ABSITE ch 17 burns.txt

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ABSITE ch 17 burns.txt
2010-01-11 11:06:59
burns ABSITE

ABSITE ch 17 burns
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  1. Sunburn (epidermal)
    1st degree
  2. Burns that are painful to touch, blister, with intact hair follicles
    2nd degree superficial dermal
  3. Burns that have decreased sensation, loss of hair follicles
    2nd degree deep dermal
  4. Burns with charred leathery surface or down to subcutaneous fat
    3rd degree
  5. Burns to bone or into adjacent muscle or adipose
    4th degree
  6. Most common burns in children and elderly
    Scald burns
  7. Burns most likely to come to hospital and be admitted
    Flame burns
  8. Rule of 9�s
    Head 9, arms 18, chest 18, back 18, legs 36, perineum/palm 1
  9. Parkland formula
    = 4cc/kg X % TBSA burned (use LR)(fluid given in 1st 24 hours, half of it in 1st 8)
  10. Situations when Parkland formula underestimates need
    Inhalational injury, ETOH, electrical injury, postescharotomy
  11. Indications for escharotomy (3)
    Circumferential, suspected compartment syndrome, ventilation difficulties + torso burns
  12. Risk factors for airway injury (6)
    ETOH, trauma, closed space, rapid combustion, age extremes, delayed extrication
  13. Most common infection in burn patients
  14. Deeper burn in acid or alkali?
    Alkali (liquefaction necrosis)
  15. Treatment of hydrofluoric burns
    Spread calcium on wound
  16. Treatment of powder burns
    Wipe away powder then irrigate
  17. Treatment of tar burns
    Cool area, wipe away tar with lipophilic solvent
  18. Treatment of electrical burn
    Cardiac monitoring, watch CK
  19. Caloric need for burn patient
    25kcal/kg/day + (30kcal X %burn)
  20. Protein need for burn patient
    1g/kg/day + (3g X %burn)
  21. Best source of nonprotein calories in burn patients
  22. Depth of STSG
  23. Order of suitability for grafts among: cadaveric homograft, autograft, dermal substitutes and xenografts
    Autograft>homograft>xenografts>dermal substitutes
  24. Goal of blood loss per burn surgery
  25. Goal of surface area debrided/grafted per burn surgery
  26. Goal of time in OR per burn surgery
  27. Most common reason for graft loss
    Seroma or hematoma under graft
  28. Type of grafts used on face
    Full thickness
  29. Treatment of deep burns on hands (2)
    Immobilization with wire fixation, full thickness grafts
  30. Treatment of palm grafts
    Splint in extension 1 week postop after full thickness graft
  31. Treatment of genital burns
    Antibiotics for 2 weeks, then graft unhealed areas
  32. Most common organism in burn wounds
  33. Immune dysfunction in burn patients
    Impaired granulocyte chemotaxis, impaired cell-mediated immunity
  34. Side effects of silver sulfadiazine
    Neutropenia, thrombocytopenia
  35. Side effects of silver nitrate
    Hyponatremia, hypochloremia, hypocalcemia, hypokalemia (all hypo!)
  36. Side effects of sulfamylon
    Painful application, metabolic acidosis
  37. Broadest spectrum topical antibiotic (covers pseudomonas)
    Sulfamylon (mafenide sodium)
  38. Most common viral infection in burn wounds
  39. Best way to detect burn wound infection
    Biopsy (need 10^5 organisms)
  40. Complication after burn of eyelid sticking to conjunctiva (and its treatment)
    Symblepharon, release with glass rod
  41. Gastric ulcer frequently seen in burn patients
    Curlings ulcer
  42. Squamous cell cancer arising in chronic nonhealing wound
    Marjolin�s ulcer
  43. Epidermal-dermal separation seen after drug reaction or viral infection
    TEN (toxic epidermal necrolysis)
  44. Treatment of TEN
    Supportive, graft if needed, NO STEROIDS
  45. Most severe form of TEN, including subepidermal bullae, epidermal cell necrosis, and dermal edema
    Stevens Johnson syndrome