Burns Flashcards
(48 cards)
Criteria for admission to burn center
1) full thickness and partial thickness burn more than 10% BSA (less than 10 yrs, over 50 - others are 20% BSA)
2) Face, hands, feet or perineum involved
3) Full thickness over 5% any age
4) Electrical (lightening included) or chemical burn
5) Inhalation injury
6) Other injuries (fractures, head injury..)
7) Existing systemic diseases
8) Suspicion of abuse
Emergency care focus
1) stop any ongoing issues
2) Airway management
3) Fluid resuscitation - getting IV access
4) Circulation assessment
5) Life threatening injuries
6) Severity of burn
Superficial burn affects what
Epidermis
Superficial dermal includes what
Epidermis and superficial dermal layer
Deep dermal includes what
Epidermis and dermis
Full thickness includes what
Epidermis, dermis, and into the subcutaneous tissue
Epidermal (first degree) burn
Correlates with superficial Encompasses the epidermis only Dry, red skin May have small blisters Painful!
Epidermal (first degree) burn - healing
2 to 7 days to heal
No scars, but may have pigmentation changes (temp)
Superficial partial thickness (second degree) burn
Epidermis and papillary dermis
Moist, large blisters
May be mottled looking
Very painful! Tends to be sensitive to stimulation
Superficial partial thickness (second degree) burn - healing
10 to 14 days
Primarily through epithelialization
Change in skin pigmentation in the area, once healed (more permanent pigment changes)
Deep partial thickness (deep second degree) burn
Epidermis and papillary dermis layers are completely involved
Reticular dermis is damaged
Might have blisters that are leaky
More fluid loss than superficial
Significant edema
Mottled red and white skin color
Pain and sensitivity is less than a superficial
Deep partial thickness (deep second degree) burn - healing
More than 30 days
May need grafting depending on how large the area is
Full thickness (third degree) burn
All layers of skin including subQ layers Eschar forms Might have marble appearance Not as painful as other depths, but surrounding tissue can be pretty painful Will not heal without grafts!!!
Zones of a burn - A
Central zone of coagulation = This is the central part of burns with complete coagulative necrosis - it is dead
Zone of a burn - B
Zone of stasis = Located at the periphery of zone of coagulation - the circulation is sluggish in this zone but it can recover after early and adequate resuscitation, and proper wound care
Dec perfusion in this zone but the tissue can be saved
Zone of a burn - C
Outer most zone of hyperemia - peripheral to the zone of stasis - result of intense vasodilation as is seen in inflammatory process after trauma
Response from fluid/blood coming in - turns red and swells - this will heal
Determination of BSA
Lund and Browder chart - best
Rules of nines
Rule of one
Determination of BSA - Lund and Browder chart
Most common
Split body into percentages
Accounts for youth and uses more sections than others like Rules of nines
Determination of BSA - Wallace rules of nines
Used if lund-browder chart is not available
Does not account for all age groups
Does not ask that the severity of the burn be included
Determination of BS - rule of 1
Use the pt hand (including digits) as 1%
Causes of burns
Thermal, flame, contact Hot liquid, scald, steam Electrical Chemical Hypothermal (frostbite) Inhalation
Thermal
Depends on the agent, mechanism, time
Protein denatures at 160 degrees
Hot liquid
Common with kids
Think abuse if all creases are saved
Hot material
Tar = ex
Does not come off easily and it won’t cool fast - so it will keep burning the tissue
