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Clinical Medicine 4 > Thermal burns and colds > Flashcards

Thermal burns and colds Flashcards

(104 cards)

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1
Q

Thermal burns most common in who?

A

Males

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2
Q

2 most severe burns?

A
  1. Flame

2. Liquid scald

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3
Q

What degree of burn is caused by sunburn and flashburns?

A

1st degree

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5
Q

Which degree of burn has no blisters, is red, and painful?

A

1st degree

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6
Q

Where is the damage in 1st degree burn and how severe?

A

Minor epithelial damage to dermis

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7
Q

Splash scalds can cause which degree burn?

A

2nd degree

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9
Q

Two types of 2nd degree burn based on depth?

A
  1. Superficial partial thickness

2. Deep partial thickness

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10
Q

Wall thickness of superficial and deep partial thickness burns?

A

Superficial=Thin-walled

Deep=Thick-walled

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11
Q

How long is healing of 2nd degree superficial partial thickness burns? Scarring?

A

2-3 weeks. No scarring

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12
Q

How long is healing of 2nd degree deep partial thickness burns? Scarring?

A

3-6 week heal. Scar likely.

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13
Q

Decreased 2-point discrimination in which type of burn?

A

2nd degree deep partial thickness

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14
Q

Which degree burn caused by immersion scalds, flame burns, chemical burns, and high voltage ?

A

3rd degree

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15
Q

Which degree is full thickness of dermis and epidermis?

A

3rd degree

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16
Q

Which degree burn are white leather appearance with underlying clotted vessels?

A

3rd degree

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17
Q

Do 3rd degree burns have sensation?

A

No

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18
Q

A 3rd degree burn >1cm requires what to heal?

A

Grafting

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19
Q

How does a 4th degree burn occur?

A

Prolonged exposure to 3rd degree burn cause

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20
Q

Which burn is full-thickness destruction of skin, SC tissue, fascia, muscle, and bone?

A

4th degree

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21
Q

What does a 4th degree burn require?

A

Surgical debridment and repair

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22
Q

Which burn is red, blanched white skin?

A

2nd degree deep partial thickness

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23
Q

Which burn is very tender, thin-walled fluid filled blisters?

A

2nd degree superficial partial thickness

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24
Q

Relationship between age and survival for burn size?

A

Inverse relationship between age and survival for any burn size. lower age=better survival

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25
Q

Palm of hand is what percent of Total Body Surface Area?

A

1%

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26
Q

Which burns not included in TBSA when calculating burn percent?

A

1st degree not included

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27
Inhalation injury to upper airway can swell within how long?
12-24h after injry
28
When to intubate upper airway inhalation injury?
Soot around nostrils even if ok now
29
What is an escarotomy?
Cut down skin until get to non-burned bleeding skin.
30
What does escarotomy reduce risk of?
Compartment sybdrome in circumferential burns to arms and legs
31
How many IVs for Moderate Burns (20% TSBA)?
1 large bore IV
32
How many IVs for Severe Burns?
2 large bore IVs
33
Maximal Edema occurs when in burns?
24-48h
34
Kids need what in addition to IV fluids in major burns?
D5W d/t hypoglycemia
35
What does Over hydration increases risk of 3-5 days postburn?
ARDS
36
What guides IV fluid resuscitation in burns?
Urine output guides if IV hydration enough or not
37
Goal urine burns for children and adults?
<2 years= 2ml/kg/hr in children <2 years Older children=1 ml/kg/hr Adults=30-40ml/h (0.3-0.5 ml/kg/hr)
38
Why do kids easily become hypoglycemis with burns?
In a catabolic state and trying to make proteins
39
Treatment for severe burns?
COLD WATER and keep PT warm
40
How often change dressings in severe burns
BID
41
When surgery required in severe burns?
If not healed in 3 weeks
42
PTs with major burns should be transported where?
Burn center
43
Do prophylactic abx reduce infection in burns?
No
44
What does reduce infection risk in burns?
Local wound care
45
Low Voltage burn below what?
<1000 V
46
Low Voltage main cause of which heart arrythmia?
VF
47
High Current at which voltage?
>1000
48
High Current cause of which arrythmia?
Asystole
49
Low Voltage burns depth?
Superficial
50
High Voltage burn depth?
Deep
51
Low Volatage is AC or DC?
AC
52
High Voltage is AC, DC, or both?
Both
53
AC or DC current easier to surpass let-go current?
AC. Elbow to flex and bring the body closer to the source.
54
Rhabdo more common in low or high voltage?
High
55
Low Voltage duration of contact?
Prolonged
56
High Voltage duration of contact?
Brief
57
"Kissing Point Lesion" with which voltage?
High voltage
58
Main complication in high voltage exposure?
Neurologic (transient agitation/confusion, delayed spinal ability)
59
Tx for low voltage burn?
Clean and dress with topical abx. Splint, elevate, and reassess in 48-72h
60
Tx for high voltage burn?
EKG! IV resus, foley, admit, t/f to burn center.
61
Degrees of Frost Bite?
1st, 2nd, 3rd, 4th (just like burns)
62
Frost Bite is due to what sort of exposure?
Prolonged exposure to cold climate -10C. Feels numb for more than a few minutes.
63
Frost Bite symptoms are sudden or progressive?
Progressive
64
What happens to fluids in Frost Bite?
Creezing and crystalization of fluids in interstitial space and cellular space from progressive exposure to freezing temp
65
What history doubles risk of frost bit?
Previous cold injury
66
What does nicotine do to vessels and frost bit?
Constricts vessels and makes frostbit worse
67
Does the initial presentation of frost bite damage indicate the end point of tissue damage?
No. It gets worse over time.
68
Which degree frost bite is central, white plaque with ring of hyperemia?
First degree frost bite
69
Which layer of skin damaged in First degree frost bite?
Outter layer
70
How long first degree frost bite takes to heal?
Over time
71
Which frost bite looks like heat injury? Clear blisters, hard outter skin with resiliant tissue under, and lots of edema.
Second degree frost bite
72
Which degree frost bite is blue-gray?
Third degree frost bite
73
Eschars and necrotic tissue occurs in which frost bite degree?
3rd
74
T/F Third degree frost bite is deep to the dermis?
True
75
Which degree of frost bite includs the muscle, bone, tendon, mottled non-blanching skin, and spontaneous amputation?
4th degree frost bite
76
How is frost bite dx made?
Clinical
77
Tx for frost bite?
Reward ASAP w/40-42C circulating warm water. Dry, loose clothes. Sterile and nonadherent dressings BID-QID. Topical aloe q6h. Aspirate blisters. Elevate and splint.
78
What sort of diet for Frost Bite treatment?
High calorie, high protein diet
79
Update which vaccine with frost bite?
Tetanus
80
How long can healing from frost bite take?
6-12 months
81
Which cold injury has no crystal formation and no tissue loss?
Frostnip
82
Frostnip or Frostbite? Blanching of skin with transient numbness and paraesthesias that resolve with rewarming
Frostnip
83
What is Trench Foot?
Prlonged exposure to wet, nonfreezing cold
84
Who gets Trench Foot?
Usually homeless
85
Crystal formation in Trench Foot?
No
86
Tx for Trench Foot?
Keep feet warm and dry. Reversible.
87
What are painful, inflammatory lesions from chronic repeated exposure to damp, nonfreezing cold temperatures?
Pernio
88
Pernio damages what vascular component?
Capillary beds
89
Pernio resolve in how long?
7-14 days
90
Hypothermia Mild, Moderate, and Severe temps? Mortality?
Mild 32-35C (89.6-95F)– low mortality/morbidity Moderate 28-32C (68-89.6F)– 21% mortality Severe <28C (<68F)– 40% mortality
91
Which hypothermia does one shiver? When does shivering stop?
Mild. | Stops at <31C Moderate
92
When does Paradoxical Undressing occur?
Moderate hypothermia
93
Which arrythmia does severe hypothermia cause?
VFib
94
When can defibrillate Vfib from hypothermia?
≥30C
95
Tx for hypothermia?
Rapid reward with hot water bottles in axillae, groin, abdomen.
96
Hyperthermia when core temp above what?
38.5C/101.3F
97
What temp is catastrophic hyperthermia?
41.1C
98
What is the #1 weather mortality, esp in elderly?
Hyperthermia
99
Temp change in Heat Exhaustion?
Normal to slight elevation in core temp
100
Tx for Heat Exhaustion?
Cool off, IV fluids, time
101
Heat Stroke when core temp above what and what other sign?
>40.5C/104.9F with anhydrosis (not sweating)
102
BP and HR in Heat Stroke?
Hypotensive, HR>130
103
Tx for Heat Stroke?
Get temp <40C within 30 minutes. Ice baths, etc.
104
Tx for NMS or Malignant Hyperthermia?
Dantrolene
105
What are Heat Cramps?
Brief muscle cramps during or after exercise in hot environment d/t muscle fatigue and lyte abnormalities
106
Tx for Heat Cramps?
Rest, hydrate

Clinical Medicine 4 (10 decks)

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