Week 11: Burns Flashcards
Define superficial burns
Erythema of the skin, with no blistering (most sunburns and some water scalds fall into this group) rarely requiring treatment
Define the term burn
A thermal insult which damages the skin and/or underlying structures
Define partial thickness burns
Results from deeper damage but variable number of the skins structures of the dermis, (capillaries, nerve endings, sweat glands, hair follicles) are still present
What is the appearance of partial thickness burn?
Blistering of the epidermis, and presence of pain, they look red and have a blotchy red and white appearance
Define the term, full thickness burn
Results from death of all layers of the skin and sometimes underlaying structures
What is the appearance of a full thickness burn?
Not painful (dead nerve endings), doesn’t blanch on pressure, appears white or even charred or leathery
What are different mechanisms of injury?
- flame/hot gas
- fluids
- contact with a solid object
- chemical burns
- electrical burns
- radiations burns
Define flame/hot gas burns
- associated with FTB
- airway burns
- blunt trauma (explosions, jumping from buildings, carbon monoxide poisoning)
Define contact with solid object burn
- usually FTB and shows the pattern of the object with which the skin has come into contact with
Define a fluid burn
- often called scalds when hot water involved
- burns from water are usually PTB and fat FTB
Define chemical burns
- identification of exact chemical
- transport of labels/containers to A&E to assist with management
Define electrical burns
- associated with cardiac arrhythmia
- factures (tectanic contraction of muscles)
What are examples of radiation burns
- sunburn rarely requires treatment
- skin burns from radioactive material indicate overwhelming radiation exposure
- rescuer safety and decontamination is essential
What is a friction ‘burn’ classed as?
More of an abrasion than a burn
What is the zone of coagulation?
Centre area of wound, where all tissues are damages
What is the zone of stasis?
Surrounds the coagulation area, some tissues are damages
What is the zone of hyperaemia?
Unburned area surrounds the stasis but it is red due to inflammation
What happens to the body in presence of a burn?
- capillary permeability increases
- leads to loss of intravascular proteins and fluid into interstitial space
peripheral and splanchnic vasoconstriction occur and myocardial contractibility decreases - combined with fluid loss from the burn may result in hypotension and end-organ hyoperfusion
What are some complications of burns?
- airway/inhalation
- fluid loss/ hypovolaemic shock
- pain
- Caron monoxide/ cyanide poisoning
- hidden injury
- hypothermia
- circumferential
How is airway/inhalation a complication of burns?
Almost always occur in the supraglottic region of the larynx, interventions such as tracheal tubes or cricothryiodotomy may be required
How is fluid loss/hypovolaemic shock a complication of a burn?
Significant fluid loss (IV fluids requires), if they burn is >25% on an adult and 12.5% surface area
How is pain a complication of a burn?
Burns are painful (unless FTB), entonox is an affective analgesic, however adapt a stepwise approach and IV drugs such as paracetamol/morphine can be considered
How is carbon monoxide/cyanide poisoning a complication of burns?
If the patient has been in a fire, initial presentation may be confusion or a reduced GCS, SPO2 reading will be normal. High flow 02 to be considered, cyanide is a result from burning plastics- variable respiratory distress, rapidly loses consciousness and often leads to cardiac arrest
What is a hidden injury as a complication of a burn?
- blunt trauma (spinal, abdominal)
- happens during falls, explosions, falls and occasionally electrics
