Burns Quiz Flashcards
What are the signs and symptoms of airway burns?
- evidence of burns to upper torso, face and neck
- facial and upper airway oedema
- sooty sputum
- burns that occurred in an enclosed space
- singed facial hair
- respiratory distress (dyspnoea, wheeze associated tachycadia + stridor)
- hypoxia (restlessness, irritability, cyanosis, decreased GCS)
What are AV goals in treating the burns patient?
- Effective cooling of the burn
- pain management
- hydration
What are three functions of the skin?
- Fluid retention
- Protective barrier
- Temperature regulation
What are the considerations when assessing burn severity?
- depth of burn (classification)
- cause of the burn
- percentage of the burn area
- location of the burn
- age of the patient
- patients underlying health
- other distracting injuries
What are the classifications of burns?
- superficial
- partial thickness (superficial, mid, deep dermal)
- full thickness
How long should you cool a burn?
- 20 mins (cooling time prior to AV arrival to be included in the timeframe)
When would you stop cooling?
- when the patient begins to shiver
- temperature <35 degrees
What are the three zones in the jacksons burn wound model?
Zone of hyperaemia (superficial)
- hyperperfused and will recover if no complications
Zone of stasis (partial thickness)
- tissue around burn hypoperfused and may be salvageable
Zone of coagulation (full thickness)
- irreversile damage to cell and coagulation of proteins
Which type of burns do we consider for fluid administration?
- any partial or full thickness burns
What percentage of burns must a patient have to get IV fluids?
- age > 15 yrs x TBSA >15% = (TBSA x pt weight (kg) = volume in ml. To be administered over 2 hours from the time of burn
- Age 12-15, TBSA > 10% = (3 x TBSA % x pt weight (kg) = volume ml to be given in 24 hours, half to be admin in the first 8 hours
Where would you transport a person ages 12-15 years with 10% burns in metro melbourne?
- RCH
- highest level of care (rural)
What is the percentage breakdown of the body using the wallace rule of nines?
- head 9%
- torso 18% front 18% back
- arm 9% each
- Leg 18 % each
- Groin 1%
why is the patient temperature critical in the management of burns?
- hypothermia patients had significantly higher mortality
- large doses of IV fluids can reduce body temp
- loss of skin - therefore loss of temperature regulation
- greater % burn area, greater risk of hypothermia
- hypothermia = trauma triage of death
List 5 complications of burns
- depth of burn can increase over the first 48 hours
- hypovolaemia (fluid loss)
- hyper metabolic state
- infection/sepsis
- scarring
- psychological
- DVT/PE (prolonged bed rest)
- Airway burns - aspiration, pneumonia, pulmonary oedema, carbon monoxide poisioning
Calculate the fluid doses for the following:
* Person 1. 24yo (80kg), with 30% full thickness burns
* Person 2. 10yo (33kg) 36% burns
* Person 3. 90yo (50kg) 20% burns
* Person 4. 50yo (60kg) 40% burns
* Person 5. 12yo (50kg) 10% burns
* Person 6. 15yo (70 kg) 15% burns
* Person 7. 34yo (90 kg) 80% burns
* Person 8. 11yo (36kg) 15% burns
* Person 9. 10yo (33kg) 70% burns
* Person 10. 12yo (36kg) 60% burns
- Person 1. 2400mls. = 1200mls per hour. (first 2 hours)
- Person 2. 3564mls = 222.75mls per hour for the first 8 hours.
- Person 3. 1000mls = 500mls per hour (first 2 hours)
- Person 4. 2400mls.= 1200mls per hour (first 2 hours)
- Person 5. 1500mls = 93 mls per hour for first 8 hours.
- Person 6. 1050mls = 525 mls per hour (first 2 hours)
- Person 7. 7200mls = 3600 mls per hour (first 2 hours)
- Person 8. 1620ml = 101.25 mls per hour for the first 8 hours.
- Person 9. 6930mls = 433mls per hour for the first 8 hours.
- Person 10. 6480mls = 405mls per hour for the first 8 hours.
- Only administer IV fluids for ages 12 and above. Extra calculations here for your maths practise!
