Burns

Question 1

Epidemiology of burns?

Answer 1

• mortality highest: over 65yo
• highest risk is 18-35 yo males
• kids: scalding injuries from hot drinks or bath

Question 2

Cellular changes seen in burns?

Answer 2

• intracellular influx of Na/H2O
• extracellular migration of K+
• disruption of cell membrane fxn
• failure of Na+ pump
• burn shock w/ depression of myocardium and metabolic acidosis

Question 3

Heme changes in burns?

Answer 3

• increase in hematocrit
• increase in blood viscosity
• anemia due to RBC destruction

Question 4

Local progressive injury of burn?

Answer 4

• liberation of vasoactivae substances
• disruption of cellular fxn
• edema formation: leaky capillaries

Question 5

When does cell damage occur? Diff zones?

Answer 5

• occurs at temps greater than 113F due to denaturation of protein
• zone of coag: irreversibly destroyed
• zone of stasis: stagnation of microcirc, can/will extend if not tx appropriately
• zone of hyperemia: increase blood flow

Question 6

1st degree burn?

Answer 6

• erythema of skin
• possibly minimal surrounding edema
• minimal pain
• sunburn

Question 7

2nd degree burn?

Answer 7

• deeper than 1st, involve partial thickness
• very deep sunburn, contact w/ hot liquids, flash burns from gas flames
• usually MUCH MORE painful than 3rd degree
• skin appears: red or mottled, blisters, broken epidermis, swelling, wet/weeping surfaces, painful, sensitive to air

Question 8

3rd degree burn?

Answer 8

• damage to all skin layers, subq tissues, and nerve endings

- skin appears: pale white, charred, leathery, broken skin w/ fat exposed, dry surface, painless to pinprick ,edema