Card Set Information
Kids with burns....
always a reportable injury
Chemical burns are caused by....
cause tissue destruction
How long does tissue destruction last when you have a chemical burn? What do I do?
up to 72 hours
remove agent by flushing copiously with water
How do you treat a person with smoke inhalation injury
high flow O2
When to suspect inhalation injury
singed nasal hair
Electrical injury is from....what do I need to assess?
lightning or live wire
check for site of entry and exit for both....and watch EKG for abnormalities and s/s of rhabdomylisis
What am I looking at at site of exit for an electrical injury?
what's the tissue like at the exit site?
4 things to do for a person with an electrical injury
Lg bore IV 16-18 gauge
IV fluids of LR to maintain UO of 75-100mL/hr
Sodium bicarb IV alkalinize the urine
Monitor peripheral circulation closely
How do you calculate the TBSA?
Total body surface area of injury....
guestimation....1% for persons own palm of their hand
1st degree and will show as red area
Partial thickness burn
will show as redness with blisters and open skin
deep wound without pain
Rule of 9's
To calculate TBSA
Head and neck 9%
Anterior trunk, posterior trunk, legs are 18% each
How does location of burn affect things?
Circumferential chest-effects respiratory fxn
Hands, feet, eyes, joints-difficulty w/self care and future fxn
Ears, nose, perineum-infection (cartilage=no blood)
Where is an area that you see compartment syndrome a lot?
What makes it harder for a person to heal from a burn?
elderly heal slower
Interventions for a person with a facial burn
shave hair to reduce infection
don't use pillows
Referral criteria for transfer to a burn center
Partial thickness burn >10%
Any full thickness burn
Burns involving face, hands, feet, genitalia, perineum or major joints
Pre ex med cond. that can affect recovery
Who requires fluid resuscitation?
anyone with burns >15%....even if have co morbidities still give them fluids!!
24 hours after a burn....
you will see fluid shifts and electrolyte imbalances
4 Stages of burn care
stop the burning....and ABC's
begins at the time of injury for 48 hrs and lasts until massive fluid and protein shift has stabilized
begins 48-72 hours after injury and continues until the wound closes
goal is to restore the patients ability to fxn in society and with their family/role
All burn victims need....
a tetanus shot if they haven't had one in last 10yrs
extubate after 3-6 days
High fowlers with 100% O2
Fluids used in resuscitation
How do you use parkland to calculate fluid volume? How is it given?
4cc's/per % of TBSA/per kg of body weight
1/2 given in first 8 hours
1/4 second 8 hrs
1/4 third 8 hrs
Example of Parkland fluid resuscitation
4 cc x 50= 200 x 70kg=14,000 cc fluid total
7,000 in first 8 hrs
3,000 in 2nd/3rd 8 hours
How do you know if a person is being successfully resuscitated with fluids?
adult will be 30-50cc/hr
appropriate BP and pulse
relief of nausea/ileus within 24 hours
not addressed till ABC's and fluid replacement are established
debridement-removal of necrotic skin
**give morphine and verced and warm the room