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82 Cards in this Set

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What are the different types of burns?
Define denature
Alter the substance of something
Define Jackson's theory of thermal wounds
Explanation of the physical effects of thermal burns
Define the zone of coagulation
Area in a burn nearest the heat source that suffers the most damage and characterized by clotted blood and thrombosed blood vessels
Define the zone of stasis
Area in a burn surrounding the zone of coagulation and that is characterized by decreased blood flow
Define the zone of hyperthermia
Area peripheral to a burn that is characterized by increased blood flow
Define the emergent phase
First stage of the burn process that is characterized by a catecholamine release and pain mediated reaction
Define the fluid shift phase
Stage of the burn process in which there is a massive shift of fluid from the intravascular to the extravascular space
Define intravascular space
The volume contained by all by all the arteries, veins, capillaries and other components of the circulatory system
Define extravascular space
The volume by all the cells (intravascular space) and the spaces between the cells (interstitial space)
Define the hypermetabolic phase
Stage of the burn process in which there is increased body metabolism in an attempt by the body to heal the burn
Define the resolution phase
Final stage of the burn process in which scar tissue is laid down and the healing process is completed
Define voltage
The difference of electrical potential between two points with different concentrations of electrons
Define current
The rate of flow of an electrical charge
Define ampere
Basic unit of measuring the strength of and electrical current
Define resistance
Property of a conductor that opposes the passage of an electrical current
Define ohm
Basic unit for measuring the strength of electrical resistance
Define Ohm's law
The physical law identifying that the current in an electrical circuit is directly proportional to the voltage and inversely proportional to the resistance
Define Joule's law
The physical law that the rate of heat production is directly proportional to the resistance of the circuit and to the square of the current
Moisture or sweat on the skin does what to the resistance of electrical flow?
It lowers the resistance
Why are electrical burns particularly damaging?
Because the current damages the pt from the inside out
The most damaged area nearest a heat source, cell membranes rupture and are destroyed, blood coagulates, structural proteins denature. This is a description of what?
Zone of coagulation
Area adjacent to the most-damaged region, inflammation increased, blood flow is decreased. This describes what?
Zone of stasis
Area farthest away from heat source, limited inflammation and changes in blood flow. This is a desciption of what?
Zone of hyperemia
Usually form a thick insoluble mass where they contact tissue through coagulation necrosis, limiting burn damage describes the burn process for what type of chemical agents?
Usually continue to destroy cell membranes through liquefication necrosis, allowing them to penetrate underlying tussue and causing deeper burns describes the burn process for what types of chemicals?
Define liquefication necrosis
The process in which an alkali disolves and liquefies tissue
Define ionization
The process of changing a substance into separate charged particles (ions)
What are the 4 different types of radiation?
Define alpha radiation
A very weak form of radiation that can be stopped by paper, clothing, or the epidermis
When is there a significant risk for exposure to alpha radiation?
When it is ingested or inhaled. This is because of the close proximity it will have to the respiratory and digestive tracts
Define beta radiation
More powerful than alpha radiation
Can travel 6-10 feet through the air
Can penetrate some clothing and the first few mm of the epidermis
True or false: Since beta particles are only able to penetrate the first few mm of the epidermis, there is not a significant danger for injury.
False. There is the potential for external as well as internal injury
Define gamma radiation
Most powerful ionizing radiation
Great penetrating power
Protection requires thick concrete or lead shielding
Also know as x-rays
True or false: Beta radiation is the most feared type of radiation because it is difficult to protect against.
False. This is a description of gamma radiation
Define neutron radiation
Small, yet moderately massive subatomic particles with no charge
Great penetrating power, but uncommon outside nuclear reactors and bombs
What are the factors to consider with an exposure to radiation?
Duration of exposure
Distance from the source
Shielding from the source
Define rad
Basic unit of absorbed radiation dose
Define gray
A unit of absorbed radiation dose equal to 100 rads
What is a dose of radiation that is lethal to about 50% of exposed individuals?
4.5 gray
If an injury occurred in an enclosed space, what type of burns should you suspect the most?
Inhalation burns
What should be suspected in all pts who were in an enclosed space during combustion?
Carbon monoxide poisoning
Define subglottic
Referring to the lower airway
Why are upper airway burns more likely than lower airway burns?
The mucosa, and supraglottic structures may absorb the heat and prevent lower airway burns
Superheated stam has a lower/higher heat content than hot dry air.
higher, because of this, subglottic burns may be present
Define supraglottic
Referring to the upper airway
______________________ ______________ is a common cause of airway burns.
Superheated steam
What is one risk factor for inhalation injury associated with burns?
Standing in the burn environment (hot gases rise)
Screaming or yelling (the open glottis allows toxic gases to enter the lower airway)
Being trapped in a closed environment
Define superficial burn
A burn that involves only the epidermis; characterized by reddening of the skin
What type of burn is also called 1st degree burn, involves only the epidermis, produces pain,minor edema, and erythema?
Define partial thickness burn
Burn in which the epidermis is burned through and the dermis is damaged; characterized by redness and blistering
What type of burn is also called 2nd degree, involves the epidermis and the dermis, produces pain, edema, erythema and blisters?
Partial thickness
Define full thickness burn
Burn that damages all layers of the skin; characterized by areas that are white and dry
What type of burn is also called 3rd degree, involves all layers of the skin and possibly structures beneath, is painless, but tissue is destroyed, has a white, brown or charred,leather like appearance?
Full thickness
Define body surface area (BSA)
Amount of a patients body affected by a burn
Define the rule of nines
Method of estimating amount of body surface area burned by a division of the body into regoins, each which represents approximately 9% of total BSA (plus 1% for the genital regoin)
When using the rule of nines, how do children differ from adults?
The anterior and posterior portions of the head and neck area are 9% each
Each lower extremity is worth only 13.5%
Define the rule of palms
Method of estimating amount of BSA burned that sizes the area burned in comparison to the pts palmar surface; used for local burns up to 10%
Define eschar
Hard, leathery product of a deep full thickness burn; it consists of dead and denatured skin
The constriction caused by ___________ can limit chest excursion or cut off blood flow to and from a limb.
True or false: Any pt with a pre-existing illness or disease or any pediatric or geriatric pt should be suspected of having a more serious burn injury.
Once a burn pt is at your side, what is the first action you should take?
Stop the burning process by using copious irrigation or a heavy wool or cotton blanket to smother the flames. Avoid synthetic materials such as nylon or polyester.
True or false: Leather articles, such as shoes, watchbands, or belts do not have to be removed as quickly as other items because they cool quickly.
False. Leather can smolder for hours and continue to cause thermal injury.
True or false: Rings, watches, and other jewelry may hold and transmit heat or may restrict swelling tissue and occlude distal circulation.
True or false: Synthetic materials produce great heat as they burn and leave a hot, smoldering residue on the pt once flames are extinguished.
Anticipate _______________ and ________________ injuries to be associated with burns.
skeletal, internal
When assessing the airway of a burn pt for possible thermal or inhalation injuries, what should you look for?
Look at the facial and nasal hairs to see if they have been singed
Examine any sputum and the area around the mouth and nose for carbonaceous residue or other signs of inhallation
Listen for airway sounds
When listening to airway sounds, which is the most alarming?
High O2 percentages can reduce the half life of carbon monoxied by how much?
Up to 2/3
Intubation of a burn pt often requires RSI. Why would you use caution while administering Sux, or not use it at all?
Sux may worsen the hyperkalemia associated with severe burns
In cases of severe airway burns, ____________________ early!
__________ evaluation tells more about the pts condition than any other aspect of pt assessment.
What should be done if burned clothing adheres to the burn or resists removal?
You should cut around it as necessary
True or false: The entire body surface area, both anterior and posterior, should be examined for anyone who has been burned.
False. However, this is true of all burn pts except for those with very localized burns.
Burns to the ________, ___________, ________, ____________, _____________, and ________________________ burns are of special concern.
face, hands, feet, joints, genetalia, circumferential
What are the things you should particularly take note of while doing your initial assessment?
Percentage of BSA affected by burns
Depth of the burns
Area(s) affected
Ongoing assessment of burn pts should include what?
Monitor vital signs
Watch for hypovolemia and airway problems
Be cautious with aggressive fluid therapy - be alert for pulmonary edema
Monitor distal circulation and sensation
Monitor EKG
Why should local cooling only be performed for partial thickness burns that involve less than 15% BSA or full thickness burns of less than 2%?
Cooling a large surface area may cause hypothermia
The benefits of immersion into cold or cool water are effective if done within what timeframe?
1-2 minutes. Immersion has some effect on reducing pain and may limit the depth of the burning process if done immediately.
Cover extensive partial and full thickness burns with _______ ______________ dressings, keep the pt _________, and initiate fluid resuscitation.
dry sterile, warm
Dry sterile dressings should be used for pts with partial thickness burns of more than ____% BSA and full thickness burns of more than ____%.
15, 5
True or false: Use of soft, non-adherent dressings between burned areas (such as between fingers and toes) is recomended to prevent further damage.
True. Without this precaution, the disrupted and wet wounds would stick together adn cause further damage when pulled apart.