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49 Cards in this Set

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s/s horseness and drooling
altered abgs, HBCO2 20-60%, DO NOT use spo2 monitors to monitor 02 saturation
INHALATION INJURY
TX: early intubation, avoid tracheostomy
early mechanical ventilation with FI02 100%, then adjjust ABGS, Early use of high frequnecy ventilators is severe
inhalation injury treatment
Complications: v-fib and other dysrhytmias, tetany of repsitaroty muscles
electrical burns
debride, wound care. Cardiac monitor and treat dysrhytmias, and intubation/ventilation PRN
electrical burns treatment
topical care (except if cause is sodium metal) remove agent and shower with cool tap water
EYES irrigate with tap water Ist aid, or sterila saline, do not use irrigation lenses
inhalation mustard gas: 100% o2 at hi pressure/frequency
SODIUM METAL EXPLODES IN WATER AND AIR, REMOVE THIS SURGICALLY UNDER OIL
CHEMICAL BURNS TREATMENT
24-72 hrs
priority: fluids
death by incineration or fluid and electrolyte imbalances
resuscitation phase of care
days to months
priority is wound care, cause of death is infection
acute phase of care
up to 2 yrs: priority return/preserve function
rehab phase of care
erythimic, mild inflamation, mild pain, usually resolves in 2-3 days, sunburn usually goes away in 2-7 days
Epidermis burn, partial thickness, superficial 1ST DEGREE
treatment aloe vera, noxema to cool skin and treat pain, moisturize but dont use butter oil porducts. Drink lots of fluid,
Use moisturizer thats water based bc oil traps heat
treament of epidermis superficial burns, sunburns 1ST DEGREE, partial thickness
very painful, erythemic (bright-light red), mottled, blotchy appearance, weapy/oozy, moist, bullae (blisters), sensitive to air currents.
Takes 7 days to 6 weeks to heal, usually minimal scarring
ONCE you get blisters, your in the dermal area
2ND DEGREE, MODERATE, EPIDERMIS AND 1/3 OF DERMIS TOP, SUPERFICIAL, partial thickneses
erythemic w white areas where there are deeper parts of the burn, weepy, DO NOT DEVELOP BULLAE/BLISTERS, delayed cap refill in burned area, long time to heal, usually requires debridement, requires skin grafting, have scarring
deep dermal, second degree burn, epidermis and deep dermis., partial thickness
White in color, charred looking leather, red brown leathery looking areas with full thickness, nerves killed in this area so USUALLY not painful. may require debridement, grafting. will have scars
full thickness 3rd degree burn, involves subq tissue
age + % burn =
mortality
age+ % burn x 2=
inhalation injury mortality
always use large IV on unburned area, IV SUTURED, always give LR
fluid resuscitation in burns
LR 2-4 ml/kg/%burn
half fluid given in first 8hrs since time of burn, remaining half over nest 16 hrs
USE big tubing, 10drops/min
parkland formula to treat burns
maintain urinary output,
if rhabdo give more fluids, double urinary output
slow fluids down after 24 hrs if developing fluid overload
30-50mls
Early intubation, hi pressure support vent, high frequency,
facial burn, suspect inhalation injury
hi vent pressure to provide adequate tidal volume, escharotomy bilaterally to prevent compartment problems, will demostrate increase in vent peak pressure
circumferential burn of the torso (chest)
morphine or fentanyl, does not interfere with bleeding
pain control in burn
arterial bleed, fast onset,
brief LOC, wake up lucid, confused, then LOC again
epidural hematoma
decrease: supply, extraction,
microemboli
decreases extraction
inter edema
decreases supply
pulm edema
decreases supply, increases demand
decreases CO
decreases extraction
respiratory acidosis
increases 02 demand
seizures
increases 02 demand, decreases supply
V-FIB
decreases supply
apnea
carbon monoxide poisoning
decreases supply, decreases extraction
increases 02 demand, decreases supply
fever
increases 02 tissue demand, decreases extraction
anemia
decreases supply, extraction and increases demand
pneumonia
decreases extraction
leaky capillaries
increases 02 tissue demand, decreases extraction
anemia
decreases supply, extraction and increases demand
pneumonia
decreases supply, decreases extraction
leaky capillaries
treat increased afterload
dilators/Nitro, labetalol, hydrolazine,

AUGMENT IABP
treat decreased afterload
pressors, epi, norepi, dopaminel evophed, not vassopressin
treat decreased contractility
postive inotropes: doapmine (2-10mcg.kg.min) dobutamine, digoxin
treat increased preload
diuretic, dilators like nitro, nitroprusside, ca channel blockers
treat decreased preload
give volume, antidysrhytmic, amiodarone
increased heart rate treatment
beta blockers metropolol, atenolol,
treat decreased HR
dopamine 2-10 mcg/kg/min, dobutamine, atropine, epinenephrine
subarachnoid hemorrhage, cough up blood, pee blood, abdominal distention, GI Bleed, bleeding gums, nose bleeds, bruises
initial stage of DIC
LOC, CVA, dysrhytmias, chest pain, embolus, resp, failure, oliguria, ATN, renal failure, diarrhea, constipation, bowel infarction, peripheral cyanosis, gangrene
second stage of DIC
ABCS,
SHOCK at 120 biphasic, CPR, SHOCK AGAIN, higher joules
EPI, VASSPRESSIN, SHOCK
LIDOCAINE, SHOCK
AMIODARONE, SHOCK
MAGNESIUM, SHOCK
V-FIB treatments
atropine or pacemaker
dopamine if low bp
epinephrine
sinus bradycardia treatments