Burns part 1 Flashcards
What causes burns?
Are they preventable?
heat, chemicals, electrical current, and radiation
usually avoidable
Types of burn injuries
thermal burns
chemical burns
smoke inhalation injury
electrical burns
cold thermal injury
What causes thermal burns?
What determines the severity of thermal burns?
flame, flash, scald, or contact with hot objects
Severity depends on temp of burning agent and duration of contact
What causes chemical burns?
Which is harder to deal with- acidic or alkali burns? why?
acids, alkalis, and organic compounds –> batteries
alkali is harder bc they cause protein hydrolysis and melting –> draino
Where are alkalis found?
What are organic compounds?
Alkalis: in cement, oven and drain cleaners, heavy metal cleaners
Org. compounds: phenols and petroleum products
What are smoke inhalation injuries?
What do smoke inhalation injuries predict?
Why is rapid/ongoing assessment critical?
From breathing noxious chems or hot air, causing damage to respiratory tract (swelling)
Major predictor of mortality in burn victims
Important bc airway compromise and pulmonary edema can quickly develop
3 types of smoke and inhalation injuries
upper airway injury
lower airway injury
metabolic asphyxiation
Metabolic asphyxiation
Brain injury accompaniement?
Inhalation of CO or hydrogen cyanide impairs oxygen consumption by tissues –> hypoxia
Death can happen when PaO2 blood levels less than 20%
not always brain injury
Upper airway injury
-which areas are affected?
What types of burns are common here?
Mucosal burns signs and symptoms
mouth, oropharynx, and larynx
thermal burns or inhalation of hot air/steam/smoke
redness, blistering, edema
Upper airway injury
-swelling
Obstruction
Swelling can be extensive and happen fast
-eschar and edema may compromise breathing
-edema from face and neck burns can be lethal
-internal pressure from edema can narrow airway
Obstruction of airway
Lower airway injury
-which areas?
-what affects the degree of tissue damage here?
-what’s weird about the swelling pattern?
affects trachea, bronchioles, and alveoli
Damage is related to duration of exposure to toxic fumes/smoke
Pulmonary edema might not happen for 12-48 hours after burn -> might manifest as acute respiratory distress syndrome (ARDS)
What should you assess for in a lower airway injury?
facial burns
singed nasal hairs
hoarseness –> talk to them so you know their airway is good
painful swallowing
dark oral/nasal membranes
carbonaceous sputum
history of being burnded in enclosed space
clothing burns around neck and chest
What causes electrical burns?
Where does it cause damage?
heat from electric current
nerves and vessels –> may lead to tissue anoxia
what determines the severity of an electrical burn?
amount of voltage
tissue resistance (density)
current pathways (go through vital organs?)
surface area
length of time current was sustained
How can electrical burns cause thermal burns?
How can electrical burns cause fractures?
-sparks could ignite clothing and cause thermal flash injury
-current can cause muscle spasms that fracture bones
Why is it hard to determine extent of electrical injury?
damage is below the skin
What are other risk factors from electrical burns?
dysrhythmias/ cardiac arrest
Severe metabolic acidosis
Myoglobinuria
Acute tubular necrosis and acute kidney injury
-myoglobin from damaged muscles and hemoglobin from damaged RBCs go to kidneys and block renal tubules
Classification of burn injuries
Determined by:
depth of burn
extent of burn in percent of TBSA (total body surface area)
location of burn
Age of patient, previous burns, circumstances/complications
Depth of burn
first, second, third, and fourth
Partial thickness = first and second
full thickness = third and fourth
Superficial partial thickess = 1st degree - involves epidermis
Deep partial-thickness burn = 2nd degree - involves dermis
Full-thickness burn = 3rd and 4th - involves all skin, nerve endings, fat, muscle, and bone
- 3rd is muscle, 4th is bone
Extent of burn: 2 tools to use DON’T NEED TO CALCULATE- JUST KNOW NAME OF EQUATION
Lund-Browder chart (more accurate)
-head = 7
-neck = 2
-arms = 4, 3, 3
-chest = 13
-back = 13
-butt = 5
- legs = 9.5, 7, 3.5
Rule of nines (for initial assessment)
In kids, palms are 1%
Severity based on location
face, neck, chest = respiratory obstruction from edema/eschar
hands, feet, joints, eyes = self-care difficulties
ears, nose, butt, and perineum = high infection risk
What do circumferential burns do?
What is compartment syndrome?
Circumferential burns of extremeties cause circulation problems distal to burns
pressure within muscles gets out of control –> nerve damage to affected extremity
Risk factors for severity of burn injuries
Preexisting, heart, lung, or kidney disease
Also diabetes and peripheral vascular disease –> delayed healing
Physical weakness due to alc/ drugs/ malnutrition make healing harder
Concurrent injuries lead to more dif time recovering
Prehospital care steps for a small thermal burn
-remove person from burn source and stop burning
-protect yourself while doing this
-cover with clean, cool, tap water-dampened towel
-cooling within 1 min helps minimize depth of injury
