wk 12 flash

Question 1

what are the three types of burn

Answer 1

thermal, chemical and electrical

Question 2

what are the characteristic of a first degree burn

Answer 2

• red, minimal swelling, moderate to severe tenderness

Question 3

what are the characteristics of a deep partial thickness (second degree) `

Answer 3

miderate to severe pain
no debridement if its small enough

Question 4

what are the characteristics of a third degree (full thickness) burn

Answer 4

leathery, white and dark brown
no pain in area, only in the edges
if not derided within 24 hours they’ll be septic

Question 5

how long does a third degree burn have to be derided before the patient goes septic

Answer 5

24 hours

Question 6

how do we calculate TBSA

Answer 6

rule of 9s
only for people who have average height and weight proportions

Question 7

how can you tell if a burn patient needs a respiratory assessment

Answer 7

• burned hair, soot on face, wheezing, SOB
  or any burns on the face, neck and chest

Question 8

what do we have to focus on if a patient has a burn on their bum or perineum

Answer 8

• worry about BM, diarrhoea, and infection from diarrhoea

Question 9

what is a circumferential burn

Answer 9

skin around the trunk
its bad because skin will get so tight you won’t be able to breathe

Question 10

what is an escharotomy and why would one need it

Answer 10

• basically you cut through burn tissue and let the skin expand
  you need it for a bad circumferential burn

Question 11

what constitutes a minor burn

Answer 11

<10% TBSA partial thickness
<2% full thickness
no burns on face, eyes, hands, ears, or perineum
no electrical or chemical burns
no inhalation injury
< 60 years of age with no chronic disorders

Question 12

what constitutes a moderate burn

Answer 12

partial thickness less than 10 % TBSA
full thickness 2-10% TBSA

Question 13

what constitutes a severe burn

Answer 13

partial thickness> 10% TBSA
3 degree burn
inhalation burn
electric/ chemical burn
burn on the face, hands, feet, perineum, joints, etc.
children in hospitals where they dont have supplies for pets

Question 14

what is the Manitoba burn unit

Answer 14

HSC H5

Question 15

in the emergency phase of smoke inhalation, what are your 3 main priorities

Answer 15

Airway: protect the airway, intubate early
Breathing: stand beside patient with 15L of oxygen ready
C: give IV fluid because the patient will be hypovolemic (NS or ringers usually)

Question 16

should you prioritise wound care in the emergent phase of a burn?

Answer 16

no, wait until airway is protected and BP is stable

Question 17

what are signs that there is a burn in the upper airway

Answer 17

• hoarseness/stridor
• difficulty swallowing
• lots of secretions

Question 18

what is the main focus of the acute phase of a burn

Answer 18

• patient will be hypervolemic and diuressing a lot
• mainly focus on wounds and preventing sepsis

Question 19

what is a patients metabolism like in the acute phase of a burn

Answer 19

patients will be hyper metabolic, they’ll likely need a tube feed

Question 20

what do you give for antianxiety in a burn patient

Answer 20

Ativan

Question 21

what do you give for pruritis in a burn patient

Answer 21

Benadryl

Question 22

what type of infusion should you give during burn dressing change

Answer 22

ketamine continuous

Question 23

what is the main thing with silver/acticoat

Answer 23

it kills bacteria, activate it by getting it wet

Question 24

what is an autograft

Answer 24

patients own skin

Question 25

what is a cultured epithelial autograft

Answer 25

take skin and grow in lab (fragile)

Question 26

what is an allgraft/homograft

Answer 26

another persons skin

Question 27

what is a heterosexual/xenograft

Answer 27

different species skin graft

Question 28

what is biobrane

Answer 28

manufactured skin (product)

Question 29

how long do people need to wear compression garments during the recovery phase of a burn

Answer 29

- 1-2 years - 24 hours a day

Question 30

why do you need to wear compression garments after a burn

Answer 30

to prevent hypertrophic scar

Question 31

which grades of frostbite need to be hospitalised

Answer 31

grades 3 and 4

Question 32

how long does it take to demarcate

Answer 32

2 weeks - 5 months

Question 33

what is demarcation

Answer 33

divides between injured and normal skin, you can see the full extent of the damage

Question 34

what are the main things we do for frostbite care

Answer 34

handle area carefully soak with warm water take off jewellery do NOT squeeze

Question 35

what does a grade 1 frostbite look like

Answer 35

decreased blood flow (hyperaemia) and edema

Question 36

what does a grade 2 frostbite look like

Answer 36

large, clear milky blisters

Question 37

what does a grade 3 frostbite look like

Answer 37

small, dark blisters cool dumb and blue non-blandkking

Question 38

what does a grade 4 frostbite look like

Answer 38

blisters all over, part is cold and bloodless necrosis extends to bone

Question 39

what is the treatment for a grade 3 frostbite

Answer 39

debridement

Question 40

what is the treatment for a grade 4 frostbite

Answer 40

amputaiton

Question 41

what is the priority for sepsis

Answer 41

early identification and antibiotics

Question 42

what is the priority for septic shock

Answer 42

treat BP

Question 43

what will lactic acid levels look like for a patient with sepsis

Answer 43

they will be high

Question 44

what will BUN and Cr levels look like for a patient with sepsis

Answer 44

they will be high

Question 45

what are the main early shock symptoms

Answer 45

- change in VS - low BP, high HR - narrow pulse pressure - warm and flushed skin

Question 46

what do late shock symptoms look like with sepsis

Answer 46

- cold and clammy very low BP narrow pulse pressure mottled skin increase in lactic acid

Question 47

what are the 6 main priorities for sepsis

Answer 47

1. give O2 2. IV fluid to raise BP 3. draw cultures 4. give IV abx (broad spectrum until culture comes back 5. baseline bloodworm 6. put foley in for accurate i/o

Question 48

what are three types of opportunistic infection someone who is HIV positive could have

Answer 48

thrush, shingles, pneumonia, yeast

Question 49

what do pupils look like in late stage shock

Answer 49

unreactive and dilated

Question 50

what are the main 2 reasons someone dies in the emergent phase of a burn

Answer 50

airway obstruction CV collapse (high pulse, low BP)

Question 51

what is the main big thing we should monitor for if a patient has stridor from an inhalation burn

Answer 51

if the stridor stops that's BAD

Question 52

what are the four main priorities in a patient with a possible inhalation burn in the emergent phase in ER

Answer 52

1) High fowlers 2) O2 mask on 3) constant oxygen sat probe 4) continually listen to chest sounds (nurse will be assigned to monitor breathing)

Question 53

what vital signs indicate hypovolemic shock

Answer 53

SBP < 90 HR > 120