The body is burning
A clinical tool used to rapidly assess the TBSA (total body surface area) affected by burns in adults.
What is the rule of 9s?
The most common cause of death in burn patients.
What is infection/sepsis?
Also will accept shock and respiratory failure.
The initial approach which includes asking about Airway, Breathing, Circulation, Disability, and Exposure.
What is primary survey?
Here is also when burning material such as clothes would be removed, intubation occurs, acute pain management is given.
Morphine acts primarily on this receptor type (given for acute pain management).
What is the μ-opioid receptor?
side effects include sedation, constipation, and respiratory depression.
Contraindicated - Significant respiratory depression (due to intoxication or sleep-disordered breathing), also pregnancy,
This healthcare professional would provide high-calorie, high-protein diet for hypermetabolism associated with burns.
What/who are Nutritists/dietitians?
A standardized clinical tool/table that estimates TBSA affected by burns by age group.
Most accurate method for assessing burn extent
Lund-Browder chart
The release of (this), due large burns, leads to Increased vascular permeability → extravasation of protein and fluid from the intravascular compartment into interstitial tissue → generalized edema, acute respiratory distress syndrome, and Disseminated intravascular coagulation (DIC)
What are cytokines and other inflammatory mediators?
After the initial approach, if the patient is considered stable, a health care personel will conduct an specific accessment including a focused history, more thorough physical examination, and select diagnostic studies (e.g., imaging). Can detect commonly missed injuries (e.g., aortic, rectal, and ureteral injuries).
What is a secondary survey?
Here is also when a catherter is placed to monitor urine output and when the professional looks for compartment syndrome.
This MDR gram-negative organism was cultured in May’s wound and bloodstream.
What is Acinetobacter baumannii.
This type of healthcare professional would be the one conducting a slit lamp exam with fluorescein staining.
What/who is an ophthalmologist?
This test identifies corneal abrasions and foreign bodies in the eye.
Fluorescein (flourescent dye) stains the basement membrane, which is exposed following damage to the cornea.
If heat does reach the eye → risk of corneal epithelial damage and limbal ischemia → detected on slit lamp with fluorescein.
This type of burn is not included when calculating TBSA.
What is first-degree burn?
To prevent this complication, patients rescued from fires, are intubated.
What is carbon monoxide poisoning?
This emergent surgery is performed when full circumferential thickness (and sometimes partial thickness) burns result in circulatory or respiratory compromise.
What is an Escharotomy?
involving incising through areas of burnt skin to release the eschar and its constrictive effects, restore distal circulation, and allow adequate ventilation.
This drug binds to the outer cell membrane (phospholipids of gram negative bacteria -> ↑ permeability → bacterial lysis
and binds+inhibits bacterial endotoxins (lipopolysaccharides).
What is colistin (polymyxin E)?
side effects = Nephrotoxicity, Neurotoxicity, and Respiratory failure
contraindications = Hypersensitivity to polymyxins, Cautious use in patients with renal dysfunction
These health care professionals would be involved with care at the burn center / early management.
Name at least 3
What are the Burn Unit nursing and physician teams as well as social work, nutrition, and therapy services?
This specific type of radiation is most effective at causing sunburns.
What is UVB?
What is an Eschars?
This formula (4 mL/kg/%TBSA in the first 24 hours post-injury based) is used for fluid resuscitation.
What is the Parkland formula?
Major burns (e.g., > 20% TBSA) result in increased capillary permeability, causing significant intravascular hypovolemia requiring IV fluid resuscitation.
This chemical (specifically) causes the antibacterial / antiseptic action from Dakin's solution.
What is hypochlorous acid (HClO)?
The main active agent in Dakin solution is created when the chlorine reacts with water in the environment to form hypochlorous acid (HClO). This hypochlorous acid produces a potent antibacterial effect in tissues.
These health care professionals could be involved in recovery in a rehabilitation facility after leaving the burn unit.
Name at least 3.
What/who are the physical therapists, occupational therapists, and mental health counselors/psychologists?
Will also take nutritionists and PM&R doctors.
The adult body is divided these 12 regions, each comprising ∼ 9% with one exception, to assess for total body surface area affected by burns.
What is the head/neck, two regions on the anterior trunk, two regions on the posterior trunk, each arm, and two regions (upper and low) on each leg and the genital/perineal region (which accounts for 1%)?
Massive capillary leak after severe burns causes this type of shock.
What is hypovolemic burn shock?
These 3 procedures (in order) would be done if there is 3rd degree or 4th degree burns.
What is wound debridement, temporary wet-to-dry would dressing, and a skin graft (split-thickness or full thickness) to fill the missing tissue?
Split thickness = entire epidermis and an altered dermal layer that has been split by a dermatome blade to enable greater surface coverage.
Full thickness = comprised of the epidermis and the entire dermis.
Autologous = from yourself
These common pathogens (5) are the primary causes of burn wound infections.
What are MRSA, Pseudomonas, Klebsiella, Acinetobacter, and Candida?
This is a (good) reason someone might not want a multidisciplinary team for major burn management.
What is (there is) no good reason?