Burn Management and Treatment Protocols
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Questions and Answers

What is the primary management for first-degree burns?

  • Fluid resuscitation
  • Wound care and antibiotics
  • Surgical interventions like grafting
  • Cool compresses and analgesics (correct)
  • Which factor increases the risk for acute kidney injury (AKI) in children?

  • Existing comorbidities
  • Polypharmacy
  • Dehydration (correct)
  • Intensive wound care
  • Which of the following is indicated for severe electrolyte imbalances?

  • Renal biopsy
  • Diet modification
  • Dialysis (correct)
  • Fluid resuscitation
  • What symptom is an expected finding with abnormal glomerular filtration rate (GFR)?

    <p>Nausea and fatigue</p> Signup and view all the answers

    In cases of third-spacing, what is the recommended management strategy?

    <p>Fluid resuscitation</p> Signup and view all the answers

    What is the primary concern during the Emergent Phase of burn care?

    <p>Airway, breathing, and circulation</p> Signup and view all the answers

    Which medications are commonly used for pain management in burn patients?

    <p>Morphine and fentanyl</p> Signup and view all the answers

    What is the formula used to calculate fluid requirements for burn patients?

    <p>Fluid Requirement (mL) = 4 × body weight (kg) × total BSA burned (%)</p> Signup and view all the answers

    Which of the following is NOT a component of the Rule of Nines for estimating Total Body Surface Area?

    <p>Anterior trunk: 20%</p> Signup and view all the answers

    Which symptom is characteristic of carbon monoxide poisoning?

    <p>Cherry-red skin coloration</p> Signup and view all the answers

    What are common nephrotoxic medications that should be monitored in patients?

    <p>NSAIDs, aminoglycosides, contrast agents</p> Signup and view all the answers

    During the Acute Phase of burn care, which intervention is a priority?

    <p>Wound care and infection prevention</p> Signup and view all the answers

    What is a common expected finding with an abnormal Glomerular Filtration Rate (GFR)?

    <p>Elevated creatinine and uremic symptoms</p> Signup and view all the answers

    Study Notes

    Parkland Formula Calculation

    • Used to determine fluid resuscitation needs for burn patients.
    • Calculation: Fluid Requirement (mL) = 4 × body weight (kg) × total BSA burned (%).
    • Administer half the calculated fluid over the first 8 hours post-burn, and the remaining half over the next 16 hours.

    Rule of Nines – BSA Calculation

    • A method to estimate total body surface area (TBSA) affected by burns.
    • Head and neck: 9%
    • Each arm: 9%
    • Each leg: 18%
    • Anterior trunk: 18%
    • Posterior trunk: 18%
    • Genital area: 1%

    Medications for Burn Management

    • Pain management: Opioids (morphine/fentanyl).
    • Infection prevention: Topical antibiotics (silver sulfadiazine) and systemic antibiotics as needed.
    • Sedatives: Benzodiazepines (lorazepam) for anxiety management.
    • Antipruritic medications: Antihistamines (diphenhydramine) for itchiness.
    • Focus on pain control, infection prevention, and comfort management.

    Carbon Monoxide Poisoning

    • Carbon monoxide has a higher affinity for hemoglobin than oxygen, causing hypoxia.
    • Symptoms: Headache, dizziness, nausea, confusion, cherry-red skin in severe cases.
    • Treatment includes high-flow 100% oxygen or hyperbaric oxygen therapy.
    • Importance of prompt treatment to mitigate tissue hypoxia and prevent death.

    Nephrotoxic Medications

    • Include NSAIDs, aminoglycosides, and contrast agents.
    • Regular monitoring and minimizing usage are necessary to protect kidney function.

    Expected Findings with Abnormal GFR

    • Elevated creatinine levels indicate kidney impairment.
    • Uremic symptoms may include fatigue and nausea.
    • May also present with fluid overload, signaling reduced kidney function.
    • Emergent Phase (24-48 hours): Priorities include airway, breathing, circulation, fluid resuscitation, and pain management.
    • Acute Phase (diuresis to wound closure): Focus on wound care, infection prevention, pain control, and nutrition.
    • Rehabilitation Phase (post-wound closure): Emphasizes psychological support, physical therapy, and scar management.

    Types of Burns and Management

    • First-degree burns: Affect only the epidermis; management includes cool compresses and analgesics.
    • Second-degree burns: Partial thickness affecting epidermis and part of the dermis; requires wound care and possible antibiotics.
    • Third-degree burns: Full thickness, affecting all skin layers; necessitates surgical interventions like grafting and intensive wound care.

    Risk for AKI and CRF Across the Lifespan

    • Dehydration risks are higher in children; polypharmacy issues arise in the elderly.
    • Pre-existing comorbidities can elevate the risk for kidney complications.
    • Early recognition and management are crucial to prevent chronic kidney failure.

    Management / Indications for Dialysis

    • Indicated for severe fluid overload, electrolyte imbalances (e.g., hyperkalemia), or manifesting uremic symptoms.
    • Management involves monitoring fluid and electrolyte status and care of access sites.
    • Dialysis serves as a substitute for kidney function in cases of severe kidney failure.

    Renal Biopsy

    • Recommended for unexplained acute kidney injury (AKI) or nephrotic syndrome.
    • Post-procedure requires monitoring for bleeding and bed rest.
    • Essential for diagnosing renal pathologies.

    Third-spacing

    • Refers to fluid shifts to interstitial spaces, commonly seen in burns and sepsis.
    • Treatment includes fluid resuscitation and monitoring for hypovolemia signs.
    • Can lead to decreased circulating volume and shock if not managed.

    Dietary Teaching

    • Renal patients should follow a low-sodium, low-potassium diet.
    • High-protein intake is essential for wound healing in burn cases.
    • Tailored dietary plans aim to support recovery and prevent complications.

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    Description

    This quiz covers critical topics in burn management, including the Parkland formula for fluid resuscitation, the Rule of Nines for estimating body surface area affected by burns, and medications used in burn treatment. Test your knowledge on how to effectively manage pain, prevent infection, and ensure comfort for burn patients.

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