Burns Flashcards Preview

SBOMs > Burns > Flashcards

Flashcards in Burns Deck (43)
Loading flashcards...
1

6 functions of the skin

Sensory organ
Endocrine
Thermoregulatory
Immunotherapy
Barrier to fluid loss
Social

2

6 causes of burns

Heat
cold
electrical
chemical
radiation
mechanical (eg friction)

3

Who is more at risk of burns?

Mad (psychological/pyschiatric problems, drugs)
Bad (Violence)
Glad (arson)
Sad (self harm, substance misuse)
Epilepsy/stroke

4

Why are the extremes of age more at risk of burns?

Poorer reflexes and spatial awareness
Inattention/carelessness
Inability to fend for themselves
Thinner and more frail skin

5

5 types of shock

Hypovolaemic (burns)
Septic
Anaphylactic
Vasovagal
Cardiogenic

6

How do burns cause hypovolaemic shock?

Tissue damage
Inflammatory mediators
Leaking vessels
Increased vascular resistance
Hypovolaemia

7

Name the 3 zones of a burn

Centre: Zone of coagulation/necrosis
Zone of stasis
Outer: Zone of hyperaemia

8

Role of histamine in the inflammatory response

Released by mast cells
Creates large endothelial gaps
Leakage

9

Role of prostaglandins in inflammatory response

Released from damaged tissue
Attract neutrophils and macrophages
Release thromboxane and interleukins
Local vasodilation and capillary leakage

10

Role of thromboxane in inflammatory response

Produced by platelets in the zone of injury
Vasoconstriction in undamaged tissue adjacent to the burn
Results in damage extension

11

What inflammatory mediator is released by platelets

Thromboxane

12

What inflammatory mediator causes thromboxane and interleukins to be released?

Prostaglandins

13

Role of catecholamines in the inflammatory response?

Reduces capillary pressure in unburnt tissue
Causes burn extension

14

Role of oxygen free radicals in the inflammatory response?

Produced by neutrophils and macrophages
Damage endothelial cell membranes
Increase capillary leakage

15

What is found in the urine after a burn?

Haemaglobin
Red cells lost
Intensifies the effect of plasma loss
50% burn, 10% loss of red blood cells

16

What is the rule of nines?

Body surface area can be estimated using 9%
Each leg 18%
Torso 18%
Each arm 9%
Head 9%

17

How do you classify depth of burns?

Erythema
Partial thickness
Full thickness

18

How do you recognise a partial thickness burn?

Painful
Blistered
Tissue paper appearnace
Wet

19

How do you recognise a full thickness burn?

Painless
Thick and leathery
Dark red/brown/balck/white
No blisters
Swelling in limbs
Dry
Non blanching

20

When do you need to IV fluid resuscitate someone after a burn?

If adult>15% BSA affected
In children>10%BSA

21

What is the aim for adequate fluid balance?

Urine output of 0.5-1 ml/kg/hour

22

What type of fluid should be used in IV fluid resus after burns? And rate?

Crystalloid (Ringer's lactate)
4ml/kg/%burn for 1st 24hrs

23

When would more fluid need to be replaced?

In myoglobinuria, electrical injury or associated skeletal injury

24

How much fluid needed for a 70kg man with 45% BSA burns?

4 x 70 x 45 = 12600ml in 24hours
6300ml in first 8 hours
6300ml in next 16 hours

25

When would you intubate early in emergency burns management?

Facial burns
Singeing of facial/nasal hair
Inflammation of oropharynx
Carbonaceous sputum

26

What would you do to manage circumferential full thickness burns?

Escharotomies
Slice through lengthways to allow breathing

27

What blood test is needed after being in a fire?

HbCO

28

How do you estimate BSA in children with burns?

Head 18%
Torso 18%
Each arm 9%
Each leg 14% at aged 0
For each year between 0 and 10 take 1% off head and add 0.5% to each leg

29

How do you stop the burning process immediately after a burn?

25ºC water for 10 mins
Beware of hypothermia

30

Causes of electrical burns?

Improper insulation
Intense curiosity of children
Occupation hazards
DIY maintenance attempts
Illegal attempts to obtain electricity
High voltage wire exposure