Burns Flashcards
(15 cards)
Superficial Partial
Extends through?
No?
Often?
May?
how does it look?
Extends thru epidermis
No surgery
Often painful
May scar
Wet, pink or clear blisters
Deep Partial
Extends?
How does it look?
Increased?
Epidermis thru dermis
Surgery, Painful, Scars
Less wet, moist red/hemorrhagic blisters
↑ infection risk
Full Thickness
Extends?
Feels?
Lacks?
Skin?
High?
Thru dermis meets adipose and muscle
Dry, leathery
Lacks sensation
Skin grafting to larger areas
High infection risk
Face, oropharynx, nasal hairs, neck, chest
Concern?
Priority?
Ears, nose, buttocks, perineum
Priority?
What does a circumferential burn look like? What is the associated complication?
CONCERN: inhalation injury
Priority: respiratory complications
Priority: infection control
Circumferential burns go “around” the extremity
compartment syndrome
Calculate the extent of the burn using the Rule of 9s (TBSA)
Ant/ pos trunk?
Ant /pos Arms?
Ant/ pos Legs?
front/ back Head?
Ant/ pos trunk: 18%
Ant /pos Arms: 4.5%
Ant/ pos Legs: 9%
front/ back Head: 4.5%
Know how to calculate fluid resuscitation using the Parkland Formula
24 hours total
8 hours total and mL/hr
16 hours total and mL/hr
4 x kg x TBSA%
First 8 hours: Take half of number to give for 8 hours and and then divide by 8 hours to get mL/hr
Next 16 hours: Take half of number and Divide by 16 hours to get mL/hr
EMERGENT PHASE
Airway?
Concern?
What should u do for Hypovolemia and burn shock?
What 2 other thigns can happen?
Wound care delayed until?
Whats priority?
This phase ends with?
Airway (ABCs)
Establish patent airway:
Concern: stridor and audible wheezes then no breath sounds; acutely restrictive chest
Hypovolemia and burn shock = fluid resuscitation STAT
Edema due to fluid shifts and third spacing
Organ Dysfunction
WOUND CARE
Delayed until ABCs stabilized
Infection control is the priority
DURATION
Ends with fluid mobilization measured by normal urinary output
Emergent phase: Fluid Resuscitation
What labs should u monitor In a patient who requires significant amount of fluid resuscitation for an extensive burn?
CBC: RBC lysis
ABGs: determine adequate oxygenation; metabolic acidosis
CMP: ↑ Cr and BUN secondary to kidney damage secondary to hypovolemia
Electrolyte panels: initially hyperkalemia & hypernatremia.
Albumin: hypoalbuminemia due to increased capillary permeability
BURN SHOCK
When what % burned?
The damage from burns causes?
This leads to?
What electrolyte imbalance can happen and what to do?
> 30% of TBSA burned
The damage from burns causes blood vessels to leak into surrounding tissues.
This leads to severe hypovolemia and massive edema
hyperkalemia = apply EKG
ACUTE/WOUND PHASE
Whats priority?
This phase ends when?
Wound care is Priority!!!
Ends when burn wounds are covered with
viable graft or healing naturally
REHAB PHASE
Formal rehab begins when?
Planning for rehab begins?
Formal rehab begins when burns and associated wounds have healed
Planning for rehab begins on admission
Discuss burn shock
HR?
BP?
3 other symptoms?
Priority electrolyte abnormality?
Increased HR
Decreased BP
Tachypnea
Peripheral edema
Decreased UO
Hyperkalemia = apply EKG
Discuss the complications of a circumferential burn and your role as the RN
6 Ps of compartment syndrome?
What’s priority?
Never apply ____ or?
Why
Paresthesia: tingling and numbness
Pain: unrelieved and at rest
Pallor: Pale
Polar: cold
Pulses
Paralysis
PRIORITY notify the healthcare provider!
Never apply ice or elevate the extremity!!!
Can cause vasoconstriction and reduced blood flow
Know which patients require transfer to a burn unit
Understand this in a case study format
What kind of burns?
Burns to the?
What kind of injuries?
Patients with?
Partial thickness (2nd°) burns > 10% TBSA
Full thickness (3rd°) burns, in any age group
face, hands, feet, genitalia or major joints
Electrical, Chemical or Inhalation injuries
Patients with pre-existing medical disorders compromising outcome
Effective pain management meds? 3
What is silvadine?
Be aware of the mythbusters
Dilaudid, morphine, fentanyl.
Silvadine: used to prevent and treat wound infections
NO oil / butter
NO toothpaste
NO egg whites
DONT pop blisters
DONT use ice or cold water
