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Disease II > Smoke Inhalation > Flashcards

Smoke Inhalation Flashcards

(49 cards)

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1
Q

Define inhalation injury

A

Nonspecific term respiratory tract or tissue damage from heat, smoke, or chemical irritants

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2
Q

Define burn injury

A

Traumatic injury to skin or other tissue mostly caused by thermal or other acute exposures

Occurs when skin or other tissue is destroyed

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3
Q

What causes burn injury

A

Heat

Electrical damage

Friction

Chemicals

Radiation

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4
Q

What factors influence the severity of smoke inhalation

A

Duration

Chemical

Size and diameter

Temp of gas

Age

Pre-existing health

Size and depth of burns

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5
Q

What are the two types of smoke

A

Pyrolysis

Combustion

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6
Q

What are the two types of common toxins found in smoke

A

Carbon monoxide

Hydrogen cyanide

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7
Q

Hazards of skin burns

A

Destroys the barrier from pathogens

Barrier contains water

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8
Q

What is the “rule of 9s”

A

Provides a quick estimate of the total estimate of body surface burned

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9
Q

According to the nines rule, the: head is how much

A

Nine per side

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10
Q

According to the nines rule, the: arm is how much

A

9 per arm

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11
Q

According to the nines rule, the: body is how much

A

18 front and back

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12
Q

According to the nines rule, the: genitals is how much

A

1

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13
Q

According to the nines rule, the: legs is how much

A

18 each

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14
Q

Explain the correlation between age, body surface burns and mortality

A

The older you are, less burns have higher mortality

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15
Q

Explain the characteristics of a superficial burn

A

First degree

Epidermal

No blisters

Bleach with pressure

No pain in 2-3 days

Heals in 6 with no scarring

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16
Q

What are the characteristics of partial thickness burns

A

Epidermis and some dermis

Superficial or deep classification

Second degree

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17
Q

What are the characteristics of superficial partial thickness burns

A

Blisters in 24hrs

first looks like only epidermis; dermis appears damaged after 12-24 hrs

Heals in 7-21 days

Usually doesn’t scare, but pigment change

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18
Q

What are the characteristics of deep partial thickness burns

A

Reaches deeper dermis

Damage to follicles and glandular tissue

Pain only to pressure

Cheesy white to red

Hypertrophic scarring

If it fails to heal in 2 wks it is cosmetically and functionally a full-thickness burn

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19
Q

What are the characteristics of full thickness burns

A

Through dermis to subcutaneous

Dry inelastic doesn’t blanch to pressure

Burn eschar remains intact, but once separated unhealed granulation tissue remains

May not heal on there own

If it reaches muscle or bone can be life-threatening

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20
Q

How is thermal injury caused

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A

Upper AW usually absorbs heat, so it absorbs excessive heat

21
Q

What does thermal injury cause

Study These Flashcards
A

Pharyngeal edema and swelling

Stridor

Hoarseness

Altered voice

Painful swallow

22
Q

Does thermal injury usually occur below larynx

Study These Flashcards
A

Not unless it is steam inhalation

23
Q

What protects the lower respiratory tract from thermal injury

Study These Flashcards
A

Upper AW which can cool the air/ absorb (Heat sink)

24
Q

What are the stages of smoke inhalation

Study These Flashcards
A

Early

Intermediate

Late

25
What happens during the early stage of smoke inhalation
Tracheobrachial tree is inflamed Bronchospasm Secretions move into AW Smoke slows down mucosal cilliary transport
26
Cardiogenic hazards associated with smoke inhalation (early stage)
Hypovolemia Hypoxia Increased systemic and pul resistance CO poisoning
27
What happens to vessels with smoke inhalation injury during early stage
Mediators increase permeability Leak into third space Much fluid but no in circulation
28
When does generalization of edema peak with smoke inhalation injury
8-24 hours
29
What is the timeline of intermediate burn inhalation injury
2-5 days
30
What happens during intermediate smoke inhalation injury
Tracheobronchial tree becomes necrotic and sloughs ARDS may develop More mucus
31
What occurs during late smoke inhalation injury
Infection of body surface PNA Pulmonary Embolism Restrictive or obstructive disorder
32
What problem accompany CO
SpO2 misleading
33
How does cyanide alter the body
In the mitochondria it binds to cytochrome oxidase enzyme so it’s unable to metabolize O2
34
What are signs of smoke inhalation
Soot Oral or laryngeal edema Cyanosis Cough with sputum
35
Is smoke inhalation usually restrictive or obstructive
Usually restrictive, but can be obstructive with airway construction
36
What percentage indicates COHB intoxication
Greater than 20 percent
37
What are the key initial assessment for patients with burn or smoke injury
ABC Respiratory status Cardiovascular status Extent of burns Depth of burns
38
What questions do you ask patients suspected on smoke inhalation
Closed or open space What type of material was burning Was CO or cyanide produced Was the patient conscious on arrival Does history indicate test for blood alcohol levels, for poisoning, or O.D.
39
What is a ideal ETT for a patient with smoke inhalation
8.0-8.5 for bronchoscopy
40
Benefits of covering burn wounds
Prevent: shock Fluid loss Heat loss Pain
41
How do we prevent infection for burn victims
Reverse isolation Positive pressure room Air filtration Wound covering
42
How do you treat CO poisoning
High FiO2 Hyperbaric oxygen
43
What medication do you treat cyanide poisoning with
Hydoxocobalamin IV (Urine looks grape) Can’t do ABG
44
What aerosols are given to burn patients
5k-10k heparin in 3mL Q4 Alternating with 20% NAC Q4 (For seven days)
45
How does NAC and heparin aid in burn care
Reduces the formation of fibrin casts in the AW Serve as scavengers for reactive O2 species and may reduce injury
46
How do you treat secretions for patients with smoke inhalation injury
Sx IPV Bronchoscopy if needed
47
Combustion gas expectation
Explodes with oxygen
48
Pyrolysis
Smolders in low oxygen
49
Why with CO poisoning is there a decrease in bicarbonate and pH with a low CO2
Inability to use O2 causes anaerobic metabolism and creating lactic acid

Disease II (14 decks)

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