Burns and Metabolic Changes Overview

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Questions and Answers

What characterizes a 2nd degree burn?

Fluid-filled blisters and painful (correct)

Only damage to the epidermis

Superficial with no damage to dermis

Full thickness with no pain

What is the primary consequence of the zone of coagulation in a burn injury?

Tissue perfusion increases significantly

Reversible tissue damage

Increased blood flow to the area

Cell death and damage to circulation (correct)

What systemic response occurs when burn injury reaches 30% of tissue areas?

Increased oxygen delivery to cells

Improved cardiac contractility

Release of inflammatory mediators and cytokines (correct)

Decreased capillary permeability

Which of the following is a consequence of hypermetabolism following a burn?

Increased breakdown of molecules Signup and view all the answers

What happens to insulin sensitivity following a severe burn?

It is reduced due to adrenaline release Signup and view all the answers

What is indicated for patients with burns around the mouth?

Using smaller tubes for airway management Signup and view all the answers

What metabolic change occurs due to an increased release of noradrenaline post-burn?

Increased glucose production from glycogen Signup and view all the answers

What is a key consideration in the circulatory response to burn injuries?

Replace lost fluid volume using the Parkland formula Signup and view all the answers

What defines major haemorrhage in terms of blood loss over a 24-hour period?

Losing 5 liters or 50% blood volume in less than 3 hours Signup and view all the answers

Which of the following components constitutes the largest percentage of blood volume?

Plasma Signup and view all the answers

What is the lethal triad associated with major haemorrhage?

Coagulopathy, Hypothermia, Metabolic Acidosis Signup and view all the answers

What initiates the intrinsic pathway of the clotting cascade?

Exposure of collagen and platelet activation Signup and view all the answers

What is the purpose of administering fluid from FFP during treatment for major haemorrhage?

To replenish clotting factors and fibrinogen Signup and view all the answers

How does hypothermia affect the body's metabolic processes during major haemorrhage?

Inhibits enzyme metabolism and electrolyte balance Signup and view all the answers

Which treatment is recommended to control blood loss during major haemorrhage?

Direct or indirect pressure Signup and view all the answers

What complication can arise from large volume transfusions of FFP?

Transfusion-related acute lung injury (TACO) Signup and view all the answers

What is the primary responsibility of Immunoglobulin E (IgE) in an allergic reaction?

To bind to mast cells and trigger histamine release Signup and view all the answers

Which of the following symptoms is characteristic of Grade 2 anaphylaxis?

Vomiting and abdominal pain Signup and view all the answers

What effect does histamine have in an anaphylactic reaction?

Promotes vasodilation and bronchoconstriction Signup and view all the answers

In the treatment of anaphylaxis, what is the recommended dose of IM adrenaline for adults?

500mcg Signup and view all the answers

Which physiological changes occur due to large releases of histamine during anaphylaxis?

Vasodilation leading to decreased blood pressure and risk of collapse Signup and view all the answers

What is the most critical concern in severe systemic anaphylaxis?

Maintaining cardiovascular and respiratory function Signup and view all the answers

What mechanism leads to capillary permeability changes during an anaphylactic response?

Histamine release from mast cells Signup and view all the answers

Which of the following conditions can result from bronchoconstriction during anaphylaxis?

Decreased oxygen levels in the blood Signup and view all the answers

Study Notes

Burns

Skin:
- Epidermis: 5 layers / Prevents fluid loss
- Dermis: 2 layers / Body temp regulates
- Deepest layer of dermis regenerates every 2-3 weeks
- Epidermis cannot regenerate without dermis

Metabolic Changes

Hypermetabolism - ↑ met. demand → breakdown of molecules
Splanchnic hypoperfusion - needs early aggressive metabolism feeding
Increased glucose production (glycogenolysis) - whiz
Insulin resistance - release of adrenaline causes cell inability to bind to insulin (insulin allows cells)
Leads to decrease in glucose uptake & clearance
Grave Crysaloids - mixed evidence of insulin
Risk of hypoglycaemia

Pathophysiology (Local Response)

Zone of coagulation - max damage (clot)
- Cell death, damage to circulation
Zone of stasis - decreased tissue perfusion
- Tries to pull oxygen in
- Can become infected, oedema.
Zone of hyperaemia - blood flow increases due to inflammation
- (Vasodilation + increased circulation + histamine)

Systemic Response

Release of cytokines & inflammatory mediators
- Once burn reaches 30% tissue areas - capillary permeability
- Peripheral + Splanchnic Vasoconstriction - due to release of catecholamines (body's adrenaline), vasopressin
- Reduce cardiac contractility - THR because O₂↓
- Less volume = less contractility - tries to maintain CO.
- Hypovolaemic shock / Distributive shock

Respiratory Changes

Stabilize airway + mechanical ventilation
Bronchoconstriction - adult respiratory distress (decreased) + more resistance
Loss of fluids: less oxygen carrying capacity

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Description

This quiz covers the fundamental concepts of burns, including skin layers and their roles in healing, as well as metabolic changes associated with burn injuries. It delves into pathophysiological responses like zones of coagulation, stasis, and hyperaemia. Test your understanding of these critical topics in burn care and management.