Burns

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Flashcards on Burns, created by Elizabeth Then on 12/06/2018.
Elizabeth Then
Flashcards by Elizabeth Then, updated more than 1 year ago
Elizabeth Then
Created by Elizabeth Then over 6 years ago
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Question Answer
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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