Week 4 Flashcards
(37 cards)
What is a burn?
An injury to the tissues of the body caused by heat, chemicals, electric current or radiation.
What are thermal burns?
-Caused by flame, fire, scald, or contact w/ hot objects.
What are chemical burns?
Result of contact with acids, alkalis etc.
What are smoke and inhalation injuries?
Occur from breathing noxious chemicals/ hot air. Can cause damage to respiratory tract.
What are the 3 types of smoke and inhalation injuries?
a) Carbon monoxide poisoning
b) Inhalation injury above the glottis.
c) Inhalation below the glottis.
What are electrical burns?
Happen b/c of heat from electricity.
What factors determine the severity of a burn?
a) Depth of a burn
b) Extent of a burn calculated by BSA.
c) Location of burn
d) Pt risk factors
How is the depth of a burn classified?
First degree: damages epidermis of skin (partial thickness)
Second degree: damages dermis (deep partial thickness)
Third degree: Damages fat, bone and muscle (Full thickness burn)
What are the 3 phases of burn management?
Emergent, acute and rehabilitative.
what is the emergent phase?
Period of time required to resolve the immediate, life-threatening problems resulting from the burn injury.
What is the major threat to pts with severe burns?
Hypovolemic shock!!!
What causes hypovolemic shock in pts with severe burns?
- Increased capillary permeability causes a shift in the fluids. Shift from vascular space into the interstitial spaces.
- Decreased blood volume
How do burn injuries affect the immune system?
Damage to the skin barrier lets invading organisms in, bone marrow depression occurs, circulating levels of immunoglobulins decrease.
WBC become defective.
Impaired lymphocytes, monocytes and neutrophils.
What are the 3 major organ systems that are susceptible to complications?
CVS, Respiratory, Urinary.
How is the CVS complicated in burn pts?
Dysrythmias, hypovolemic shock, decreased circulation to affected areas (which may cause necrosis, ischemia, and paresthesias).
What is sludging?
when microcirculation is impaired because of damage to the small capillary systems.
How is the respiratory system affected by severe burns?
2 Types of injury: upper airway burns, causing edema formation and airway obstruction.
Lower airway injury w/ or w/o smoke inhalation.
What can happen to the upper respiratory system?
Inhalation injury can happen to the mouth, oropharynx, larynx. Edema may occur, causing obstruction.
What can happen to the lower airway with severe burns?
Injury to the trachea, bronchioles and avleoli. Pulmonary edema may not occur till 12 to 48 hrs after the burn.
How is the urinary system complicated by severe burns?
Acute tubular necrosis from decreased renal perfusion, due to lack of blood volume.
What are the main priorities for pts with burns?
Airway, circulation, breathing. Airway management, fluid therapy.
How is fluid therapy determined for severe burns?
Depends on the severeity of the burn and size and depth. Parkland formula used most commonly.
What is the Parkland Formula?
4 mL LR/kg/% TBSA burned.
What is debridement?
Removal of necrotic skin. Done to prevent infection, and promote skin healing.
