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26 Cards in this Set
- Front
- Back
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"Local and Minor Burns"
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Partial Thickness - 15% or less BSA
Full thickness - 2% or less BSA - can use water for pain therapy |
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"Moderate to Severe Burns"
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Partial greater than 15%
Full greater than 2% - Dry sterile dressing - Maintain warmth - Careful for fluid overload (auscultate for breath sounds often) *ESPECIALLY in CHILDREN/GERIATRIC |
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Parkland Burn Fomrula
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2ml X (Weight in KG) X %BSA = Fluid given in 24 hours
1/2 that in first 8 hours 1hr rate = 0.25ml X KG X %BSA |
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Inhalation Injury
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- Provide high-flow O2 by NRB
- Consider Intubation if swelling (Use size 8 if possible) - Consider Hyperbaric O2 therapy - Signs: Stridor, wheezing, soot around mouth, coughing |
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STEAM IS __________ times hotter than Room Air
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4000!
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Electrical Burns
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***Every patient place on monitor
- Entrance and Exit wounds - Greatest heat @ point of resistance (dry skin = more, wet skin = less) - Longer contact = greater potential for injury - Smaller point of contact = more concentrated the energy - Travels through tissues with less resistance = Blood vessels & Nerves |
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Flash Burn
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Superheated air causing burns (electrical burn)
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Chemical Burns (Acid vs. base)
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*Treat all chemical burns as CRITICAL PATIENTS
Acid (pH 0-7) = Coagulation Necrosis - Limits burn damage Base (pH 7-14) = liquefaction necrosis - Continues to burn, deeper penetration ***Worse *Concentration causes/determines damage |
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How to manage chemical burns?
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- "Scrape off extra" (if possible)
- Remove clothing (about 80-85% of contamination comes off) *** WATER WATER WATER |
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Radiation Burns (Clean vs. Dirty)
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Clean - not contaminated by products: little danger to personnel
Dirty - Associated with fire at scene: Need trained personnel |
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Radiation causes damage how?
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- Rapidly dividing cells are killed
*** Infection + Hemorrhage (WBC and RBC destroyed) - Bone marrow sensitive |
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Head Injury: Coup / Contrecoup
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Coup - Injury at site of impact
Contrecoup - Injury on opposite side |
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Cerebral contusion
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Blunt trauma to local brain tissue, capillary bleeding
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Concussion
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Blow to the head with no permanent damage
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Epidural Hermatoma
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- Bleeding between dura mater & skull
- Involves ***ARTERIES (MIDDLE MENINGEAL ARTERY) - Rapid bleed and reduction of O2 to tissue - Herniates brain towards foramen magnum - Lucid Interval |
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Lucid Interval
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Period of time after KO, where patient becomes alert
- KO > Alert > KO |
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Subdural Hematoma
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- Bleeding within meninges (beneath dura and within subarachnoid space above pia)
*Usually Venous bleed (slow) - Slow progress over several days |
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Monroe Kellie Doctrine
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Compensate for a "Mass" in the skull, by decreasing CSF and Blood
Normal: Brain = 80%, Blood = 10%, CSF = 10% Compensated: Mass present, Blood = 5, CSF = 5 Uncompensated: Mass larger, Blood = 4, CSF = 4 |
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Cushing's Triad
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Clinical Evidence of *HERNIATION
1) Change in breathing pattern 2) Bradycardia (vagus nerve stim) 3) Hypertension (autoregulation) - via vasoconstriction *3) is the only one that is compensatory. To overcome building pressing in skull. |
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For Herniation, Need Cushing's Triad + 1
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Pupils unequal/blown
- Seizure - Posturing - Drop in GCS |
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Therapeutic Hyperventilation
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Start at normal ventilation rates
- Keep end-tidal CO2 around 30-35 |
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Cerebral Perfusion Pressure (CPP) = Norm: 70-80
Mean Arterial Pressure (MAP) Intracranial Pressure (ICP)= Norm: 0-15 |
N/A
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CPP = MAP - ICP
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N/A
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MAP =
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MAP = (1X Systolic) + (2 X diastolic) / 3
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Diffuse Axonal Injury (DAI)
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- Axons are sheared due to injury = inflammatory response
- Microscopic Damage spread all over the brain - Surgery doesn't help *** Worst brain injury |
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Osmitrol/Mannitol
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Osmotic diuretic
- large glucose molecules draw H20 into blood. Thus increasing BP > increasing glomerular filtration rate (GFR) = excrete more water |
