burns

Question 1

whats the most frequent age group to have burns

Answer 1

20-30

Question 2

describe education on burn prevention

Answer 2

• high risk behaviors should be avoided (alcohol/drug abuse/smoking)
• smoke detectors/CO monitors/fire extinguishers
• keeo matches and lights out of reach of children
• avoid extension cords/electric cords under rugs
• home exit plan/drill
• community education

Question 3

whats the leading cause of fire death in the US

Answer 3

smoking

Question 4

hoe can age effect burn severity

Answer 4

young/old ppl have less fat tissue, more burn damage

Question 5

describe first degree burns

Answer 5

• top layer of skin - epidermis
• common burns like sunburn

Question 6

descrbe second degree burns

Answer 6

• epidermis and part of dermis
• blistering, edema, 2-3wks healing period
• permanent scarring/pigment change
• flash flame/scold, usually associated with cooking

Question 7

describe third degree burns

Answer 7

• full thickness = epidermis, dermis, and subcutaneous
• fluid loss
• cell destruction, swelling
• white/leathery skin, eschar/slough
• long recovery, skin grafts
• some loss of movement and function
• not much pain r/t loss of nerve function

Question 8

describe fourth degree burns

Answer 8

• full thickness with deep tissue/muscle/bone involved
• can occur from electrical shock
• high risk of shock
• skin turns black/charred
• amputation likely

Question 9

what are some methods to determine the extent of body surface area affected by the burn

Answer 9

• rule of nines (commonly used in adults, good for field)
• lund and browder method (super specific)
• palmer method (size of pts hand and counts it as 1%)

Question 10

describe burn injury

Answer 10

result of chemical injury or heat transfer from one site to another, causing tissue destruction

mechanisms of burns:
- heat
- chemicals
- radiation
- thermal
- inhalation

Question 11

what are the three zones of a burn

Answer 11

• zone of coagulation
• zone of stasis
• zone of hyperemia

Question 12

describe zone of coagulation

Answer 12

central area of burn

most damage, cells are dying here

Question 13

describe zone of stasis

Answer 13

surrounding zone

tissue might live or might die

Question 14

describe zone of hyperemia

Answer 14

outermost

tissue will probs fully recover

Question 15

what are some clinical manifestations of burns

Answer 15

• CV alterations (decreased CO, hypovolemia, shock, increased vascular permeability, third spacing)
• fluid and electrolyte imbalance
• alterations in resps
• kidney alterations
• immunologic alterations
• thermoregulatory alterations
• GI alterations (digestion issues)
• pain responses

Question 16

describe the prolonged hospital lengths of stay r/t burns

Answer 16

• multiple surgical interventions
• extensive pain control
• immobilization
• rehabilitation
• prolonged IV meds
• increased risk for morbidity and mortality

Question 17

what are the three treatment phases of burns

Answer 17

• emergent/resuscitative phase
• acute/intermediate phase
• rehabilitation phase

Question 18

describe on scene of emergent/resuscitative phase

Answer 18

• remove patient from source/stop burning process
• establish airway/supply oxygen
• insert large bore IV line
• cover wounds with clean dry cloth/gauze
• is chemical, irrigate wound continuously

Question 19

what are the top priorities for the emergent/resuscitative phase

Answer 19

• prevention of shock
• prevention of resp distress

Question 20

describe the duration of emergent/resuscitative phase

Answer 20

from onset of injury to completion of fluid resuscitation (0-48hrs)

Question 21

what are priorities in the acute/intermediate phase

Answer 21

• wound care and closure (wound debridement and grafting)
• prevention or treatment of complications/infection
• nutritional support
• pain management

Question 22

describe the duration of the acute/intermediate phase

Answer 22

from beginning of diuresis to near completion of wound closure

Question 23

donor site for skin grafting should be kept…

Answer 23

clean, moist, and covered

usually take 2wks to heal

Question 24

what are some priorities for the rehabilitation phase

Answer 24

• prevention and treatment of scars and contractures
• different types of rehabs
• functional and cosmetic reconstruction
• psychosocial counseling

Question 25

describe the duration of the rehabilitation phase

Answer 25

from major wound closure to return to an individuals optimal level of physical and psychosocial adjustment

Question 26

which degree of burn would you find skin that is white, charred, and leathery?

Answer 26

third

Question 27

what is out main focus in the emergent phase of burn recovery? 1) returning normal function 2) surgical closure of the wound 3) fluid volume management 4) preventing contractures

Answer 27

fluid volume management