Burns and Bites

Question 1

burn that appears wet, BLISTERS, painful. partial thickness or deep partial thickness

Answer 1

second degree thermal burn

Question 2

burn that involves subcutaneous tissues and is a/w electrical burns

Answer 2

fourth degree thermal burn

Question 3

burn that is red, painful, appears dry, and no blisters. superficial

Answer 3

first degree thermal burn

Question 4

full thickness burn with white eschar. NOT painful

Answer 4

third degree thermal burn

Question 5

parkland formula

Answer 5

4 x weight (kg) x BSA for fluid resuscitation- give half over first 8 hours. remaining half over 16 hours

Question 6

burn assessment

Answer 6

fluid resuscitation using parkland formula, maintain urine output at 0.5 ml/kg/hour, and heartrate less than 120 bpm

Question 7

burns involving __ at risk for severe complications

Answer 7

face, perineum, hands, and feet

Question 8

birn tx

Answer 8

would care- silver sufadiazine dressings and silver release dressings, debridement and grafting - split thickness skin graft and free graft

Question 9

burn maintenance tx

Answer 9

early and proper grafting, splint and ROM exercises, elevate, compression dressings

Question 10

complications of burns

Answer 10

infection and sepsis syndrome, circumferential burns, stress gastritis and ulcers, and seizures in children

Question 11

most susceptibe in frostbite injury

Answer 11

skin and muscle over tendons and bone

Question 12

how does frostbite injury develop

Answer 12

looks white and waxy, painless at beginning. After rewarming, becomes mottled blue/urple, very painful, and blisters form. sloughing may occur

Question 13

rewarming in frostbite

Answer 13

done in warm water bath for 20-30 minutes. no massage! do not thaw until warmth can be maintained

Question 14

hypothermia

Answer 14

core body temp less than 35 degrees C

Question 15

shivering stops at …

Answer 15

less than 32 degrees C

Question 16

what organ is most sensitive in hypothermia and what can result?

Answer 16

heart- V. Fib happens between 21-24 degrees C

Question 17

BP and HR in hypothermia

Answer 17

BP normal, heart rate slow

Question 18

EKG on hypothermia

Answer 18

PR is lengethened, J wave at junction of QRS and ST segment

Question 19

hypothermia causes patients to become…

Answer 19

coagulopathic..watch for clots!

Question 20

labs in hypothermia

Answer 20

hypoglycemia, dehydration, elevated amylase

Question 21

what’s worse, acidic or basic burns?

Answer 21

basic burns- keep burning while acidic burns form eschar, but don’t burn deeper

Question 22

tx of human bites

Answer 22

medical urgency. if skin broken, abx. cleanse and irrigate would, anesthetize, debride, give tetanus vaccine

Question 23

types of human bites

Answer 23

clenched fist injury (“fight bite”, can occur with fracture) or occlusive bites (crush injury, break the skin)

Question 24

bacteria in human bites

Answer 24

Eikenella corodens, HBV can also be transmitted

Question 25

bacteria in dog and cat bites and abx

Answer 25

pasturella multicoda, augmentinq

Question 26

dog and cat bites tx

Answer 26

clean and irrigate wound, anesthetie, debride. get xray to check for cat teeth

Question 27

Rabies virus produces

Answer 27

encephalitis, nearly always fatal

Question 28

types of spider bites

Answer 28

lactrodectus (black widow) or loxosceles (brown recluse)

Question 29

spider bites prognosis

Answer 29

heal slowly, self limited

Question 30

tx for lactrodectus sp. bite

Answer 30

calcium gluconate or opiods and benzos will help relive pain. self-limited.

Question 31

wound excision helpful in spider bites?

Answer 31

NO

Question 32

snake bites have 2 major effects

Answer 32

hemotoxins- anticoagulation and hemolytic anemia causing ATN and neurotoxins that act on Ach receptors and block condution- that can cause paralysis of respiratory muscles

Question 33

non venemous snake bites tx

Answer 33

cleanse area, give tetanus vaccine

Question 34

venemous snake bites tx

Answer 34

determine envenomation - administer antivenom only if moderate or severe envenomation has occured. If coral snake bite- give antivenom no matter waht.

Question 35

labs/tx in snake bite

Answer 35

type and crossmatch, coags, CBC, UA, ABCs, apply compressive bandage, keep patient still and warm, remove rings, antivenom