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NB506 Trauma > Thermal Trauma > Flashcards

Thermal Trauma Flashcards

1
Q

Layers of the Skin

A
  • Epidermis - outer layer
  • Dermis - nerve endings, blood vessels
  • Subcutaneous - fat and muscle
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2
Q

Severity of Burns

A
  • Superficial Epidermal Burns
  • Superficial Dermal Burns
  • Deep Dermal Thickness Burns
  • Full Thickness Burns
  • 4th Degree
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3
Q

Superficial Epidermal Burns

A
  • Involves the epidermis only
  • Red and painful
  • No blisters
  • Heals within 7 days
  • No scarring
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4
Q

Superficial Dermal Burns

A
  • Involves the epidermis and upper dermis
  • Pale pink in colour
  • Fine blisters
  • Blanches to pressure
  • Extremely painfu;
  • Heals within 14 day
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5
Q

Deep Dermal Thickness Burns

A
  • Involves epidermis and significant part of dermis
  • May blister
  • No CRT
  • White/pale pink/ blotchy red
  • Decreased sensation
  • Heals over 21 days
  • 81% chance of scarring
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6
Q

Full Thickness Burns

A
  • Epidermis, dermis and cell adnexal structures destroyed
  • White/waxy/charred
  • No blisters
  • Will scar
  • Dry
  • Can require skin graft
  • Prone to infection
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7
Q

4th Degree

A
  • Involves muscle or bone
  • Leads to loss of burned part
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8
Q

Adult Rule of 9

A
  • Head - 9
  • Arms - 9
  • Front/Back - 18
  • Legs - 18
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9
Q

Baby Rule of 9

A
  • Head - 18
  • Front/Back - 18
  • Legs - 13.5
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9
Q

Rule of Palm

A

The palm equates to 1% burn coverage so multiple palms across the body can be used to estimate the percentage cover

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9
Q

Types of Inhilation Injury

A

Thermal - hot steam 4,000 times worse than dry air

Asphyxiation/Smoke inhalation - Carbon monoxide, cyanide gas, particulate matter

Delayed toxin-induced lung injury - may manifest after several days, severity related to composition of inhaled gas and duration of exposure

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10
Q

Inhilation Injuries; Signs and Symptoms

A
  • Singed/abscent facial hair
  • Facial burns
  • Difficulty speaking, hoarness or stridor
  • Soot in and around oropharynx
  • Oropharyngeal oedema
  • Crackles auscultated in lungs
  • Respiratory failure
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10
Q

Treatment of Inhilation Injuries

A
  • Early intubation before airway becomes occluded
  • High-flow O2
  • Rapid transportation
  • Sit upright
  • Early and aggressive airway management is critical for these pts
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11
Q

Breathing Complications with Burn Injuries

A

Circumferential burns to the chest - burns will dry and become tight making it impossible for the chest to expand - CCP will escharotomy (cut across the wall so the chest can expand)

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12
Q

Chemical Burns

A
  • Alkaline worse than acid as the alkaline can alter the pH of the skin so the enzymes don’t work
  • Can have organic (eg gasoline) or inorganic (hydrofluoric acid) substances as causes
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13
Q

Management of Chemical Injuries

A
  • Think scene safety and PPE
  • In MOST cases, flushing the area with water will dilute/remove the chemical
  • Brush off powdered chemicals
  • Fire can help with protocol
  • Burns to eyes should be flushed continuously
14
Q

Types of Electrical Burns

A
  • Current burns
  • Arc (flash) burns
  • Contact burns
15
Q

Complicating Factors in Burns

A
  • Age
  • Chronic diseases
  • Circumferential burns
  • Distracting injury
  • Fluid loss
  • Already compromised immune system
16
Q

Fluid Resucitation

A
  • Most important component to preventing hypovolaemic shock
  • Try to avoid cannulating through burned tissue
  • Oedema can make veins difficult to find
  • There is a large infection risk
  • And due to the nature of the skin, the cannula will be difficult to secure
    Fluids will be determined by percentage of burns depending on adult or paeds (Use JRCALC and page for age)

Must let the hospital know how much fluid is left to be given on our system before they switch over to theirs

17
Q

Irrigation

A
  • Copious amounts of tepid water
  • Can be beneficial to irrigate up to 3 hours after burn
  • 20 mins max
  • Chemical burns up to one hour
18
Q

General Management Principles

A
  • Cut off burning/smouldering clothes
  • Remove jewellery
  • Do not use ice, creams or ointments
  • If no water then use burns gel
  • Cover in cling film (don’t wrap)
  • Don’t burst blisters
  • Keep the pt warm
19
Q

Pain Management

A
  • Ensure area is covered as airflow can cause sever pain
  • Use pain ladder
  • Cling film
20
Q

Criteria for Hospital Admmission

A
  • Greater than 15% in adults
  • Greater than 10% in a child
  • Any burn to very young (<5) and elderly (>60) or the infirm
  • Any full thickness burn
  • Burns to special regions; face, hands, perineum
  • Circumferential burns
  • Inhalation injuries
  • Pregnant people
  • Assc trauma or significant burn illness eg diabetes, lung/liver/hear disease or immuno-insufficiency

NB506 Trauma (12 decks)

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