week8 Flashcards
What are epidermal burns?
Burns of the epidermal layer of the skin, these are pink, red and painful and take up to 7 days to heal
What are superficial partial thickness burns?
Burns of the epidermis and the superficial dermis, these blister are red or mottled and heal within 14 days
What are mid dermal partial thickness burns?
Burns of the epidermis and dermis, creating a large zone of non-viable tissue, these are less painful and are pale to dark pink
What are deep partial thickness burns?
Burns that go deep into the dermis, they are pink to pale ivory in colour and the skin does not blanch
What are full thickness burns?
Burns where the epidermis and dermis are destroyed and burns may penetrate the underlying structures, they are white, waxy and charred looking
What is the treatment of circumferential burns?
Escarotomy
What is the rule of nines?
It is a way of calculating the total body surface area of burns
What are each of the following worth on the rule of nines?
Head – 9% Each arm – 9% Leg (whole) – 18% Trunk (front) – 18% Trunk (back) – 18% Perineum – 1% Hands (incl. fingers) – 1%
What are the local effects of major burns?
Zone coagulation
Zone of stasis
Zone of hyperaemia
What are the systemic effects of major burns?
Cardiovascular
Respiratory
Metabolic
Immunological
What are the 2 phases of the care of a patient with a burn injury?
Immediate care
Care provided throughout the first 24hrs
What is the care of a patient with a burns injury?
Emergency care – remove patient from danger and stop the burning process, place under running water for 20mins, provide adequate analgesia
Airway – Supplemental oxygen for all patients, monitor for signs of obstruction
Breathing – monitor for signs and symptoms of dyspnoea, tachypnoea and pulmonary oedema
Circulation – Fluid Resuscitation
Minimisation of hypothermia and hyperkalaemia
Burns Dressings
What is the criteria for fluid resuscitation?
Adults (>15%TBSA burn)
Children (>10%TBSA burn)
What is the formula for fluid resuscitation?
4mls/kg x %TBSA x pre-burn body weight (kg) = Vol in mls
On top of the formula the patient also requires the “normal” daily intake over 24 hours
An 80 kg patient has 25% TBSA burns. The patient is NBM so also include the 2L maintenance fluid requirements. Formula: 4ml/kg/TBSA% + 2000mls.
What are the fluid requirements for the first 24 hours?
a) 4000ml
b) 7380ml
c) 10,000ml
d) 14,760ml
c) 10,000ml
The incidence of burns injuries in Aust/NZ 1999-2004 is?
a) 460 admissions
b) 4,600 admissions
c) 46,000 admissions
c) 46,000 admissions
True or false, the classification of burns injuries is superficial, partial thickness and full thickness
true
The aim of Pre-hospital care is:
Education Keep matches/lighters away from children Replace batteries in smoke detectors Set hot water to temperature no higher than 50* Use caution when cooking
What is the A-E for a burns patient?
Airway/breathing – consider need for early intubation
Circulation – fluid replacement
Disability – monitor GCS and possible reasons for lowered GCS
Exposure – loss of fluid
What are the further nursing considerations for a burns patient?
Analgesia
Neurovascular
Dressings
What is another name for Enoxaparin?
Heparin
What is Enoxaparin?
It is an anticoagulant used to prevent VTE
What are the contraindications for Enoxaparin?
Haemorrhage risk
Haemorrhagic stroke
What are the possible reactions to Enoxaparin?
Haemorrhage Anaemia GI upset Headache Skin necrosis Pain Haematoma at site Allergic Reaction
