Term
| What are the 4 major mechanisms of burn injury? |
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Definition
| Thermal, Chemical, Electrical and Radiation. |
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Term
| What are the three types of thermal burns? |
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Definition
| Conduction, radiation and convection. |
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Term
| How are conduction burns acquired? |
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Definition
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Term
| What are some mechanisms of thermal radiation burns? |
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Definition
| tanning beds, heat lamps, sun |
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Term
| How are thermal convection burns acquired? |
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Definition
| Through heat carried by air current. ie: nearby explosion. |
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Term
| What factors determine damage from a thermal burn? |
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Definition
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Term
| What temperature leads to protein denaturation? |
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Definition
| 110-120 degr.F, or 44 degr. C |
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Term
| What factors determine the extent of the damage caused by a chemical burn? (3) |
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Definition
| Concentration and quantity of the agent, and the length of exposure. |
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Term
| What are the possible systemic effects of chemical burns due to absorption of the chemical? (3) |
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Definition
| Airway damage, pulmonary damage, and cardiac damage. |
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Term
| What makes electrical burns unique from other burn types, in terms of the wound it creates? |
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Definition
| It creates an entrance and an exit wound, as well as a channel of damage through the body. |
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Term
| What parts of the body take the most damage in electrical burns, in general? |
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Definition
| The places that introduce the most resistance to the electrical current. |
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Term
| Why is a hand to hand electrical burn more dangerous than an equivalent hand to foot electrical burn? |
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Definition
| because the current has to cross paths with the heart, which introduces resistance to the current, therefore places the individual at high risk for heart damage. |
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Term
| What three things change skin resistance to electricity? |
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Definition
| thickness, cleanliness, wetness. |
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Term
| What tissues are most susceptible to radiation burns? |
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Definition
| Rapidly dividing tissues: skin cells and bone marrow. |
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Term
| What are the major systemic effects of radiation burns? |
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Definition
| Nausea, vomiting, diarrhea, fatigue, fever, headache, increased WBC, decreased RBC, GI problems, Vascular problems. |
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Term
| What are the metabolic alterations that are important to take into consideration in the burn patient? (3) |
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Definition
| High resting energy requirements, increased glycogenolysis and gluconeogenesis. |
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Term
| Why is it critical for burn patients to have proper nutrition? |
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Definition
| Because they have increased metabolism due to repairs to the new open wounds, and because they have to maintain their core temperature, which is difficult with a lot of open surface area caused by the burn. |
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Term
| What are the 10 major systemic effects of a general burn injury? |
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Definition
| High levels of pain, increased metabolism, sleep disturbances, cardiovascular problems (insufficient blood flow to maintain capillary perfusion), pulmonary changes, cardiac dysfunction, GI alterations, change in levels of R & W blood cells, kidney problems |
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Term
| What are the GI problems a burn patient may experience? |
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Definition
| Altered nutrient processing, decreased ability to prevent entrance of bacteria through GI tract (can lead to: ischemia, increased intestinal permeability, incr. bacterial/endothelial movement, infection/sepsis) |
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Term
| What pulmonary problems might the burn patient experience? |
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Definition
| inhalation injury, edema, infection, ARDS |
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Term
| What is the hematopoietic response to a burn injury? |
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Definition
| Increased WBC, decreased RBC and platelets |
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Term
| What are some additional considerations to take into account in the older adult or child burn patient? (2) |
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Definition
| hydration and vascular or cardiac problems prior to the burn. |
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Term
| Using the rule of 9s, document the extent of injury (%) in a patient who sustained a second degree burn after stepping into a hot tub up to her knee. |
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Definition
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Term
| Using the rule of 9s, document the extent of injury (%) in a patient who sustained a burn from laying in the sun for 2 hours on her back, completely uncovered. |
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Definition
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Term
| A patient sustained major burns to her entire right arm, the right front half of her upper torso, and her entire face. Use the rule of 9s to determine the % of her body that's affected. |
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Definition
| 23.5% (arm = 9, 1/4 of 1 side of torso = 4.5, face = 10) |
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Term
| A patient burned his hand on a wood stove. The burn covers the entire palm of his hand. What percentage of his body is this? |
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Definition
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Term
| How deep (in terms of skin layers) does a first degree burn go? |
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Definition
| It involves only the epidermis. |
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Term
| Does a second degree burn affect the dermis? |
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Definition
| Why, yes! It does! (part of it) |
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Term
| You inspect a burn and note bright red skin with tiny blisters. What grade of burn is this? Should your patient be concerned w/ scarring? |
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Definition
| 1st degree burn, should heal without scarring. |
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Term
| A mom brings her baby to the hospital. The child's skin is bright red with blisters about the diameter of a silver dollar. What degree burn is this? |
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Definition
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Term
| Will the surface of a 2nd degree burn typically be moist or dry? |
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Definition
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Term
| For what degree burns do you use the rule of nines? |
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Definition
| 2nd and 3rd. 1st degree burns are not taken into consideration by the rule of 9s. |
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Term
| Would you expect a deep partial thickness burn to be moist or dry? |
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Definition
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Term
| What is usually more painful: a 2nd or 3rd degree burn? Why? |
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Definition
| 2nd. Because in 3rd degree burn most of the nerve endings have been burnt off, so sensation is not as in-tact as it is in the 2nd degree burn pt. |
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Term
| How are hair follicles important to the healing process of a burn? |
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Definition
| They contain a lot of epithelial cells that aid in healing of the tissue. |
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Term
| How deep does a third degree burn go? |
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Definition
| all layers of the skin, and into subcutaneous tissue. |
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Term
| Do you expect a 3rd degree burn to be moist or dry? |
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Definition
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Term
| How intense is the pain with a 3rd degree burn? |
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Definition
| There's no pain. The nerve endings are gone. |
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Term
| Can a third degree burn heal on its own? |
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Definition
| Nope. They need a skin graft. |
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Term
| What type of sensation may still be intact with a deep partial thickness burn? |
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Definition
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Term
| In what degree burn does edema become a real problem? |
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Definition
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Term
| Do you expect good capillary refill in the 2nd degree burn pt? |
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Definition
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Term
| What is an escharotomy? How is it helpful in the burn pt? |
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Definition
| An incision made laterally along the entire length of the burn to restore circulation to tissue beneath by decreaseing the pressure caused by edema. |
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Term
| In what type of wound would an escharotomy most likely be done? |
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Definition
| Circumferencial full-thickness wounds |
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Term
| Would you expect a graft to be required for a burn affecting the superficial dermis? |
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Definition
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Term
| Describe Primary Wound Closure |
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Definition
| The endges of the wound are brought together and sewn. |
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Term
| What is the advantage, and what is the disadvantage to using a full-thickness skin graft? |
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Definition
| Adv: The burn heals very well. Disadv: you've created another full-thickness wound. oops. |
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Term
| What is the advantage and what is the disadvantage to using meshed split thickness skin grafts? |
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Definition
| Adv: can cover a large area of burn with just a small chunk of skin. Disadv: Heals with a meshed appearance, so may not be desirable, cosmetically. |
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Term
| What are your major graft options? (4) |
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Definition
| full thickness, split thickness (sheets, meshed), artificial skin, skin flaps. |
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Term
| What are the 2 major types of 'skin flaps' that can be used for grafting? |
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Definition
| Skin from another person, cultured skin, or skin from an animal. |
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Term
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Definition
| Skin graft from an animal. |
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Term
| Why would a patient want to have burn scar excision? |
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Definition
| To re-align the scar to increase ROM. |
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