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Flashcards in Burns Deck (15)
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1

What is the rule of 9's?

helps estimate % of burns: head, anterior chest, posterior chest, anterior abdomen, posterior abdomen, the whole head, anterior leg, posterior leg.... each count as 9%
The perineal area is 1%; each arm is 4.5%

2

What chart is frequently used to estimate burn % of a pediatric/newborn?

Lund-Browder chart

3

What is the palm of hand estimation for % TBSA burn?

the palm of the PATIENT's hand represents 0.5% TBSA, the palm including fingers is 1% TBSA

4

What is the % difference in a minor, moderate, and major burn?

20% TBSA respectively

5

Describe the basic local pathophysiology associated with a burn?

acute burn injury..... inflammatory mediators released..... increased capillary permeability..... extravasation of fluids into burned tissues.... tissue edema

6

How should fluid resuscitation be regulated in a burn patient?

should be titrated to maintain a urine output of 0.5-1.0mL/kg/hr in adults and 1-1.5mL/kg/hr in pediatrics; replacement volume must be individually adjusted based on clinical response

7

What is the Parkland formula?

In the first 24 hours: give LR at 4mL/kg per % TBSA (1st half to be administered in the first 8hrs and the remaining in the next 8 hours)
Crystalloid in the second 24 hours: give 20-60% of the estimated plasma volume
Colloid in the 2nd 24 hours titrated to UO of 30mL/hr

8

When is capillary leak at its greatest?

in the first 24hrs after a burn injury

9

When does capillary integrity improve?

capillary integrity greatly improves 2nd day post burn

10

Why is the use of colloids controversial during the first 24hours following a burn?

d\t increased capillary permeability... if colloid leaks into interstitial space it can worsen the edema d\t oncotic effects

11

Based on the Parkland formula, if a patient weighs 70 kg and has burns of 40% TBSA... how much LR should be administered in the first 24hour period?

11,200mL.... so 5,600mL in the first 8 hours and 5,600mL in the following 16 hour period

12

T/F? Patients with >40% TBSA burns may have a metabolic rate 200% of normal rate.

True

13

What may cause a false high reading in the pulse-ox of a burn patient?

carboxyhemoglobin levels

14

Why should Sux be avoided in burn patients?

exaggerated hyperkalemic response

15

What considerations should be made when administering non-depolarizing agents to a burn patient?

may require higher doses (2-5x) and have significantly quicker recovery times when TBSA burned is 10-40%