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18 Cards in this Set
- Front
- Back
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What are the side effects of silver sulfadiazene?
What are the side effects of mafenide acetate? What are the side effects of silver nitrate? |
silver sulfadiazene: Causes transient leukopenia (5-18%) and rash (5%)
Mafenide: Painful application, causes hyperchloremic metabolic acidosis by inhibiting carbonic anhydrase AgNO3 leaches cations, which leads to hyponatremia, hypophosphatemia and hypokalemia |
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When is the post-burn diuresis phase?
What are the 2 major causes of post-burn hyponatremia? |
Occurs 48-72 hours after thermal injury
1. hypotonic fluid resuscitation 2. silver nitrate |
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What is the amount of evaporative water loss after burn?
What are the causes of early AKI? |
2-3 ml/kg x %TBSA per day
1. hypovolemia 2. rhabdomyolysis 3. abdominal compartment syndrome |
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How can rhabdomyolysis be diagnosed in burn patients?
What are the 2 metabolic phases in severly burned patients? How long does each phase last? What are the major characteristics of each phase? |
1. creatinine phosphokinase > 100 u/L
2. ck-mb > 3000mcg/L 3. urine myoglobin 1. ebb/shock/hypodynamic: 24-72 hrs 2. flow/hyperdynamic/catabolic |
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_____ are the primary mediators of burn hypermetabolism?
What is the estimated caloric need of burn patients? Daily required protein? |
Catecholamines
30-40 kcal/kg/day (at least 30 kcal/kg/day) 2-2.5 g/kg/day |
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What are the 4 ways to perform nutritional assessment in burn patients?
Which drug is used to antagonize catecholemines in burn patients? What is the goal of this therapy? |
1. daily wt
2. wound healing 3. prealbumin < = 15mg/dL 4. N2 balance Propanolol in the hypermetabolic phase Decreasing HR by 20% |
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Which anabolic steroid is used in burn patients?
What is the most common side effect? |
Oxandralone used to promote anabolism
A transient elevation in LFTs |
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Which 2 drugs are used to promote anabolism in pediatric burn patients?
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1. recombinant HGH
2. insulin-like growth factor-1 |
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Which organisms are not covered by silvadene?
Which organisms are not covered by sulfamylon? |
Pseudomonas and enterobacter
Fungi |
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The phase of systemic capillary leak lasts ___
Which hormones regulate the hyperdynamic phase? What is the best way to truncate hypermetabolic state? |
18-30 hrs
Cortisol, catecholamines and glucagon Burn excision and closure |
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____ is a reliable method of securing ET tube
Patients not responding to resuscitation should have ___ |
Twill tie
Cortisol checked |
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What are the early consequences of inhalation injury?
How are they managed? What are the late consequences of inhalation injury? |
Airway edema (obstructive) and bronchospasm
Intubation, albuterol Secondary to sloughing of necrotic endobronchial debris which leads to distal airway obstruction mismatch shunt, PNA |
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Hyperbaric O2 should not be used in patients with ____
What 2 things should be done before HBO treatment? |
PTX or seizure disorder
The ET tube balloon should be filled saline (not air), upper extremity CVL should be removed |
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Patients in structural fires are often exposed to ______
What is the only proven medical treatment for spinal cord injury? |
Carbon monoxide and Hydrogen cyanide
Methylprednisolone 30mg/kg bolus followed by 5.4mg/kg//hr for 23 hr if pt seen within 3 hr, for 48 hr if pt seen in 3-8 hrs |
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What treatments are used for carbon monoxide poisoning?
In order to use steroids to treat SCI, pt must be seen within _____ |
1. 100% O2
2. Hyperbaric O2: 2-3 atm x 90 min 8 hours |
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What may cause unexplained metabolic acidosis immediately after structural fire?
What is the treatment? |
Cyanide
Amyl nitrate and sodium thiosulfate |
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What is the MOA of amyl/sodim nitrate?
What is the MOA of sodium thiosulfate? |
Induces the formation of methemoglobulin
Transfers sulfur group to cyanide -> thiocyanate |
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Carbon monoxide disrupts cellular function by binding to _____
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Cytochrome oxidase
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