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