Burns Flashcards Preview

Clinical Science > Burns > Flashcards

Flashcards in Burns Deck (27)
Loading flashcards...

Burn classifications based on

depth, surface area, location


superficial burns

only involve epidermis
pain and swelling subsides in 48 hours
healed in 7 days


partial burns

destruction of epidermis and superficial dermis
appears blistered


superficial partial thickness burns

bright red and moist, very sensitive, heal in 2-3 weeks, minimal scarring


deep partial thickness burns

dark red or yellow white, more than 3 weeks to heal, hypertrophic scarring occurs


full thickness burns

involves epidermis and dermis including dermal appendages
appears charred or pearly white, brown or black colours. dry and leathery
normally without sensation
healing only occurs with scarring or skin grafts


Minor burns

less than 10% TBSA in adults, less than 5% in young or eldery, less than 2% full thickness burns


Moderate burns

10-20% TBSA adult, 5-10% young or eldery, 2-5% full thickness


Major burns

greater than 10% in young or eldery, greater than 20% in adults, full thickness greater than 5%


thermal burns

soft tissue is burned when exposed to greater than 45 degrees causing coagulation of soft tissue


coagulation of soft tissue leads to:

soft tissue temp increase, capillary permeability increase, fluid loss, plasma viscosity increase, microthrombi formation


zones of injury

zone of coagulation - centre of wound
zone of stasis - surrounds critically injuried area
zone of hyperamia - at periphery of wound


Acids cause:

coagulation, formation of tough eschar that can limit further damage


Alkalis cause:

liquefactive necrosis, deeper penetration


Thickness of chemical burns

superficial: itching, burning, pain
Partial: tissue oedema, bullae
full: damage to dermis, extent depends on chemical and duration


Treatment of chemical burns

if liquid, irrigate with copious fluids
if powder, dust of pt and remove clothing


Electrical injuries

low voltage
high voltage
lightening strikes


High voltage burns can cause:

flash burns: significant electrical charge causes combustible substances to ignite
Direct contact burns: deep muscle damage may occur under apparently normal skin and may be very extensive and life threatening


Lightening strikes

signigicant injury especially with exit burns to feet


Severity of electrical burns related to:

current type, voltage, intensity, resistance, area, duration of contact, environmental factors


Symptoms of electrical burns

contact burns, thermal heating, flash arc and flame thermal burns, blunt trauma, prolonged muscle tetany, skin injury does not correlate with underlying damage, low V = VF, high V = asystole, dysrhythmias can occur up to 24-48 hours later


Non accidental injury

delay in call, vague or inconsistent history, presence of other trauma, certain patterns of injury, info should be passed into recieving hospital


Stop the burning process

sover burn with clean cool cloth soaked in cool water, continue cooling with running water, remove clothing not adhered to pt, cover burn with a clean sterile dressing or cling wrap


haemodynamic Instability

Hypovolaemic shock assoc with decreased venous return and CO, increase vascular resistance
renal failure may occur due to haemolysis or rhabdo


Resp system involvement

inhalation burns, pulmonary injury and airway burns should be considered in presence of history of fire, facial burns, carbonaceous sputum, oedema to face, hoarse voice, stridor, obvious resp distress


Hyper-metabolic response

stress of the burn increases nutritional and metabolic needs of the body
characterised by increased O2 need, increased glucose need, protein and fat wasting


Fluid replacement

% of BSA x weight over 2 hours