Burn Injury Incidence and Prevention

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Questions and Answers

What characterizes the zone of coagulation in burn injuries?

  • Surrounding tissue shows signs of rapid healing.
  • Tissue is completely destroyed with cellular death. (correct)
  • Tissue is viable with a compromised blood supply.
  • Increased blood flow and inflammation are present.

Which classification corresponds to a second-degree burn covering 20% TBSA in an adult?

  • Major Burn Injury (correct)
  • Severe Burn Injury
  • Minor Burn Injury
  • Moderate, Uncomplicated Burn Injury

How does the zone of stasis differ from the zone of coagulation?

  • Stasis may still be viable with compromised blood supply, whereas coagulation is dead tissue. (correct)
  • Stasis is where tissue death occurs; coagulation shows viable tissue.
  • Stasis shows increased blood flow while coagulation is avascular.
  • Stasis has normal inflammatory response while coagulation has none.

Which of the following best describes the systemic effects of burns that exceed 20% TBSA?

<p>Both local and systemic responses may arise. (B)</p> Signup and view all the answers

In burn management, which intervention is vital for the wound healing process?

<p>Maintaining a sterile environment to prevent infection. (D)</p> Signup and view all the answers

What is a significant characteristic of a third-degree burn covering less than 10% TBSA?

<p>It can be classified as a minor burn injury. (A)</p> Signup and view all the answers

Which statement correctly describes the zone of hyperemia?

<p>It exhibits increased blood flow due to inflammation. (B)</p> Signup and view all the answers

Which of the following conditions excludes a patient from being classified as having a minor burn injury?

<p>Presence of concurrent trauma. (D)</p> Signup and view all the answers

What condition is caused by burns affecting more than 20% TBSA, especially in medically fragile patients?

<p>Burn shock (A)</p> Signup and view all the answers

Which process contributes to the massive edema formation observed in severe burns?

<p>Altered capillary permeability (A)</p> Signup and view all the answers

In the context of burn injuries, what does hypoproteinemia lead to?

<p>Fluid shift to interstitial spaces (A)</p> Signup and view all the answers

What is a primary characteristic of burn shock as described in the content?

<p>Increased systemic vascular resistance (C)</p> Signup and view all the answers

Which of the following is a consequence of the initial systemic response to severe burns?

<p>Loss of capillary integrity (C)</p> Signup and view all the answers

When does the loss of fluid and electrolytes peak following a severe burn?

<p>Between 8 to 12 hours (D)</p> Signup and view all the answers

What plays a key role in the alteration of cardiovascular function following a severe burn?

<p>Loss of intravascular plasma volume (C)</p> Signup and view all the answers

What underlying mechanism leads to hypovolemic shock in burn victims?

<p>Fluid loss from intravascular space (A)</p> Signup and view all the answers

Which of the following accurately describes full-thickness burns?

<p>They extend through the dermis and into subcutaneous tissue. (B), They can appear translucent with visible clotted vessels. (D)</p> Signup and view all the answers

What is the primary characteristic of wound healing in burns?

<p>It can heal by contraction or epithelial migration. (A)</p> Signup and view all the answers

What is the nurse's priority action for a patient with a suspected full-thickness burn?

<p>Remove all jewelry or constricting items. (D)</p> Signup and view all the answers

Which of the following statements about local effects of burns is correct?

<p>They can lead to the denaturation of protein. (A)</p> Signup and view all the answers

What immediate action should be taken within 24 hours of a deep partial-thickness burn?

<p>Assess and apply cool tap water to the area. (D)</p> Signup and view all the answers

Which type of burn requires excision and grafting due to its depth?

<p>Full-thickness burns. (C)</p> Signup and view all the answers

What is a common misconception about the effects of scald burns?

<p>They require hot water exposure for several minutes. (B), They heal rapidly without intervention in adults. (C), They can only cause superficial damage. (D)</p> Signup and view all the answers

Why should burning clothing be removed immediately from a burn victim?

<p>To prevent further heat retention and thermal injury. (B)</p> Signup and view all the answers

Flashcards

Full-thickness burn characteristics

Full-thickness burns involve damage to the epidermis, dermis, and deeper tissues, potentially including subcutaneous tissue, fascia, muscle, tendon, and bone. They appear dry, firm, depressed, and insensate.

Burn healing mechanism

Burns heal through contraction or epithelial migration (new skin growth).

Burn wound appearance

Burn wounds can vary in color (mottled white to red, brown, or black) and might be charred or leathery. They may also appear translucent with visible vessels.

Scald burn damage

Even brief contact with hot water (69°C/156°F) for one second can cause full-thickness burns (damaging epidermis and dermis).

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Post-burn inflammation

Burns cause a cascade of local tissue and systemic inflammation; they disrupt cells, release chemicals, and cause fluid buildup.

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Early burn management

Early assessment and management, like cool water application for 5 minutes or more, is key to prevent deeper damage. Immediately remove jewelry and adhered clothing.

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Deep partial-thickness burn conversion

Deep partial-thickness burns can progress to full-thickness burns within 24 hours of injury, highlighting the urgency of initial care.

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Burn wound treatment

Burns necessitate immediate removal of adhering clothing, and covering the wound with a losely wrapped sterile dressing or clean cloth.

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Zones of Burn Injury

Burn injuries create distinct zones: coagulation, stasis, and hyperemia.

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Coagulation Zone

The inner zone; tissue is completely destroyed.

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Stasis Zone

Surrounds non-viable tissue, potentially salvageable.

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Hyperemia Zone

Outermost zone; least damage, increased blood flow.

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Minor Burn Injury

Second-degree burns less than 15% TBSA (adults) or 10% TBSA (children).

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Moderate Burn Injury

15-25% TBSA (adults) or 10-20% TBSA (children) second-degree burns.

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Major Burn Injury

Burns exceeding 25% TBSA in adults and 20% in children.

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TBSA

Total Body Surface Area - the percentage of the body that has been burned.

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Burn Shock

A life-threatening condition caused by significant fluid loss and circulatory abnormalities due to severe burns, leading to both hypovolemic and distributive shock.

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Hemodynamic Instability

An unstable state of the circulatory system characterized by changes in blood pressure, heart rate, and blood flow, often seen in burn shock.

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Leaky Capillary Syndrome

A condition characterized by increased permeability of blood vessels, allowing fluid, proteins, and other substances to leak out of the capillaries and into the surrounding tissues.

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What are the systemic responses to burn shock?

The body releases cytokines and other inflammatory mediators into the bloodstream, leading to widespread effects like increased vascular resistance and decreased cardiac output.

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What are the key cardiovascular alterations in burn shock?

Intravascular volume depletion, increased pulmonary vascular resistance, elevated systemic vascular resistance, and depressed cardiac output.

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When does burn shock typically occur?

Burn shock commonly develops when more than 20% of the total body surface area (TBSA) is burned, but it can occur even with lower percentages in medically fragile patients.

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What is the initial systemic event in burn shock?

Hemodynamic instability due to the loss of capillary integrity and subsequent fluid shifts into the interstitial spaces.

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Study Notes

Burn Injury Incidence

  • Flame and scald burns are the most common types, with home accidents accounting for 73% of cases.
  • Scald injuries are most common in children under 5.
  • Approximately 486,000 people with burn injuries receive treatment each year, with over 3,000 deaths annually, many due to residential fires.
  • Males constitute 68% of burn victims.
  • Burns are a leading cause of death in all age groups, particularly affecting children under 14 and older adults.
  • Risk factors in older adults include reduced mobility, sensory decline, cognitive impairment and chronic illnesses.
  • Mortality is high in older adults (>60 years), patients with more than 40% TBSA burns, and those with inhalation injuries (nearly 90%).
  • Prevention methods include smoke detectors, fire extinguishers, and fire safety campaigns.
  • Preventing scalds involves water temperature regulation in bathrooms with anti-scald technology.

Burn Depth Classification

  • Burn damage is categorized by tissue depth.
  • Burns are categorized as superficial, superficial partial-thickness, deep partial-thickness, or full-thickness.
  • Superficial burns affect only the epidermis (outer skin layer), causing redness and pain like a sunburn, usually healing in 7 days without scarring.
  • Superficial partial-thickness burns involve the epidermis and part of the dermis, causing blistering, redness, and moist exposed skin; these heal in 2 weeks.
  • Deep partial-thickness burns extend deeper into the dermis, causing pain, dry or moist, mottled red/white skin, and potentially longer healing times with scarring.
  • Full-thickness burns penetrate through the dermis into the subcutaneous tissue, or even deeper muscle or bone, leading to a painless, dry, white or blackened appearance, and require grafting or other advanced treatment.

Burn Shock

  • Burn shock occurs in patients with burns greater than 20% of total body surface area (TBSA).
  • Shock develops due to fluid loss from the bloodstream into damaged tissues (capillary leak) in combination with the systemic response (distributive shock).
  • Early signs include tachycardia, hypotension, decreased urine output.
  • Significant loss of fluid, protein, and electrolytes can lead to systemic issues.
  • Monitoring of vital signs, and fluids is required, along with frequent assessments for proper fluid resuscitation.

Burn Care Phases

  • Burn care is divided into three phases: emergent/resuscitative, acute/intermediate, and rehabilitation.
  • Emergent phase prioritizes immediate first aid, preventing shock and respiratory distress, and assessing the extent and depth of injuries.
  • The acute/intermediate phase focuses on wound care, preventing complications, and providing nutritional support.
  • The rehabilitation phase aims at wound closure, scar management, and restoring functionality and well-being to the patient.

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