Burns Exam 3

Question 1

What is the function of the skin

Answer 1

1. Contain body fluids
2. Maintain elasticity
3. Physical appearance
4. Identity
5. Sense organ
6. Barrier against infection
7. Maintain body temp

Question 2

As far as anatomy is concerned, what is the epidermis of the skin

Answer 2

Outer proof waterproof layer

Question 3

What is the dermis of the skin

Answer 3

Elasticity, hair follicles, sebaceous glands, sweat glands, nerve fibers for pain, temperature, touch, pressure

Question 4

What is the subcutaneous layer of the skin

Answer 4

Connective tissue and fat

Question 5

What is a superficial partial burn

Answer 5

AKA FIRST DEGREE BURN

reddened dry, painful area

Question 6

What is a example of a superficial partial burn

Answer 6

Sunburn

Question 7

What is a partial thickness burn

Answer 7

AKA SECOND DEGREE BURN
Blistering, skin may slough off, moist and weepy, very painful
Red under blisters
( pale areas are deeper partial thickness and may convert to full thickness)

Question 8

What is a full thickness burn

Answer 8

AKA THIRD DEGREE BURN
Dry and non elastic
Color may be white, tan, cherry red or charred.
Little or no pain or sensation to burned area

Question 9

How is severity of a burn determined

Answer 9

Depth of burn

% of body surface area burned

Question 10

What is the burn size estimate

Answer 10

Victims palm is 1% BSA

Question 11

What is the fluid of choice for burn patients

Answer 11

LR bc it mimics normal intravascular fluid

It treats hypovolemia and intracellular Na deficits

Question 12

For fluid resuscitation, how much LR should a Child 5 years and younger receive

Answer 12

125 ml/HR

Question 13

For fluid resuscitation, how much fluid should a child 6-13 yrs of age receive

Answer 13

250 ml/HR

Question 14

For fluid resuscitation, how much fluid should a person 14 yrs and older receive

Answer 14

500 ml/ HR

Question 15

What is considered the first survey of a burn patient

Answer 15

Provide fluid resuscitation

Question 16

What is considered secondary survey of a burn patient

Answer 16

Obtain weight and closely estimate BSA

Question 17

What is a thermal burn

Answer 17

Flame, flash, scold, contact

Question 18

What is the leading cause of burns in children

Answer 18

Scalds ( thermal burn)

Question 19

What are the ABCs of a thermal burn

Answer 19

Stop the burning process

Cool the burn never use ice

Question 20

What is a complication of electrical burns

Answer 20

Immediate fatal arrhythmias ( v fib, or systole)
May be at a higher risk for arrhythmias later
Assess for other trauma ( C- spine, fractures)
Assess for compartment syndrome - fasciotomy may need to be done to release pressure

Question 21

What is myoglobinuria

Answer 21

Damaged muscle that release myoglobin

It precipitates in the kidneys resulting in kidney failure

Question 22

What color is the urine of a patient with myoglobinuria

Answer 22

Port wine colored urine

Question 23

What is a target UO of a person with myoglobinuria

Answer 23

75-100 cc HR

Question 24

What type of blood products does west pen give to large burn BSA patients

Answer 24

FFP

Question 25

What type of dressing is preferred for a burn patient

Answer 25

Dry dressing are preferred but, less than 10% TBSA can use a wet dressing, no ointments

Question 26

What are commonly used topicals of a burn patient

Answer 26

Silver sulfadiazine Sulfamylon Enzymes ( accuzyme) Bacitracin, neomycin

Question 27

What is the therapuetic use of sliver sulfadiazine

Answer 27

``` Does not penetrate eschar May cause leukopenia Wide spectrum Minimal pain Low toxicity Contraindicated with sulfa injury ```

Question 28

What is sulfamylon

Answer 28

``` Penetrates eschar Can be painful Wide spectrum Used on ears, nose, (cartilage) Contraindicated with sulfa allergy Can cause metabolic acidosis ```

Question 29

What are enzymes ( accuzyme)

Answer 29

Made from papaya fruit, Disolves eschar Well tolerated, may burn for first 5 minutes, harmless to healed intact tissue

Question 30

What is bacitracin, neomycin

Answer 30

Does not penetrate eschar May be used on face Low toxicity Used on skin grafts until healed

Question 31

What are pressure garments

Answer 31

Constant pressure to keep scar flat Worn 23 out of 24 hours a day Worn for 18-24 months Very warm to wear

Question 32

What should a burn patient use for itching

Answer 32

They must never scratch | Give the anti histamine (Zyrtec)

Question 33

Loss of plasma in a burn patient is greatest when

Answer 33

4-6 hours after the burn injury