pale pink to white, decreased cap refill, may be less painful
deep partial thickness burn
pink, moist, blisters
superficial partial thickness burn
examples of the 3 burn types?
superficial burn- sunburn
partial thickness burn- hot water scald (superficial)
full thickness burn- flame burn
who is at highest risk for burn shock?
pts w/ >20% TBSA
intubate if… (many)
closed space injury, carbonaceous sputum, facial burns, Hb CO >5, hoarse voice, singed facial hair, large dose of narcotics
risk of smoke inhalation injury (6)
closed space injury, carbonaceous sputum, CO Hb >5, hoarse voice, singed facial hair
management of inhalation injury (4)
mechanical ventilation
aggressive pulmonary toilet
pneumonia prevention/tx
supplemental nutrition
parkland formula?
4 mL LR x Wt x TBSA = 24h postburn total fluids
signs of abdominal compartment syndrome (4)
decreased urine output
increased bladder pressure
increased peak expiratory pressure
poor ventilation
management of chemical burns
irrigate copiously with water
don’t try to neutralize
find out what its from, get MSDS
concern with electrical burns?
current follows path of least resistance –> damage may be hidden under good skin
management of electrical burns (3)
monitor for heart abnormalities
fluid resuscitation, even for small injuries
watch for rhabdo- myoglobinuria will require dialysis
which burns have a risk of compartment syndrome?
circumferential burns
only definitive skin graft?
autograft
metabolic needs of a burned pt (4)
increased- can require more than 5000 cal/day
duodenal route is better tolerated, TPN not recommended
Need a lot of protein- 1.5-2.0 g/kg
supplement Vit A, D, E, C, selenium, zinc
which scar overgrows beyond the area of injury
keloid
which scar doesn’t grow beyond the area of injury
hypertrophic
consequence of connective tissue being replaced with fibrotic tissue? (2)
decreased ROM
shortening of muscle
