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Principles 2 > Exam 1 (Burns) > Flashcards

Exam 1 (Burns) Flashcards

1
Q

What is the depth of thermal injury related to?

A
  • Contact temp.
  • Duration
  • Thickness of skin
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2
Q

Heat burns usually involve the?

A

Epidermis & dermis

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3
Q

An electrical burn magnitude depends on what 3 things?

A
  • Pathway of current.
  • Resistance to current flow.
  • Strength & duration of current flow.
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4
Q

Chemical burns cause what 3 caustic reactions?

A
  • pH alteration,
  • cell membrane disruption.
  • Toxic effect on metabolism
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5
Q

An acid chemical burn causes what kind of necrosis?

A

Necrosis by coagulation

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6
Q

An alkali chemical burn causes what kind of necrosis?

A

Necrosis by liquefaction

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7
Q

Radiation burns magnitude depends on?

A
  • Dose & time of exposure.
  • Type of particles
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8
Q

How long does it take burns to show their extend?

A

12-48hrs

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9
Q

Who is at higher risk for deeper burns?

A

Adults >55 or kids <5yrs

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10
Q

Which burn does not calculate TBSA?

A

1st degree burns

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11
Q

How long does it take for superficial 2nd degree burns to heal?

A

10 - 14 days

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12
Q

Which burn has white patches?

A

Deep Partial 2nd degree burns

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13
Q

Which burn has decreased moisture as its hallmark sign?

A

Deep partial thickness (2nd degree burn)

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14
Q

How long does it take for deep partial 2nd degree burns to heal?

A

21-28 days

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15
Q

Which burns usually have no bleeding?

A

3rd degree

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16
Q

What areas of the body account for 18% each?

A
  • Each leg.
  • Anterior trunk.
  • Posterior trunk.
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17
Q

In infants, the head & neck area account for how much BSA?

A

21%

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18
Q

What is the palmar method?

A

Pt’s hand w/ fingers together accounts for 1% of BSA

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19
Q

What burn % needs IV resuscitation?

A

> 20% TBSA

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20
Q

What are the consequences of fluid under resuscitation in burns?

A
  • Decreased perfusion.
  • Burn shock.
  • End organ failure
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21
Q

What are the consequences of fluid over resuscitation in burns?

A
  • Abd compartment syndrome.
  • Pulm edema/ARDS
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22
Q

What is the body’s general response to burns & how long can it last?

A
  • Auto-cannibalism.
  • Can last months
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23
Q

Explain carbohydrate metabolism in burns?

A
  • Increased cortisol, catecholamines & glucagon results in hepatic gluconeogenesis.
  • peripheral insulin resistance
  • impaired intracellular glucose transport.
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24
Q

Explain lipid metabolism in burns?

A

Accelerated lipolysis → elevated glucagon, TNF, Interlukens, FFA & ATP

25
Q

Why treat burns with beta-blockers?

A

To decreases lipid oxidation, which leads to cytotoxic substances. Beta blockers decrease metabolic rate, therefore ↓ lipid oxidation

26
Q

What mediators cause vasodilation in burns?

A

Histamines, prostaglandins & cytokines

27
Q

What is the Parkland formula?

A
  • 4mL x kg x %BSA
  • 2mL x kg x %BSA in 1st 8hrs, then
  • 2mL x kg x %BSA in next 16hrs
28
Q

What is the US Army’s Rule of 10 for adults?

A
  • 10mL/hr x TBSA.
  • If >80kg, add 100mL per 10kg
29
Q

What is the targeted U/O for burns?

A

1cc/kg/hr

30
Q

LR or NS have the risk to cause ____ ___ ___ in burns?

A

Hypernatremic hyperchloremic acidosis (non-gap acidosis)

31
Q

With what percentage of burns does capillary permeability increase in peds?

A

Burns > 20-25%

32
Q

What is added to pediatric burns weighing <20 kg?

A

Add maintenance rate of D5LR

33
Q

When is the adult crystalloid formula used in pediatrics?

A

When >40kg

34
Q

When does the “flow” phase start in burn patients?

A

At 72-96hrs post burn

35
Q

What is applied to eye lids in facial burns? What about the eyes?

A
  • Bacitracin to the eyelids.
  • Erythromycin to the eyes.
36
Q

What is a normal COHb level for smokers?

A

4 – 9%

37
Q

At what COHb levels could seizures & ARF occur?

A

20-25%

38
Q

Burned plastics can lead to what kind of poisoning?

A

Cyanide

39
Q

What kind of diet do burn victims need?

A

High calorie & high protein

40
Q

When is Scc not used in burn victims?

A

After the First 24hrs

41
Q

Does the sensitivity to depolarizers correlate to the severity of burn?

A

No

42
Q

What happens to nAChR’s in burns?

A

They are upregulated for months to 2yrs

43
Q

What kind of warming devices are used for burn patients?

A

Convection

44
Q

What is the approximate TBSA of the lungs in %?

A

> 40%

45
Q

What is the concern when inducing a burn Pt with etomidate?

A

Adrenal insufficiency

46
Q

What is the concern when inducing burn Pt with ketamine?

A

SNS reserve.

47
Q

What med is often used for dressing changes in burn Pts?

A

Ketamine

48
Q

What can be used off-label for burns?

A

Factor 7 & TXA

49
Q

What is the goal CVP for burn & what is done if not at goal?

A
  • Goal: 6-8mmHg.
  • Increased IVF rate by 20-25%
50
Q

What is the target pCO2 for burns, what about pH?

A
  • 30-35 mm Hg
  • or pH>7.20
51
Q

What is nebulized and given with albuterol for inhalation burns q4h? Why?

A
  • 5,000 units heparin
  • Nebulized heparin can cause bronchospams
52
Q

Why is albuterol given with heparin?

A

Because heparin can cause bronchospasm

53
Q

What is the max dose of Tumescent LA?

A

55mg/kg

54
Q

What is the mortality rate for a burn patient with an open abdomen?

A

90%

55
Q

What bladder pressure indicates early intra-abdominal HTN?

A

> 12 mmHg

56
Q

What is the pressure for abdominal compartment syndrome?

A

> 20 mmHg

57
Q

Which burn victims get a tetanus booster?

A

If it’s been >5yrs

58
Q

Are steroids and IV Abx indicated for burns?

A

No

59
Q

Where is Silvadene not applied to?

A

The face

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