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