Burns

Question 1

What age has the best survival rate for burns

Answer 1

15 to 45

Question 2

In what classification will the epidermis be destroyed?

Answer 2

First degree burn aka superifical partial thickness

Question 3

In what classification will the epidermis down to deep dermis be destroyed?

Answer 3

Deep partial thickness aka 2nd degree burn

Question 4

In what classification would the epidermis, dermis, subcutaneous and maybe muscle be destroyed?

Answer 4

Full thickness aka 3rd degree burns

Question 5

What might you see for first degree burns? How do you treat them?

Answer 5

Sunburn or flash burn; minimum pain; erythema; cool water compress or submerged, no ointments; don’t disturb blister; educate

Question 6

What would you expect a second degree burn to look like?

Answer 6

Severe pain, blisters, edema, erythema

Question 7

What would you expect with a third degree burn

Answer 7

No pain, lack of color, edema, leathery texture, possible loss of digits

Question 8

What is the % of the head, arm, chest, groin,and legs

Answer 8

Head 9%, arm is 9%, chest is 18%, abdomen 18%, groin 1%, legs 18% ( these include anterior and posterior damage)

Question 9

Dry heat like flames, moist heat from liquid, and hot surface contact are examples of what?

Answer 9

Thermal burn

Question 10

Caustic agents on skin causes what kind of burn?

Answer 10

Chemical burn

Question 11

Electrical injury can result in?

Answer 11

V fib

Question 12

Parkland formula? What does it tell you? What fluid?

Answer 12

4 ml × kg of pt × % of body affected. The amount of fluid resuscitation needed in 24 hrs. Lactate ringers

Question 13

How do you figure out how much fluid resuscitation is needed in the first 8hrs and the last 16 houra?

Answer 13

Use the parkland formula for the total in 24 hrs. Divide by 2. Divide by 8 for the hourly rate in the first 8 hrs. Divide by 16 for the hourly rate for the last 16 hours

Question 14

What do you do if a patient has a radiation burn?

Answer 14

Stop tx, disconnect, find a safe place for patient, hydrate, cut clothes off, you special gloves in equipment to remove clothes from patient, get patient to decontamination center, don’t shower the patient because the water needs to be collected

Question 15

What are the stages of burn injury question

Answer 15

Emergent or resuscitative, acute, and rehabilitative

Question 16

What prehospital treatment can we give a burn patient?

Answer 16

Limit the severity by removing things that cause damage, cardiac help in monitoring in the first hour is critical, CPR, fluid resuscitation in the field of possible, maintain body temperature cuz we don’t want patient to become hypothermic by placing patient in a warm environment, and get patient to proper hospital

Question 17

In the emergent phase how long is it? What are the main concerns? What are our goals?

Answer 17

From onset to 48 hours. We are concerned with fluid loss, edema, decreased blood flow and fluid and electrolyte imbalances. The goal is maintaing a patent Airway, fluid replacement, comfort with analgesics, wound care to decrease infection, maintain body temperature and emotional support

Question 18

What is the time frame for the acute stage of burn injury? Where are the main concerns? What are the goals?

Answer 18

48 hours to wound closure is complete the main concerns are perfusion, pneumonia because of pain breathing too short and shallow breathing, respiratory compromise, infection. The goals are maintaining skin integrity, maintaining adequate nutrition for proper healing, not overloading the patient come encouraging adequate mobility and movement, supporting family

Question 19

What is the time frame for the rehabilitative stage of burn injury? what are the goals?

Answer 19

From wound closure to the patient reaching the highest level of functioning. The goals are monitoring vital signs to get the patient back to baseline, activity intolerance, mobility concerns secondary to pain, comfort with analgesics but no aspirin due to an increase in GI ulcers and impaired healing, maintain skin integrity and reduce contractures with turning every two hours, and provide family and patient with support

Question 20

If a patient comes in suffering from smoke inhalation and you see soot what can you do?

Answer 20

Intubate, suction, oxygen therapy with a face mask with humidified air, incentive spirometer for deep breathing, mucolytics to remove mucus, CPR, pain meds

Question 21

What might you see if burn shop occurs?

Answer 21

A usually occurs in the first 12 to 36 hours, increase capillary permeability leading to fluid leakage and Thurs spacing leading to fluid volume deficit and hemoconcentration, decreased cardiac output, tissue perfusion and agrees bTW, metabolic and respiratory acidosis

Question 22

When does fluid remobilization occur? What do you expect to

Answer 22

2 days to 2 weeks after burns. Expect to see if fluid shifting back into intravascular spaces, increase blood pressure and cardiac output, hemo dilation. We would expect to Diuresis the patient because you can see CNS changes with decreases in sodium and potassium

Question 23

What oxygenation issues might you see with smoke inhalation?

Answer 23

Think of a smoky kitchen. So you might see wheezing, respiratory may need to be assessed, there may be a need for oral care

Question 24

What might you see if you have a patient who comes in from heat inhalation?

Answer 24

Imagine that have been rescued from a burning house so you would see Lorenzo spasms, swollen lips, then maybe horse or an able to speak, decrease respiratory status

Question 25

With 10 to 20% of carbon monoxide poisoning what might you see?

Answer 25

Headache, dizziness, nausea, abdominal pain

Question 26

With 20 to 40% carbon monoxide poisoning what would you expect to see?

Answer 26

Drowsiness, irritability, change your personality, hypotension, bradycardia, decreased heart rate, decreased pulse or the skin might be dark red

Question 27

For a patient with 41 to 60% carbon monoxide poisoning what might you expect

Answer 27

Convulsions and tachycardia

Question 28

For patient with over 60% carbon monoxide poisoning what would you

Answer 28

Death

Question 29

What is the treatment for carbon monoxide

Answer 29

Hyperbaric chamber

Question 30

With burn patients what GI issues and considerations might you have?

Answer 30

There is decreased blood flow because the blood is shunted to the brain heart and vital organs. So you would experience gastric dilation which could lead to a paralytic ileus due to decrease in motility and curling is also which usually occurs after 24 hours of the incident because of decreased blood flow. Stress bleeding can lead to GI ulcers so we give protonix and carafate to keep the stomach. If there’s a decrease in H&H think GI tract

Question 31

Autograft is what kind of wound covering?

Answer 31

The patients ownskin transplanted

Question 32

What is homograft or an allograft wound covering?

Answer 32

From a cadaver or a living person

Question 33

What is hetero graft also known as? What type of wound covering is this?

Answer 33

Xenograft, the from another species like a pig

Question 34

What graft would you use for the eye

Answer 34

Amniotic membrane

Question 35

What is cultured skin?

Answer 35

Skin grown from your own skin cells skin grown from your own skin cells

Question 36

What is the difference between hypertrophic scarring and keloid?

Answer 36

Hypertrophic scarring is the overgrowth of collagen that grows over burns and it will stay the same size where keloid what can grow and change in size

Question 37

A pressure dressing is individually made for burn victims. When can think when can’t believe them? What are they used for

Answer 37

Stay tight so you wouldn’t use them for an open wound, the individually made, the patient wears them 23 hours per day. And they are used to prevent and reduce hypertrophic scarring