Burns Flashcards
(28 cards)
What is the immediate management of a burn?
Airway
Breathing
Circulation
What is the immediate management of a burn caused by heat?
Remove the person from the source.
Within 20 minutes of the injury irrigate the burn with cool (not iced) water for between 10 and 30 minutes
Cover the burn using cling film, layered, rather than wrapped around a limb
What is the immediate management of a burn caused by electric?
Switch off power supply, remove the person from the source
What is the immediate management of a burn caused by chemicals?
Brush any powder off then irrigate with water
DON’T Attempt to neutralise the chemical
What is used to assess the extent of the burn?
Wallace’s Rule of Nines
What is Wallace’s Rule of Nines?
Head + neck = 9%
Each arm = 9%
Each anterior part of leg = 9%
Each posterior part of leg 9%
Anterior chest = 9%
Posterior chest = 9%
Anterior abdomen = 9%
Posterior abdomen = 9%
What percentage is given for front of chest?
18%
What percentage is given for back of chest?
18%
What percentage is given for each leg?
18%
How does a first degree burn/ superficial epidermal burn appear?
Red and painful
Dry
No blisters
How does a partial thickness superficial dermal burn appear?
Pale pink
Painful, blistered
Slow capillary refill
How are second degree burns divided?
Partial thickness- superficial dermal
Partial thickness-deep dermal
How does a partial thickness deep dermal burn appear?
White but may have patches of non-blanching erythema
Reduced sensation
Painful to deep pressure
How does a third degree/ full thickness burn appear?
White (‘waxy’)/brown (‘leathery’)/black in colour, no blisters, no pain
When should burns be referred to secondary care?
all deep dermal and full-thickness burns.
superficial dermal burns- more than 3% TBSA in adults, or more than 2% TBSA in children
superficial dermal burns involving the face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck
any inhalation injury
any electrical or chemical burn injury
suspicion of non-accidental injury
Which superficial burns are referred to secondary care?
If they affect more than 3% TBSA in adults, or more than 2% TBSA in children
If they involve the face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck
What is the management of superficial epidermal burns?
Symptomatic relief- analgesia, emollients etc
What is the management of superficial dermal burns?
Cleanse wound, leave blister intact, non-adherent dressing, avoid topical creams, review in 24 hours
How could the airway be affected in someone with burns?
smoke inhalation- airway oedema
early intubation should be considered e.g. if deep burns to the face or neck, blisters or oedema of the oropharynx, stridor etc
What can smoke inhalation result in?
Airway oedema
When would you consider early intubation in a patient with burns?
Deep burns to the face or neck
Blisters or oedema of the oropharynx, stridor
When would patients with burns require IV fluids?
Children- Burns greater than 10% of total body surface area
Adults- Burns greater than 15% of total body surface area
How are fluids calculated for a patient with burns?
Parkland formula
Volume of fluid= total body surface area of the burn % x weight (Kg) x4
How is IV fluid administered in someone with burns?
Half of the fluid is administered in the first 8 hours.
