14143508
Descripción
Fichas por Elizabeth Then, actualizado hace más de 1 año
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Creado por Elizabeth Then
hace más de 6 años
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| Pregunta | Respuesta |
| Whats is a burn? | tissue loss caused by an exogenous injurious agent, heat, cold, chemicals, electricity, radiation severity depends on temp, conc of agent, duration of contact |
| skin functions | protects against infection prevent loss of body fluids control body temp functions as excretory organ functions as sensory organ produces vitamin D |
| General first aid priorities | stop burning process remove clothing, unless stuck cool/irrigate/re-warm thermal - cool running water for 20 minutes acid -irrigate -decontaminate 1 hr until burning sensation gone alkali - irrigate - decominate 2 hr until burning sensation gone cold induced injury - warm/tepid buckey water cover the burn and elevate avoid hypothermia |
| primary survey | airway maintenance with c-spine control breathing and added oxygen circulation with haemorrhage control disability - neurological status exposure and environmental control fluid resuscitation |
| airway | mechanism of injury envirionment injury occured examine patient for signs of: burns to mouth, sooty sputum, change in voice, productive cough, stridor, nasal flaring |
| breathing | deep dermal/full thickness burns can affect chest expansion soot in lower airways trauma associated injuries - haemothorax, pneumothorax, barotrauma |
| circulation | haemorrhage control temp, pulse, BP, colour, capillary refill, escharotomy required? to allow expansion intravenous access |
| disability | state of consciousness, AVPU, GCS |
| Exposure and environment | keep pt warm, remove all clothing, remove all jewellery, prevent hypothermia, assess burn size, warmed blankets |
| superficial | rapid capillary refill (blanch), thin walled blisters, moist wound (light reflection), pain, heal 7- 10 days |
| Mid dermal | thicker blister decreasing mosture, decreasing sensation, decreasing cap refill, heal 10-14 days |
| deep dermal | central white area dull sensation (no pain) slow cap refill slight moistue, heal 2-4 weeks |
| full thickness | no sensation, no cap refill, no moisture, need graft, flap |
| SHOCK | from depleted blood volume, low co, vasoconstriction, decrease tissue perfusion, fluid shift continues 36-48 hours |
| fluid resusitation | 1st 24 hours - hartmann solution fluid (mls) = 4mls x %TBSA X WEIGHT (KG) - give half in first 8 hours - give half in next 16 hours monitor urine output - aim 0.5ml/kg/hour *urine output key to monitoring |
| What increase fluid needs? | inhalation injury, dehydration, electrical |
| probelms of fluid resuscitation | oliguria, poluria, fluid overload, haemoglobinuria |
| aims of burn wound care | promote healing, prevent desiccation of wound, prevent infection, comfort, management, allow movement |
| management of | temp, hydration, nutrition, infection, oedema |
| choose a dressing | generally silver based due of risk of infection transporting patients products |
| initial wound care | give appropriate pain relief debride all blistered non-vial skin shave wound to decrease bacterial load shave 5-10cm margin around wound aid future wound cleansing |
| Scar management | requires skin grafting un-grafted area that take longer than 10-14 days to heal on assessment involves massage and moisturisation, pressure garments generally 2-3 times daily, water-based moisturiser, firm pressure benefits - softens scar, increase pliability, reduces, cracking,decrease itch and risk of infective breakdown |
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