Flashcards
453: Test 1 Burns
Cards in this deck (60)
- 1A burn occurs when there is injury to the tissues of the body caused by ____, _____, _______ or _______.heat
chemicals
electric current
radiation - 2Burns have both a _____ and _________ inflammatory reaction, the end result of which is an almost immediate shift of intravascular fluid into the surrounding interstitial space.local and systemic
- 35 types of burnsThermal burns
Chemical Burns
Smoke and Inhalation Burns
Electrical Burns
Cold Thermal Injury - 4What is the most common type of burn?Thermal
Can be caused by flame, flash, scald, or contact with hot objects - 5What causes chemical burns?acids, alkalis and organic compounds.
household cleaners and fertilizers - 6Are alkali or acid burns more difficult to treat and why?Alkali
Damage can continue even when neutralized - 7____________ burns can cause respiratory problems, eye injuries, liver and kidney problemsChemical
- 8How to treat chemical burnsremove the chemical from
the skin, remove clothing with
chemical on it then flush with lots of water - 9With chemical burns tissue destruction may continue for up to ____ hours72
- 10Result from inhalation of hot air or noxious chemicals and can cause damage to the tissues of the respiratory tractSmoke/Inhalation Burns
- 11Clues may be facial burns, singed nasal hair, hoarseness, painful swallowing, or darkened oral and nasal membranessmoke/inhalation burns
causes redness and airway edema - 12Metabolic asphyxiationaccount for majority of deaths at a fire scene. (Displaces 0xygen on the hgb, causing hypoxemia – manage with 100% humidified 02 and monitor levels of carboxyhemoglobin. May occur in the absence of burned skin. Hyperbaric tx controversial
- 13Inhalation injury above the glottisusually thermally produced. Redness, blistering, edema. Mechanical obstruction usually occurs quickly.
- 14usually chemically produced. Clinical manifestations in 12-24 hrs. Can progress to ARDS.inhalation injury below the glottis
- 15Direct damage to nerves and vessels can occur causing tissue anorexia and death Can cause muscle contractions strong enough to break boneselectrical burns
- 16This is seen with electoral burns: majority of damage beneath the skin making it hard to determine.iceberg effect
- 17Which burns have a very High risk for fall injuries, fractureselectrical burns
- 18Risks associated with an electrical burn besides falls and fracturesdysrhythmias, cardiac arrest, severe metabolic acidosis (due to tissue destruction), and related renal issues
- 19Causes vasoconstriction- Ice crystals form in intracellular spacesCold thermal injury/frostbite
- 20Complications with cold thermal injury/frostbiteRe-warming is extremely painful
Pain may last weeks to years
May require amputation - 21There are 2 guides for determining the extent of 2nd and 3rd degree burns. What is considered a 1st degree burn?sunburns "don't count"
- 22classification of burn injury that is the most accurate and provides a percent calculationLund-Browder Chart
- 23classification of burn injury that is simplistic and used more for adultsRule of nines
- 24Treatment of a burn depends on its severity. Severity is determined by what 4 things?Extent of burn
Depth of injury
Location of burn,
Risk factors - 25Criteria for burns to be treated in burn units (1-5)1. Partial-thickness burns >10% of total body surface area (TBSA).
2. Burns that involve the face, hands, feet, genitalia, perineum, or major joints.
3. Third-degree burns in any age-group.
4. Electrical burns, including lightning injury.
5. Chemical burns. - 26Criteria for burns to be treated in burn units (6-7)6. Inhalation injury.
7. Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality risk (e.g., heart or kidney disease). - 27Criteria for burns to be treated in burn units (8)8. Any patients with burns and concomitant trauma (e.g., fractures) in which the burn injury poses the greatest risk of morbidity or mortality. In such cases, if the trauma poses the greater immediate risk, the patient may be initially stabilized in a trauma center before being transferred to a burn center.
- 28Criteria for burns to be treated in burn units (9-10)9. Burn injury in children in hospitals without qualified personnel or equipment needed to care for them.
10. Burn injury in patients who will require special social, emotional, or long-term rehabilitative intervention. - 29burn classification: epidermis to dermispartial thickness
- 30burn classification: deep dermis including sweat and oil glandsdeep partial thickness
- 31burn classification: all layers of the skin and beyond including bone and musclesfull thickness
- 32Which types of burns are the most painful?Partical thickness
- 33Full thickness burns lead to release of _______ and _________myoglobin and hemoglobin
- 34fluid and electrolyte shifts: The greatest threat initially with burns is ______________hypovolemic shock:
Caused by massive shift of fluids out of vascular space
Water, sodium, proteins move into interstitial spaces - 35Fluids and electrolyte shifts: what are the concerns?1. evaporation occurs through the burns
2. Hemolysis of RBC’s
3. Blood flow to kidneys decreased
4. 3rd spacing occurs
5. K+ released into the circulation
6. Shock and death may result - 36This phase usually lasts 24-72 hours. Always consider other injuries!Emergent phase= Resuscitative Phase!
- 37What is the primary concern with Emergent phase= Resuscitative Phase?Hypovolemic shock
- 38Why shivering occurs in burn victimschilled by heat loss, anxiety or pain
- 39When does the emergent phase end?when fluid mobilization and diuresis begins
- 40Medical priorities in the emergent phaseassess & re-assessmentof:
1. ABC’s
2. perfusion
3. vital signs
4. cardiac rhythm
5. oxygenation
6. LOC - 41What is the airway management of a burn patient?Intubation, extubation when edema resolves. If no intubation necessary, humidified 02
- 42Fluid therapy consideration in the treatment of a burn patientlarge bore IVs or Central Line
crystalloids (NS or LR) or colloids (Albumin) or combo
Weight specific
You know you have enough fluid when UO of 30-50 ml/hr is achieved. - 43Treatments of a burn patientIV Pain meds!!
Tetanus shot- anaerobic contamination.
Escharotomies/fasciotomies-respiratory or vascular compromise
Labs- monitor ABG’s, fluid/electrolytes
Wound care-debridement Infection control!
PT starts very soon- ROM!
Antimicrobials (topical) unless septic - 44Wound healing is also know as what phase? How long does it last?Acute phase
weeks to months - 45When does the acute phase of a burn begin?with the mobilization of fluid and diuresis
Less edema, Burns are more evident…necrotic tissue begins to slough - 46Electrolyte abnormalities with acute phase of burnsHyponatremia - or hypernatremia from resuscitative fluid replacement/
- 47What do monitor in the acute phase of a burnInfection, sepsis, prevention of contractures, prevention of ileus, increase in blood glucose (stress), pain control, psychosocial support
- 48When does the burn acute phase end?Phase ends when burned area is covered by skin grafts or wounds are healed
- 49What phase begins when burns have healed and patient can perform at a level of self care? When does it occur?Rehabilitation phase=Restorative
2 weeks-8 months - 50What are the greatest risks in the burn rehabilitation phase?contractors and scar tissue
Pressure garments (up to 24hr/day for 12-18 months) - 51What to access during the burn rehabilitation phase?Itching during healing (Benadryl & lotions), initial skin is friable, protect from direct sunlight.
Emotional support, self esteem issues- identity issues, loss of function, disfigurement, financial burdens, fear, anger, anxiety, guilt, depression, PTSD. - 52wound care: pink or cherry red, wet & shiny with serous exudate (may or may not have blisters) and painful to touch or exposed to airpartial-thickness burn
- 53wound care: dry & waxy white to dark brown or black and minor/localized sensationFull thickness burn
- 54necrotic tissue is removedDebridement
- 55which method? burn covered in topical antimicrobial and no dressing over the woundopen method
- 56Which method? sterile gauze laid over topical antimicrobials Changed Q12-24hr depending on product Must use PPE (sterile gloves to open wound)closed method
- 57What type of burn may grafting be necessary for?full thickness
- 58Surgury that may be necessary with burns: Think about swelling, stretch or lack of….. Think about circulationFasciotomies or Escharotomies:
incision in tissue to relieve swelling - 59Nutritional therapy:____________ state due to increased metabolism by 50-100% of a normal patientHypermetabolic
>20% BSA burn usually require
enteral feedings - 60Nutritional therapy considerations for burn patientsGoal is to provide adequate calories and protein to facilitate healing.
Fluid replacement first then nutrition
Nutritional support within hours of burn can decrease mortality and increase healing time
Information
- Description
- Flashcards on 453: Test 1 Burns , created by brittny beauford on 05/02/2017.
- Created by
- brittny beauford
- Views
- 23
- Rating