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34 Cards in this Set

  • Front
  • Back
which are worse: alkali or acidic burns?
alkali because it penetrates more deeply
what is the immediate life-threatening risk with electricity exposure or burns?
cardiac arrhythmias - get an EKG
define first-degree burn
involves epidermis only (painful, dry, red areas without blistering)
define second-degree burns
involve epidermis and some dermis (painful, swollein, blisters, open weeping surfaces)
how do you treat first degree burns?
keep them clean
how do you treat second-degree burns?
remove blisters; apply antibiotic ointment, and dressing
define third-degree burns
involve all layers of skin, including nerve endings (painless, dry, charred)
how do you treat third-degree burns?
surgical excision of eschar and skin grafting - watch for compartment syndrome
burn site infected with fruity smell and/or blue-green color
what do you give to all burn patients?
tetanus booster
define hypothermia
body temp <95 F (35 C), usually accompanied by MS changes and generalized neurologic deficits
classic EKG finding in hypothermia
J wave - small, positive deflection following QRS complex
treatment for patient with hypothermia
slow rewarming with blankets if patient is conscious; consider immersion in tub of warm water if pt. unconscious; monitor lytes, renal function, blood gas
treatment for hyperthermia?
immediate cooling
what are immediate threats to life with hyperthermia?
convulsions - treat with diazepam - and CV collapse
treatment for malignant hyperthermia?
malignant hyperthermia typically caused by exposure to what agents?
succinylcholine, halothane
treatment for neuoroleptic malignant syndrome?
stop antipsychotic, lots of IV fluids to prevent renal shutdown from rhabdomyolysis; consider dantrolene
treatment for tooth avulsion
put tooth back in place with no cleaning & stabilize ASAP
choice of fluids for burn patients?
sequelae of electrical burns?
muscle necrosis, myoglobinuria, acidosis, renal failure
treatment for chemical burns?
copious irrigation
extremely high CK and MS changes in patient taking antipsychotic
neuroleptic malignant syndrome
distinguish between frostnip and frostbite
frostnip - milder; affected skin is cold and painful vs. frostbite - skin is cold and numb
Parkland formula
fluids for the first 24 hours = 4 x pt's weight x %BSA; give 50% of fluids over first 8 hours and remaning 50% over the following 16 hours
treatment for penetrating wounds to zone I of neck (below cricoid)
treatment for penetrating wounds to zone II (cricoid to angle of mandible)
surgical exploration if platysma is penetrated; in some EDs, angiography and triple endoscopy (tracheobronchoscoy and esophagoscopy) are also being used
treatment for penetrating wounds to zone III of neck (above angle of mandible)
aortograpy and triple endoscopy
what are the most important steps in the treatment of contaminated wounds?
early wound irrigation and tissue debridement, not antibiotics
hypoxemia, cherry-red skin, confusion, headaches; coma or seizures in severe cases
carbon monoxide poisioning
singed nose hairs, facial burns, haorseness, wheezing, carbonaceous sputum
suspect smoke inhalation
diagnosis of carbon monoxide poisioning
check ABG, serum carboxyhemoglobin; laryngoscopy/bronchoscopy if smoke inhalation suspected, check EKG in elderly and pts with hx of cardiac disease
treatment of CO poisoning
100% oxygen, hyperbaric oxygen for pregnant patients, pts with neuro sx, or those with severely increased carboxyhemoglobin
in what ratio are fluids replaced in trauma settings?
3:1 isotonic fluids to blood loss