MOD E Tech 35 Burns and Scalds Flashcards Preview

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Flashcards in MOD E Tech 35 Burns and Scalds Deck (17)
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1
Q

Burns & Scalds

.What causes a burn ?

What causes a scald

A

Burns are caused by dry heat:

  • Flame or radiation
  • Electricity
  • Friction
  • Corrosive chemicals

Scalds are caused by wet heat:

  • Water
  • Steam
  • Fat
  • Hot liquid chemicals
2
Q

Thermal Burns

3 dangers/complications associated with thermal burns:

A
  1. Hypovolaemic shock
  2. Infection
  3. Damage to the respiratory tract
3
Q

Complications burns

A

Shock:

•All patients suffering burn injury will be suffering from both clinical and psychological shock

•Loss of fluid from the circulation leads to hypovolaemic shock

4
Q

Burns

Complications - Infection

A
  • Do not touch the burn unnecessarily
  • Wear sterile gloves
  • Remove burnt, non-adherent clothing
  • Cover with a sterile dressing, “waterjel” or “cling film”
  • Do not burst blisters
5
Q

Complications – Damage to the Respiratory Tract

Look for:

A

Look for:

  • Facial or neck burns
  • Sooty sputum
  • Singed nasal hair, eyebrows
  • Soot in the nose and mouth
  • Hoarse voice, persistent cough
  • Altered breath sounds – stridor, wheezing
  • Loss of consciousness
6
Q

Other Complications of Burns

A
  • Pain
  • Hidden injury – falls, explosions, electrical injury
  • Hypothermia – children especially susceptible due to over enthusiastic irrigation
  • Circumferential Burns
7
Q

Specific Types of Thermal Injury

Electrical Burns

A
  • Caused by AC or DC electrical current
  • Isolate any electrical current before beginning your assessment
  • Attach the cardiac monitor – 12 lead
  • Treat as for a normal burn
  • There may be 2 burn points
  • deep dermal injury may have occurred
  • Assess for other injuries (Consider C-spine)
  • Be aware of possible tetany
8
Q

Lightning Injury

A

Classic “Splatter” or “fernlike” pattern

9
Q

Chemical Burns

Immediate treatment should include

A
  • Removing all contaminated clothing
  • Irrigating freely with tepid water/saline (min. 15 minutes)
  • Do not use Clingfilm – use wet dressings
  • Treating as for a normal burn
  • Keeping phosphorous burns continually wet
  • It is vital to note the nature of the chemical
  • Alkalis, in particular, may cause deep, penetrating burns – it may take hours of irrigation to neutralise the alkali
  • Certain chemicals such as phenol or hydrofluoric acid can cause poisoning by absorption through the skin
10
Q

Chemical Burns

How would we treat chemical burns to the eyes?

A
11
Q

Classification & Assessment of Thermal Injury

i. Name and briefly describe the three different classifications of burn depth.
ii. State how you would assess the area of burn.

A

1.Superficial (erythema)

2.Partial thickness

3.Full thickness

rule of 9

12
Q

Burn Assessment - Assessing the Area (BSA)

A
  • BSA is more significant than depth
  • Age of patient is significant
  • Superficial burns are usually more painful than deep ones
  • (If age + % BSA is > 100 the prognosis is poor)
  • Consider all of the burn – do not differentiate (erythema should not be included as it can be transient initially)
  • Give a rough indication of the extent of the burn
  • Note the time that the burn occurred
13
Q

Assessing the Area of Burn

A

Wallace’s Rule of Nines (age >14yrs)

OR

The Lund and Browder chart

14
Q

Lund & Browder Chart

A
15
Q

Time Critical Features of Burns

A
  • Any major ABCD problems
  • Any signs of airway burns
  • History of inhalation of hot gases / air
  • Respiratory distress
  • Evidence of circumferential burns to the chest or neck (or limbs)
  • Any significant facial burns
  • Adults with > 15% BSA (>10% in children)
  • Presence of other major injuries
16
Q

Burns & Scalds

General Management

A
  • Stop the burning process – if safe
  • Ensure an open airway
  • High levels of oxygen (15 litres/min target SpO2 of 94-98%) – don’t rely on pulse oximetry (carboxyhaemaglobin)
  • Consider nebulisation if the patient is wheezing
  • Remove anything constrictive
  • Irrigate with copious amounts of water – 15 to 20 mins.
  • Remove clothing which is hot and wet and not adherent to the skin – after irrigation with water
  • Consider “Waterjel” for burns <12.5% BSA – Water treatment preferred
  • If burn gel not appropriate - Cover the burn with “cling film” – overlapping rather than bound and continue to irrigate over the cling film – max. 10 mins
  • Do not use cling film on chemical burns
  • Be aware of hypothermia!
  • Provide analgesia as required. (Morphine if severe pain)
  • (Entonox is not considered appropriate if >50% O2 is required)
17
Q

Important information to pass on:

A
  • Extent of burn
  • Time of burn
  • Burning agent
  • Whether first aid was undertaken
  • Any indication of airway burns
  • Any evidence of potential for circumferential burns