size of the burn, what burns do we consider in our calculation?

A
  • only partial and full thickness burns
26
Q

When assessing the size of the burn, what burns do we consider in our calculation?

A
  • only partial and full thickness burns
27
Q

What is another method of calculating TBSA

A
  • Palmar method
  • patients palm = 1%
28
Q

How do you calculate TBSA for peads?

A

e.g. older they get head goes down 1% and legs go up by 0.5% until 9yo

29
Q

What is the management provided by the paramedics for burns?

A
  • rest and reassurance
  • cooling the burn if possible (20 mins running water) beware of hypothermia
  • analgesia
  • consider MICA
  • apply clin wrap longitudally
  • fluid replacement
  • notify recieving hospital
30
Q

Which patients require a specialised burn service? e.g. the alfred

A
  • Burns >10% total body surface area (TBSA)
  • Full thickness burns >5% TBSA
  • Circumferential burns
  • Burns to special areas (hands, feet, genitalia, major joints).
  • Pre-existing medical conditions that may impair recovery.
  • Burns to the very old or very young
  • Burns associated with trauma
  • Non-accidental burns
  • Burns with an associated inhalation injury
  • Chemical burns
  • Electrical burns

HCPAR6002 Exam Revision (13 decks)

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