Burns (Adult) Flashcards
(20 cards)
Recite the Burns CPG
How do you calculate the TSBA of burns in an adult?
What are the care objectives in burns?
- To identify and manage potential airway burns as a priority
- To minimise the impact of injury by maintaining tissue and organ perfusion, minimising pain, appropriate burn wound cooling and minimising heat loss during transfer to hospital
What are the indications for NaCl?
What are the contraindications for NaCl?
What are the precautions for NaCl?
What are the side effects of NaCl?
Why do we use NaCl in burns treatment?
1. Fluid Resuscitation
* Burns (especially >15–20% total body surface area) cause massive fluid loss from:
* Damaged capillaries (leakage into interstitial space),
* Evaporative loss from exposed skin.
* This leads to hypovolemia, which can cause burn shock.
* Normal saline helps restore intravascular volume, supporting:
* Blood pressure,
* Organ perfusion,
* Urine output.
2. Isotonic Solution
* 0.9% saline has an osmolality similar to blood plasma, so it stays in the intravascular space better than hypotonic fluids, making it useful for initial volume replacement.
Does the O2 therapy guideline apply to this presentation?
ONLY if toxic inhalation exposure
Does the trauma triage guideline apply to this presentation?
- Yes
- Burns >20% TBSA
- Suspected respiratory tract burns
- High voltage (>1000 volts) burn injury
- Explosion
- AND age >55
- OR pregnant
- OR significant underlying medical condition
What are 3 different differential diagnoses of burns?
- 1st degree burns
- 2nd degree burns
- 3rd degree burns
- chemical burn
- gravel rash
- trauma
What are the care pathways/treatment options for burns?
- Reassurance
- Fluids if TBSA > 15%
- Pain relief
- Cool the burn - warm the patient
- Apply appropriate dressing (longitudally)
- Reassessment
- Transport to an appropriate facility
What are some transport considerations?
What are some symptoms of airway burns?
- Evidence of burns to the upper torso, neck and face
- Facial and upper airway oedema
- Sooty sputum
- Burns that occurred in an enclosed space
- Singed facial hair
- Respiratory distress (dyspnoea +/- wheeze as associated tachycardia, stridor)
- Hypoxia (restlessness, irritability, cyanosis, decreased GCS)
As per the major trauma CPG, list 2 care objectives
Immediate control of major haemorrhage
Ensure
* Airway patency
* Breathing (adequate oxygenation and ventilation)
* Circulation (adequate perfusion for the patients presentation)
Prioritise transport
Supportive care as required
What secondary surveys would be appropriate for a burns pt?
- TBSA % calc
- DOLOR
- AEIOUTIPS if ACS
Are there any relevant CWI’s?
- IV insertion
What are the indications for IV insertion
What are the contraindications for IV insertion
What are the precautions for IV insertion
