Thermal Injuries Flashcards

1
Q

In Thermal ijuries what are indications for early intubation

A

40-50% TBSA
extensive and deep facial burns
burns to mouth or circumferential neck burns
burns in children
prolonged estimated transport time

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2
Q

What is one simple BLS manouver that you can do to minimise risk of glottal oedema in burns victims

A

elevate to 30’

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3
Q

If you suspect someone has inhalation injury what is the management of this

A

intubaion with a size 7.5-8ET tube to facilitate bronchoscopy

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4
Q

what investigations should always be performed in someone with ?inhalation injuries

A

CXR + ABG

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5
Q

When is BURNS fluid resus needed inburns

A

If there are any Partial (deep) -> full thickness burns or >20% TBSA

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6
Q

What is the fluid resus equation for adults in burns

A

2ml x kg x %TBSA

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7
Q

What is the fluid resus equation for paeds in burns

what about if theyre under 30 kg?

A

3 ml x Kg x %TBSA

add maintenence fluids of 5% dex

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8
Q

what is the equation for maintenence fluids in paeds

A

0-10 KG:
10ml xkg x hr

11-20kg
1000 + 50ml x kg x hr (for every kilo over 10)

> 20Kg
2000 + 20ml x kg x hr (every kilo oer 20)

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9
Q

How does fluid resus change in electric burns in adults and children over 30kg

A

in adults and children over 30kg

4ml x kg x hr to mainatin UO 100ml/hr

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10
Q

How does fluid resus change in electrical burns in children under 30kg

A

1-1.5ml x kg x hr

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11
Q

what should a carboxyhaemoglobin level of >10 be a warning of

A

inhalation injury

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12
Q

when should you think about CO exposure

A

fires in enclosed spaces

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13
Q

what are 2 imprtan steps in co exposure

A

100% O2
carbxyhaemoglobin levels

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14
Q

what should you be wary of in circumferential burns, limbs or abdomen/pelvis

A

compartment syndrome may occur needing escharoomy / fasciotomy

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15
Q

how would you manage patient who is suffering from 30% partial burns, tachy, no airway issues

A

O2 as needed
IVF burns resus fluids
NGT in anyone with burns >20% TBSA
clean skin and cover burns do not break blisters

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16
Q

if a burns pt has dark urine and minimal UO what may be occuring

how do you treat

A

rhabdomylosis

IVF until 100ml x hr urine

mannitol

17
Q

why is mannitol useful in rhabdomylosis

A

mops up free radicals and an osmotic diuretic

18
Q

how to treat frost bite

A

moist air rewarming

19
Q

what is the pathophysiology of frost bite

A

ice crystalisation f cell membrane causing microvascular occlusion and anoxia

20
Q

what is the pathophysiology of non freezing cold injuries

A

long exposure to wet/cold conditions abd teps just above freezing causing stasis and vascular occlusion with alternating vasospasm to dilation (numb to painful)

21
Q

how do you treat non freezing ocld injury

A

blankets
circulating war, water of 40’
po hot fluids

22
Q

what happens in reperfusion syndrome

A

hyperkal
high lactate

23
Q

what is classed as severe hypothermia

A

T < 32