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NNSOCM 2023 > SKIN & BURNS W3 > Flashcards

SKIN & BURNS W3 Flashcards

1
Q

Skin consist of which 4 components

A
  1. Skin
  2. Hair
  3. Sweat glands
  4. Oil glands
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2
Q

What is the function of the skin?

A
  1. Protection
  2. Temperature regulation
  3. Waste elimination
  4. Absorb vitamin D
  5. Sensation
  6. Blood reservoir
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3
Q

What are the 3 layers of the skin?

A

Epidermis
Dermis
Subcutis

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4
Q

The functions of the epidermis are?

A
  1. Protect the body
  2. Keep fluids inside the body
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5
Q

Which components do we find in the dermis?

A
  1. Nerves
  2. Sweat glands
  3. Hair follicles
  4. Large Capillary beds
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6
Q

What are the primary functions of subcutis?

A
  1. Isolation (fat)
  2. Blood supply (vessels)
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7
Q

Jaundice is a sign of…

A

Lever failure (eyes and skin turn yellow due to excessive bilirubin levels)

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8
Q

What are the primary function of Melanin (pigments)

A
  1. Protect against UV-Radiation
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9
Q

Urticaria is a sign/symptom of

A

Systemic allergic reaction (analphylaxia)

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10
Q

An incision is typically…

A

Longer than deep

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11
Q

Name the 3 phases of wound healing

A
  1. Hemostatic phase
  2. Inflammatory phase
  3. Proliferative phase
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12
Q

Wound healing can be disturbed by…

A
  1. Infection
  2. Suboptimal surgical technique
  3. Dead tissue
  4. Smoking (bad perfusion)
  5. Leakage of plasma protein
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13
Q

Important steps in wound management

A
  1. Hemostasis
  2. Pain control
  3. Remove foreign objects
  4. Cleaning of wound
  5. Keep wound moist
  6. Inspect for infection
  7. Change dressing (every 24-48h)
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14
Q

What should you consider especially with large, dirty, crush or bite wounds?

A

Keep them open and clean

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15
Q

What are the impaired skin functions caused by burns?

A
  1. Fluid balance (barrier function lost)
  2. Thermoregulation (evaporation)
  3. Protection (against microbes)
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16
Q

Signs & symptoms of inhalation injury?

A
  1. Swelling of tongue
  2. Burns in mouth/nose
  3. Stridor/altered voice
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17
Q

How do we classify severity of burns?

A
  1. Degree (superficial)
  2. Degree (partial thickness)
  3. Degree (full thickness
  4. Degree (underlying organs etc.)
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18
Q

What are the three zones of a burn injury?

A
  1. Zone of coagulation/necrosis
  2. Zone of stasis
  3. Zone of hyperemia
19
Q

Considering the rule of 9 how many percentages covers the whole torso?

A

36% Front and back combined

20
Q

Considering the palmar rule how many percentages can you cover with your hand?

A

Approximately 1%

21
Q
  1. Degree burns is minor tissue damage to the…
A

Epidermis

22
Q
  1. Degree burn is damage to…
A

Epidermis + variable part of dermis

23
Q

What are the charateristiscs of 2. degree burns?

A
  1. Blisters
  2. Swelling
  3. Pain
  4. Detachment of hair
24
Q

Dense or waxy burns with damage to all layers of the skin are classified as…

A
  1. Degree burns
25
Q

In a 3. degree burn were can you expect painful 2. degree burns?

A

Most commonly around the edges of the 3. degree burn

26
Q

What is delayed necrosis?

A

The progression of a burn wound over the duration of 3-5 days

27
Q

Why are infections (sepsis) one of the most common complications of burn injuries?

A

The protective epidermis is damaged/gone so bacteria and other microbes can easily enter the body

28
Q

Name some of the burns sites that suggests the CAX needs a hospital specialised in burn injuries?

A

Hands
Feet
Face
Genitalia
TBSA >20%
Deep joint near burns
Inhalation injuries
Circumferencial burns

29
Q

Signs & symptoms of CO poisoning?

A
  1. Confusion
  2. Headache
  3. Tachycardia, arrhythmia
  4. Vomiting
  5. Dilated pupils
  6. Cyanosis
  7. Seizure
  8. Bounding pulse (patient feels his pulse harder)
30
Q

What is the ISR rule of 10?

A

Fluid resuscitation rate = % TBSA x 10ml/hr for adults 40-80kg
For every 10kg above 80kg, increase flow rate by 100ml/hr

31
Q

What is the fluid resuscitation rate (ISR) for an adult weighting 100kgs with a 25% TBSA?

A

450ml/hr
25% TBSA x 10ml/hr + 200ml/hr =450ml/hr

32
Q

Electrical discharge to the body can cause the following 3 things

A
  1. Acute renal failure
  2. Cardiac arrythmias
  3. Compartment syndrome to extremities
33
Q

Name the 4 different mechanisms of burn injuries

A
  1. Thermal
  2. Chemical
  3. Electrical
  4. Radiation
34
Q

In chemical burns what does acid do?

A

Causes coagulation necrosis of tissue

35
Q

In chemical burns what does alkaline substances do?

A

Causes liquefaction necrosis of tissue

36
Q

What are the 3 stages of radiation burns

A
  1. Intense burning/tingeling
  2. Symptom free interval
  3. Red skin (erythema)
37
Q

CASE:
CAX has been in a burning building and now presents with:
M: No massive bleeds
A: Patent, singed nostril hairs, rusty voice
R: Tachypnea, bilateral respiration, cyanosis on nails
C: Tachycardia, bounding pulse
H: Dialated pupils, nausea, confusion, headache
O: 1.degree burns on both arms and in the face
P: Does not express pain.

What is your FIRST concern?

A

You need to consider the possibility of the airway becoming obstructed soon -> Find CRIC set and be ready…
Reassess airway frequently

38
Q

Per TCCC what are the preferred type of fluid for burn injury resuscitation?

A
  1. Lactated ringers
  2. Isotonic NaCl (saline)
39
Q

What are the resuscitation goal in fluid therapy for burn injuries?

A

Urine output of 30-50ml/h

40
Q

What are one of the cons of using prefabricated burn shields for burn injuries?

A

They might cause hypothermia

41
Q

What might be the issue with putting bandage/cling film circumflexial on burn injuries?

A

Tissue may expand/swell and circumflexial bandage might be too tight

42
Q

A puncture wound is typically…

A

Deeper than wide

43
Q

A patient with a TBSA >30% is likely to have…

A

Systemic/globalised edeema

NNSOCM 2023 (16 decks)

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