Thermal Injury Flashcards Preview

APA3 levi 2019 S.Horvath > Thermal Injury > Flashcards

Flashcards in Thermal Injury Deck (50)
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1
Q

what does myoglobinemia lead to?

A

renal failure

2
Q

first degree burns are limited to the ____

A

epidermis

3
Q

second degree burns are also called ___ , ____

A

deep, superficial partial thickness

4
Q

T/F Second degree burns may need grafting, but for third degree burns, grafting is required

A

TRUE

5
Q

Third degree burns extend to the ___ layer

A

subcutaneous

6
Q

Fourth degree burns affect the ___, ___, ___

A

muscle, fascia, bone

7
Q

A second degree burn affects >__% for adults, >___% for extremes of age

A

10, 20

8
Q

a third degree burn affects >__%

A

10

9
Q

how do you estimate mortality with a burn pt

A

Age + TBSA%

if >115, mortality is >80%

10
Q

inhalation injury ___ the chance of mortality

A

doubles

11
Q

rule of 9’s — legs are worth __%

A

18

12
Q

rule of 9’s — front chest to waist is worth

A

18

13
Q

rule of 9’s — back is worth

A

18%

14
Q

rule of 9’s — arms are worth

A

9% each

15
Q

rule of 9’s — baby head is worth

A

18

16
Q

rule of 9’s — baby leg is worth

A

14 each

17
Q

rule of 9’s - for a baby subtract __ from head for each year of age over 1

A

1%

18
Q

what is the most common type of burn in children?

A

thermal

19
Q

skin damage to tissues may continue over ___hrs

A

48-72

20
Q

what are the 3 zones of burn?

A

zone of coagulation, zone of hyperemia, zone of stasis

21
Q

T/F Succinylcholine is contraindicated after 24h of burn injury.

A

TRUE

22
Q

when is succs ok in a burn patient?

A

after the wound is closed and the pt is gaining weight again.

23
Q

T/F Burn patients may have a decreased requirement for NDNMB.

A

FALSE - may have increased requirement 2-3fold.

24
Q

CO affinity for hemoglobin is ___x that of oxygen.

A

200

25
Q

CO poising causes what acid base imbalance?

A

metabolic acidosis at cellular level.

26
Q

if patient has CO poisoning, what will these labs show?

SAO2
ABG
Co-oximetry

A
SAO2 normal
-------
ABG decreased total oxygen 
----------
co-ox true o2 sat
27
Q

T/F Treating CO Poisoning with 100% 02 decreases CO half life from 4h to 40min.

A

TRUE

28
Q

Massive fluid loss from burns is greatest when?

A

first 12 hours.

begins to stabilize after 24h

29
Q

what is the formula for fluid resuscitation in an adult

A

LR 2-4ml x kg x percent BSA burned.

[one half of the estimated volume of fluid should be administered in the first 8h after the burn. the remaining half should be given over the subsequent 16h of the first post-burn day.

30
Q

what is the formula for fluid resuscitation in a child

A

LR 3-4ml x kg x percent BSA burned.

31
Q

T/F infants and young children should receive fluid with 5% Dextrose at maintenance rate in addition to the resuscitation fluid.

A

TRUE

32
Q

what is the minimum urinary output for an adult

A

0.5ml/kg/hr

33
Q

what is the minimum urinary output for a child weighing <30kg

A

1ml/kg/hr

34
Q

what is the min urinary output in patients with high voltage electrical injuries

A

1-1.5ml/kg/hr

35
Q

The hypermetabolic/ hyperhemodynamic phase can persist for up to ____

A

2 years

36
Q

The hypermetabolic/ hyperhemodynamic phase usually starts after ____h

A

48-72

37
Q

how is the hypermetabolic/ hyperhemodynamic phase manifested?

A

hyperthermia, tachypnea, tachycardia, increased serum cats, increased O2 consumption, increased catabolism, increased BMR

38
Q

what is the hallmark of burn shock and how is it initially preserved?

A

decreased CO.

initially preserved by catecholamine release - inc HR and vasoconstriction

39
Q

The immediate intravascular fluid loss happens for about ___h

A

36

40
Q

ventilation can increase from 6L/min to ___L/min

A

40

41
Q

what is the leading cause of death in burn pt’s

A

sepsis

42
Q

how should you tx myogloinemia

A

sodium bicarb

43
Q

what is renal failure r/t?

A

hypovolemia, decreased CO, increased cat

44
Q

for ___% burn, ___% higher energy expenditure

A

40, 132

45
Q

stop tube feeds _h for non-intubated

A

4

46
Q

__ - __ EBL for each 1% debridement

A

200-400

47
Q

in the resuscitative phase, the patient experiences hypovolemic shock due to a severe depletion of ____ , and a marked increase in ____

A

plasma, extracellular volume

48
Q

after 48 hours, burn patients get _____

A

hypermetabolic

you see: increased CO, tachycardia, lower SVR

49
Q

how does decreased alumni affect pharmacokinetics?

A

altered VOD, protein binding. highly protein-bound drugs have a higher free fraction and thus a larger VOD

50
Q

what happens if you give succs to a burn patient after 24h?

A

lethal hyperkalemia