Which Pt Populations are most likely to suffer burns?
- 60yo
- Lower Socioeconomic status
- Teens/Drug Users
Describe the Patho of a Burn??
➚ in Capillary Permeability
⇢Edema/➘Intravascular Vol (3rd spacing)
-in as little as 20min
⇢➚Hct/blood becomes viscous
⇢➚Peripheral Resistance
⇢Burn Shock (Hypovolemic)4 Types of Burns?
- Electrical
- Chemical
- Thermal
- Radiation
Treatment and severity of burns is dependent on??
- Depth of burn
- Extent (Total body surface area %) of burn
- Location of burn
- Pt Risk Factors
4 goals/focus areas in Burn care?
- wound healing
- Prevent infection
- Pain Management
- Return to Pre-Injury function
Name the Degree of the Burn…
Epidermis only, red, hot, dry, mild pain, poor turgor, and requires 7-10 days to heal.
First Degree Burn
Name the degree of the Burn…
Deep partial thickness burn including epidermis and dermis, Red, Blisters, Edema, Extremely painful
Second Degree Burn
Name the degree of the burn…
Full Thickness burn affecting all skin layers, Pale, White, Charred, Leathery (Eschgar), Painless, dry , hard skin.
Third Degree Burn
Name the Degree of the burn…
Skin, Muscle, & Bone affected.
Fourth Degree Burn
What to do to stop the burning process.
- Cool it with cool water to temp of unburned skin.
- Remove clothing/Jewlery/Smothering fabrics that hold the heat in.
Rule of nines %’s:
Trunk? Legs? Arms/Hands? Head? Groin?
T- 18% per front/back (Total 36%) L- 9%per front/back (18%ea total leg) A/H- 9%ea (4.5% per hand/arm) H- 9% (4.5% per front/back) G- 1%
3 types of inhalation injury related to burns.
- Carbon Monoxide Intoxication
- Above Glottis
- Below Glottis
Characteristics of an above the glottis inhalation injury.
- Limited to upper airway
- swelling in first hr
- damage to pharynx/vocal chords
Characteristics of a below the glottis inhalation injury.
- mostly associated with chemicals
- impaired cilliary activity, edema, mucus membrane ulceration, stridor, wheezing, crackles, ➚WoB
S%S of Carbon monoxide Intoxication?
“flu-like” S&S, confusion, altered judgment, disorientation, lethargy, stupor, Bright Red Skin (Very Late Sign).
Treat with 100% O2
Do you early intubate an inhalation burn??
yes, and 100% Humidified O2
-➚ing edema may prevent intubation later
________: Scalpel/ incision through the full thickness eschar to be performed to restore circulation.
Escharotomy
Diet Considerations for a burn Pt?
High calorie, High protein Diet.
IV fluid formula for Burn Pt’s?
2-4mL/kg/TBSA (total body surface area)
-Chlidren 3-4mL/kg/TBSA
top 3 topical antibiotics for burns?
-Silvadene (Gold-Standard)
~Cooling effect
~Don't use for facial burns
-Silver nitrate
-Sulfa/mefanide acetate (Sulfa Allergies)The spinal column is divided into what three sections with how many total??
-7 cervical
-12 thoracic
-5 lumbar
~7+5+12
-33 total including sacral area
What are primary and secondary Spinal Chord injuries??
-P: initial injury d/t stretch/laceration
-S: ongoing damage that occurs post injury
~ischemia/hypoxia/edema
Injury to C5 and up can mean what?
- sensation and movement from neck up
- MIGHT be able to breath w/o vent
- Resp compromise/No diaphragm stimulation
Suspected Spinal injury CPR…
Do a jaw thrust NOT a head tilt back
