Burns

Karin McConville

TEST TAKING TIPS

Test Taking Tips

Count on using the Parkland formula to calculate the volume of fluids that you need to give to your burn patient. Don't forget that the start time of volume resuscitation is at time of burn, not at time of arrival to the hospital.

Review topical antimicrobials such as silver nitrate or sulfamylon and their side effects and what they have best coverage for.

CLASSIFICATION

What are the 5 different causal categories for burns?

Flame: damage from superheated, oxidized air
Scald: damage from contact with hot liquids
Contact: damage from contact with hot or cold solid materials
Chemical: contact with noxious chemicals
Electrical: conduction of electrical current through tissues

What is a 1st-degree burn?

Injury localized to the epidermis

What is a superficial 2nd-degree burn?

Injury to the epidermis and superficial dermis

What is a deep 2nd-degree burn?

Injury through the epidermis and into the deep dermis

What is a 3rd-degree burn?

Full-thickness injury through the epidermis and dermis into the subcutaneous fat

What is a 4th-degree burn?

Injury through the skin and subcutaneous fat into underlying muscle or bone

Identify the depth of the burn:

A painful, erythematous burn with an intact epidermal barrier that blanches to the touch?
1st degree
Painful burn with blebs and blisters; hair follicles intact; blanches to the touch?
Superficial 2nd degree
Sensation decreased; loss of hair follicles?
Deep 2nd degree
Leathery feeling, no sensation?
3rd degree

FIGURE 23-1.

Illustration of the zones of injury after burn. Factors likely to affect the zone of stasis determine the extension of injury from the original zone of coagulation. (Reproduced from Felliciano DV, Mattox, Moore EE. Trauma. 6th ed. http://www.accesssurgery.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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PATHOPHYSIOLOGY

What are the 3 zones of injury from a burn?

Zone of coagulation, zone of stasis, zone of hyperemia

Define the zone of coagulation:

Irreversibly damaged necrotic area of a burn where cells have been disrupted

Define the zone of stasis:

Area associated with vascular damage and leakage that is immediately adjacent to the necrotic zone with a moderate degree of insult and decreased tissue perfusion that can either survive or progress to coagulative necrosis

Zone of hyperemia:

Area of vasodilation from inflammation surrounding the burn with viable tissue where the healing ...

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