Emergency Interventions for Burn Injuries Quiz

Initial Assessment and Interventions

• Counting of the first eight hours starts from the time of burn injury
• Minor burns: run the area over water or apply a cold compress, but not directly on the wound
• Pain management: administer medications such as Diclofenac, Tramadol, Nalbuphine, or Morphine
• Tetanus Prophylaxis: administer ATS and TT
• Antibiotics administration: necessary for preventing infections
• Debridement: remove devitalized tissue
• Wound care: apply antimicrobial agent (SILVER SULFADIAZINE), and use a WET to WET DRESSING, covered with dry sterile gauze on top

Emergency Interventions

• Draw blood samples for CBC, ABG, BUN, Crea, and Serum Electrolytes
• Monitor vital signs, I and O, and CVP
• Insert NGT and IFC
• For electrical burns: perform 12 L ECG, and treat fatal dysrhythmias according to ACLS protocol
• For chemical burns: irrigate the wound with copious amounts of water or Plain NSS
• Do not use a weak base (Sodium Bicarbonate) to neutralize burns caused by strong acids

Burn Management

• Nutritional and Surgical Management: DIET: NPO until NABS, but small amounts of isotonic enteral tube feedings can be started within 24 hours to maintain GI function
• HYDROTHERAPY: facilitate cleansing and debridement of the burned area, and promote daily assessment of BSA and ROM exercises
• ESCHAROTOMY: removal of non-viable tissue (eschar)
• TANGENTIAL EXCISION: a procedure using a special blade to slice off thin layers of damaged skin until live tissue is evidenced by capillary bleeding
• BIOLOGICAL DRESSINGS: allograft (cadaver skin)

Systemic Changes in Burns

• Gastrointestinal changes: decreased peristalsis and gastric distention due to SNS response, leading to constipation and risk of gastric and duodenal ulcers
• Psychological changes: body image disturbance, fear, ineffective coping, and hopelessness

Inhalation Injury Assessment

• Monitor for signs and symptoms of carbon monoxide poisoning: headache, visual changes, confusion, irritability, nausea, ataxia, and collapse
• Inspect the oral cavity for blistering lips, singed nasal hair, soot in oropharynx, and dark gray or black sputum
• Listen for hoarseness and crackles (stridor and drooling may indicate intubation)
• Obtain ABG and Carboxyhemoglobin levels

Fluid Therapy

• Use the Parkland Formula for fluid resuscitation
• Administer Plain Lactated Ringer's Solution for the first 24 hours post-burn
• Administer Colloid (5% Albumin) for the second day
• Calculate fluid requirements based on the burn size and weight of the patient

Burn Size and Assessment

• Use the Rule of Nines to estimate the percentage of burned surface area (BSA)
• Major burns: third-degree burns on more than 10% BSA, or second-degree burns on more than 25% adult BSA or 20% child BSA
• Moderate burns: third-degree burns on 2-10% of BSA, or second-degree burns on 15-25% of adult BSA or 10-20% child BSA
• Minor burns: third-degree burns less than 2% of BSA, or second-degree burns on less than 15% of adult BSA or 10% child BSA

Triage Criteria

• Major burns: consider triage criteria for major burns, including third-degree burns, electrical burns, and burns in high-risk patients
• Moderate burns: consider triage criteria for moderate burns, including third-degree burns on 2-10% of BSA, or second-degree burns on 15-25% of adult BSA or 10-20% child BSA
• Minor burns: consider triage criteria for minor burns, including third-degree burns less than 2% of BSA, or second-degree burns on less than 15% of adult BSA or 10% child BSA