AP Final - BURNS

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AP Final - BURNS
2013-05-04 13:02:08
aa emory AP

Anesthesia for Burn patients
Show Answers:

  1. How many burn injuries per year receive medical tx?
  2. How many burn related deaths per year?
  3. What is the survival rate upon admission to Burn Center?
  4. Gender ratio M:F?
  5. what percent of burns occur at home?
  6. leading cause of burn?
  7. highest ethnicity for burn tx:
    caucasion (63%)
  8. Define a Fire/Flame burn:
    what risk is associated with this?
    • direct tissue injury.
    • CO/CN risk and inhalational inury
  9. define scald:
    more ______=greater ________
    • results from contact with hot liquid
    • viscous = danger
  10. Steam burn produce extensive injury due to _____ ______ _______ ________, can cause injury to ____ airway.
    • high heat carrying capacity
    • distal
  11. Gas burn:  upper airway at risk for _____ and ______.   Distal at risk due to ______
    • thermal injury, edema
    • combustion
  12. electrical burns  cause what to problems:
    • tissue heat injury
    • Heart injury
  13. voltage reg for electrical burn
    • 1000V
    • 200+ for children
  14. what type of burn is due to rapid ignition of gas or liquid?
  15. chemical burns can be associated with _______ ________.
    systemic toxicity
  16. what are the 7 types of burns?
    • flame
    • scald
    • steam
    • gas
    • electrical
    • flash
    • chemical
  17. a 1 degree burn involves only the ______.  Sx?
    • epidermis
    • erythema
  18. a 2 degree burn can be either superficial or _____.  also called _____ thickness Sx?
    • deep (susally req surgery)
    • partial
    • blistering
  19. A 3 degree burn is a _____-thickness burn.  and includes loss of all _______ ________, extending to subQ tissue.
    • full
    • dermal elements
  20. What is the RULE OF 9s?
    used to measure percent of body burned.  each part of body is 9%.
  21. what are the 3 ways to determine extent of burn injury?
    • rule of 9s
    • palm (1%)
    • lund browder
  22. ______ damage requires immediate attention
  23. What are the Sx of inhalational injury? (8)
    • Stridor
    • Hoarseness
    • Accessory muscle use
    • facial burns
    • eyebrow singe
    • soot or redness of mucosa in mouth
    • black sputum
    • accident in confined space
  24. what are the functions of the skin?
    protect, regulate temp, waste elimination, vit d production, sensation
  25. Why does fluid accumulate in unburned tissue?
    systemic spillover of histamines and cytokines
  26. capillary fluid transport in governed by the _________ equation.
  27. what procedure can be done to prevent compartment syndrome?
  28. What 3 alteration in alveoli with injury?
    • surfactant denaturation
    • loss of endo and epithelial barrier
    • inlfux of inflammatory cells
  29. How quickly will edema develop in burn pt's?
    24 hours
  30. what happens to WBC function?
    decrease in macrophage, increase in neutrophils
  31. there is potential you may not be able to extubate after durgery due to:
    decreased airflow and gas exchange caused by sloughing of mucosal surface, decreased ciliary function
  32. CO causes a ___ shift in the OHDC
  33. will pulse ox show CO poisoning?
    No- same wavelength as oxyHgb
  34. Why does cyanide poisoning occur quickly? what is the source?
    • inhibits cellular metabolism
    • can be caused by burning plastic or chemicals
  35. what should you look for with CO poisoning?
  36. What is used to score mortality risk with burns?
    • BAUX score.  Age plus BSA. 
    • inhalational adds 17 years.
    • score of 100 = 50% risk
  37. What is important in Tx?
    • fluid resuscitation
    • urine output
    • O2 therapy
    • antibiotics
    • debridement
    • escharotomy
  38. What must be in the OR before the Pt?
  39. keep the OR _____
  40. How long should sux not be used in burn pt's?
    8 hours to 2 years
  41. why is SUX contraindicated in burn pt's?
    increased acetylcholine receptor density!
  42. Burn pt's have a DECREASED sensitivity to what type of drug?
  43. Burn pt's will have an increased _____ req.
  44. what is blood loss for BSA excised?
  45. what is pre-renal azotemia?
    excess of toxins due to less filtering by kidneys due to BP drop
  46. What are common organ issues associated with burn pt's?
    • CV hypermetabolic states
    • clotting problems (hyper or Hypo)
    • renal
    • GI ulcers (be careful with NSAIDS)