Burns

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Questions and Answers

What is a common early sign of carbon monoxide poisoning?

Chest pain

Skin rash

Headache (correct)

High fever

What is the recommended treatment for carbon monoxide poisoning?

Intravenous antibiotics

Oral hydration

100% oxygen administration (correct)

Glucose infusion

How is the Parkland formula for resuscitation scheduled?

One quarter in the first 6 hours

Half in the first 8 hours, half in the next 16 hours (correct)

All fluid volume over 24 hours

One third in the first 12 hours

What should be monitored every hour during fluid resuscitation?

Fluid intake and output Signup and view all the answers

What is the purpose of an escharotomy?

To relieve circulatory constriction Signup and view all the answers

Which of the following is a complication that can occur after severe burns?

Heart failure Signup and view all the answers

What is a common effect of burns that may necessitate the insertion of a nasogastric tube?

Paralytic ileus Signup and view all the answers

Why is daily debridement of burn wounds important?

It prevents infection and promotes healing Signup and view all the answers

What method should be used for facial burns during traditional wound care?

Open method or exposure method Signup and view all the answers

What determines the extent of the effects of a burn injury?

Depth of burn injury and total body surface area Signup and view all the answers

What is primarily responsible for the plasma shift to interstitial spaces immediately after a burn injury?

Capillary dilation and hyperpermeability Signup and view all the answers

What is a major concern in the emergent phase after a major burn?

Hypovolemic shock resulting from fluid loss Signup and view all the answers

Which symptom is NOT typically associated with burn shock?

Increased urine output Signup and view all the answers

What type of burn is characterized as superficial (first degree)?

Sunburn with mild redness Signup and view all the answers

Which of the following is likely to be a late symptom of inhalation injury after a burn?

Hoarse voice Signup and view all the answers

What can significantly reduce the risk of burn injuries in the home?

Proper use and maintenance of appliances Signup and view all the answers

What is a characteristic appearance of a superficial partial thickness burn?

Blistered and moist skin Signup and view all the answers

Which type of burn typically does NOT cause pain?

Full thickness burn Signup and view all the answers

What does the Rule of Nines indicate?

It calculates the total body surface area burned. Signup and view all the answers

What is the first priority at the scene of a burn injury?

Preventing further injury Signup and view all the answers

What is a common complication of a full thickness burn if not treated properly?

Sepsis and extensive scarring Signup and view all the answers

Which type of burn may require skin grafts for proper healing?

Deep partial thickness burn Signup and view all the answers

Why is the Rule of Nines less accurate for children?

Children have larger heads compared to their body size. Signup and view all the answers

What is recommended to stop the burning process at the scene of injury?

Use the 'stop, drop and roll' technique Signup and view all the answers

How quickly can a superficial partial thickness burn heal?

Within 2 weeks Signup and view all the answers

Study Notes

Burns: Etiology and Pathophysiology

Burns are categorized as thermal (heat), non-thermal (electricity, chemicals, radiation).
Burn severity depends on the extent (TBSA) and depth of the burn injury.
Prevention includes safe use of appliances (space heaters, electrical cords).
Physiologic changes occur within minutes/hours post-injury, primarily within the first 12 hours.
Emergent phase (24-48 hours): major concern is hypovolemic shock.
Capillaries dilate and become hyperpermeable, shifting intravascular fluid into interstitial spaces. This leads to edema and blistering.
Blood pressure drops (hypovolemic shock) within 48 hours after the burn injury.
Blood flow to kidneys decreases resulting in acute renal failure.
Burn shock is characterized by hypotension, decreased urine output, rapid pulse, rapid respirations, and restlessness.
Most burn deaths occur due to burn shock.

Intermediate/Acute Phase

The intermediate phase (48-72 hours) is characterized by fluid shifting from interstitial spaces back into capillaries.
Kidneys excrete large volumes of fluid (diuretic phase).
This stage involves circulatory overload (potential for heart strain).
Inhalation Injuries: Patients with burns around the face, neck, or who have inhaled smoke, chemicals, steam or flames may experience respiratory issues. Look for singed facial hair, black-tinged sputum, soot in the throat, hoarseness, or burns around the face. Difficulty breathing can occur a few hours after the burn. CO poisoning is a concern in enclosed spaces during burn events. CO poisoning symptoms include headache, nausea, vomiting, and unsteady gait. Early intervention with 100% oxygen is recommended.

###Fluid Resuscitation

Parkland formula is used to calculate fluid resuscitation: 4 ml Ringer's lactate (TL) x % burn x weight in kg.
Half of the fluid volume is administered in the first 8 hours, and half in the next 16 hours.
Monitor fluid intake and output hourly using a Foley catheter.
Frequent physical assessment is crucial during the emergent phase, addressing circulatory status.
Insert a nasogastric tube to prevent aspiration to manage paralytic ileus.

Treatment of Burns

Rule of Nines: A method for estimating the extent of burns, calculating the total body surface area (TBSA) burned (not accurate for children).
Addressing the burn wound involves removal of eschar.
Debridement and special cleaning support tissue regeneration and prevent infection.
Traditional (open) and closed-method wound care depends on the burn's severity. -Open method: Exposure for better visibility, but there are disadvantages as well (painful, potential for contamination) -Closed method: Covering the burn area.
Skin grafting is used for extensive burns.
Types include autografts (patient's own skin), allografts/homografts (cadaver skin), and heterografts/xenografts (animal skin).
Supplemental nutrition is crucial because of the increased metabolic demands.
Proper positioning and range-of-motion exercises are essential.

Complications

Renal failure: elevated blood urea nitrogen and serum creatinine.
Contractures.
Paralytic ileus.
Curling's ulcer (duodenal ulcer following severe burn).
Infection
Heart failure (a concern in some cases)

Priorities

Maintain a safe scene and prevent further injury to patient.
Assess airway promptly, address CO poisoning concerns, and stabilize the airway .
Control bleeding.
Administer analgesics before debridement.
Address circulatory status and maintain circulation.

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Description

This quiz focuses on the causes and effects of burns, detailing the types, severity, and physiologic changes occurring post-injury. It discusses prevention strategies and the critical phases of burn management, highlighting the risks associated with hypovolemic shock. Test your understanding of burn care concepts and mechanisms.