Burns Flashcards
(17 cards)
Stage 1 burn appearance
pink to red in color, no blisters, blanches when pressure
Stage 1 layers affected
damage to epidermic only
ex. sunburn
Stage 2 Superficial partial appearance
moist, red in color with blisters, mild to moderate edema, no eschar, blanches with pressure
Stage 2 superficial partial layers affected
damage to entire epidermis with intact dermal elements
Stage 2 deep partial appearance
mottles, red to white in color, blisters, moderate edema, blanches
Stage 2 deep partial layers affected
damage to entire epidermic and some parts of the dermis, sweat glands, hair follicles remain intact
Stage 3 Full thickness appearance
red to tan, black, brown, or waxy white, dry, leathery, no blanching
Stage 3 layers affected
damage to entire epidermis and dermis and possibly sub-q tissue; nerve endings, hair follicles, sweat glands destroyed
Stage 4 Deep Full Thickness appearance
color variable, dull and dry, charring, possible visible ligaments, bone, tendons
Stage 4 layers affected
damage to all layers and muscle, fascia and bones
Primary Surgery
ABCs
Airway
patent, maintainable, or unmaintainable; signs of airway injury or smoke inhalation
Breathing
respiratory effort, symmetry of breathing, breath sounds; pulse oximetry, ABG, carboxyhemoglobin
Circulation
skin color, pulse strength, HR, perfusion status, edema, ECG if electrical burn
Secondary survery
burn depth, body surface area (BSA), other traumatic injuries
Fluid Resuscitation
based on total body surface area (TBSA) for 2&3 degree burns, LR used first 24 hrs, colloids (albumin, FFP) added when capillary permeability improves (24-48 hrs after burn)
maintain UOP 1-2mL/kg/hr
monitor daily weights/F&E/I&O
complications
inhalation injury: occurs with burns to face/lips from inhalation of heated gases/toxic chemicals produced during combustion; S/S wheezing, hoarseness, singed nasal hairs, soot-ting secretions
carbon monoxide injury
hypovolemic/septic shock
wound infections
