Burns

Front 1

What are the different types of burns?

Back 1

Thermal
Chemical
Electrical
Radiation

Front 2

Define denature

Back 2

Alter the substance of something

Front 3

Define Jackson's theory of thermal wounds

Back 3

Explanation of the physical effects of thermal burns

Front 4

Define the zone of coagulation

Back 4

Area in a burn nearest the heat source that suffers the most damage and characterized by clotted blood and thrombosed blood vessels

Front 5

Define the zone of stasis

Back 5

Area in a burn surrounding the zone of coagulation and that is characterized by decreased blood flow

Front 6

Define the zone of hyperthermia

Back 6

Area peripheral to a burn that is characterized by increased blood flow

Front 7

Define the emergent phase

Back 7

First stage of the burn process that is characterized by a catecholamine release and pain mediated reaction

Front 8

Define the fluid shift phase

Back 8

Stage of the burn process in which there is a massive shift of fluid from the intravascular to the extravascular space

Front 9

Define intravascular space

Back 9

The volume contained by all by all the arteries, veins, capillaries and other components of the circulatory system

Front 10

Define extravascular space

Back 10

The volume by all the cells (intravascular space) and the spaces between the cells (interstitial space)

Front 11

Define the hypermetabolic phase

Back 11

Stage of the burn process in which there is increased body metabolism in an attempt by the body to heal the burn

Front 12

Define the resolution phase

Back 12

Final stage of the burn process in which scar tissue is laid down and the healing process is completed

Front 13

Define voltage

Back 13

The difference of electrical potential between two points with different concentrations of electrons

Front 14

Define current

Back 14

The rate of flow of an electrical charge

Front 15

Define ampere

Back 15

Basic unit of measuring the strength of and electrical current

Front 16

Define resistance

Back 16

Property of a conductor that opposes the passage of an electrical current

Front 17

Define ohm

Back 17

Basic unit for measuring the strength of electrical resistance

Front 18

Define Ohm's law

Back 18

The physical law identifying that the current in an electrical circuit is directly proportional to the voltage and inversely proportional to the resistance

Front 19

Define Joule's law

Back 19

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

Front 20

Moisture or sweat on the skin does what to the resistance of electrical flow?

Back 20

It lowers the resistance

Front 21

Why are electrical burns particularly damaging?

Back 21

Because the current damages the pt from the inside out

Front 22

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?

Back 22

Zone of coagulation

Front 23

Area adjacent to the most-damaged region, inflammation increased, blood flow is decreased. This describes what?

Back 23

Zone of stasis

Front 24

Area farthest away from heat source, limited inflammation and changes in blood flow. This is a desciption of what?

Back 24

Zone of hyperemia

Front 25

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?

Back 25

Acids

Front 26

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?

Back 26

Alkalais

Front 27

Define liquefication necrosis

Back 27

The process in which an alkali disolves and liquefies tissue

Front 28

Define ionization

Back 28

The process of changing a substance into separate charged particles (ions)

Front 29

What are the 4 different types of radiation?

Back 29

Alpha
Beta
Gamma
Neutron

Front 30

Define alpha radiation

Back 30

A very weak form of radiation that can be stopped by paper, clothing, or the epidermis

Front 31

When is there a significant risk for exposure to alpha radiation?

Back 31

When it is ingested or inhaled. This is because of the close proximity it will have to the respiratory and digestive tracts

Front 32

Define beta radiation

Back 32

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

Front 33

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.

Back 33

False. There is the potential for external as well as internal injury

Front 34

Define gamma radiation

Back 34

Most powerful ionizing radiation
Great penetrating power
Protection requires thick concrete or lead shielding
Also know as x-rays

Front 35

True or false: Beta radiation is the most feared type of radiation because it is difficult to protect against.

Back 35

False. This is a description of gamma radiation

Front 36

Define neutron radiation

Back 36

Small, yet moderately massive subatomic particles with no charge
Great penetrating power, but uncommon outside nuclear reactors and bombs

Front 37

What are the factors to consider with an exposure to radiation?

Back 37

Duration of exposure
Distance from the source
Shielding from the source

Front 38

Define rad

Back 38

Basic unit of absorbed radiation dose

Front 39

Define gray

Back 39

A unit of absorbed radiation dose equal to 100 rads

Front 40

What is a dose of radiation that is lethal to about 50% of exposed individuals?

Back 40

4.5 gray

Front 41

If an injury occurred in an enclosed space, what type of burns should you suspect the most?

Back 41

Inhalation burns

Front 42

What should be suspected in all pts who were in an enclosed space during combustion?

Back 42

Carbon monoxide poisoning

Front 43

Define subglottic

Back 43

Referring to the lower airway

Front 44

Why are upper airway burns more likely than lower airway burns?

Back 44

The mucosa, and supraglottic structures may absorb the heat and prevent lower airway burns

Front 45

Superheated stam has a lower/higher heat content than hot dry air.

Back 45

higher, because of this, subglottic burns may be present

Front 46

Define supraglottic

Back 46

Referring to the upper airway

Front 47

______________________ ______________ is a common cause of airway burns.

Back 47

Superheated steam

Front 48

What is one risk factor for inhalation injury associated with burns?

Back 48

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

Front 49

Define superficial burn

Back 49

A burn that involves only the epidermis; characterized by reddening of the skin

Front 50

What type of burn is also called 1st degree burn, involves only the epidermis, produces pain,minor edema, and erythema?

Back 50

Superficial

Front 51

Define partial thickness burn

Back 51

Burn in which the epidermis is burned through and the dermis is damaged; characterized by redness and blistering

Front 52

What type of burn is also called 2nd degree, involves the epidermis and the dermis, produces pain, edema, erythema and blisters?

Back 52

Partial thickness

Front 53

Define full thickness burn

Back 53

Burn that damages all layers of the skin; characterized by areas that are white and dry

Front 54

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?

Back 54

Full thickness

Front 55

Define body surface area (BSA)

Back 55

Amount of a patients body affected by a burn

Front 56

Define the rule of nines

Back 56

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)

Front 57

When using the rule of nines, how do children differ from adults?

Back 57

The anterior and posterior portions of the head and neck area are 9% each
Each lower extremity is worth only 13.5%

Front 58

Define the rule of palms

Back 58

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%

Front 59

Define eschar

Back 59

Hard, leathery product of a deep full thickness burn; it consists of dead and denatured skin

Front 60

The constriction caused by ___________ can limit chest excursion or cut off blood flow to and from a limb.

Back 60

eschar

Front 61

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.

Back 61

True

Front 62

Once a burn pt is at your side, what is the first action you should take?

Back 62

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.

Front 63

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.

Back 63

False. Leather can smolder for hours and continue to cause thermal injury.

Front 64

True or false: Rings, watches, and other jewelry may hold and transmit heat or may restrict swelling tissue and occlude distal circulation.

Back 64

True

Front 65

True or false: Synthetic materials produce great heat as they burn and leave a hot, smoldering residue on the pt once flames are extinguished.

Back 65

True

Front 66

Anticipate _______________ and ________________ injuries to be associated with burns.

Back 66

skeletal, internal

Front 67

When assessing the airway of a burn pt for possible thermal or inhalation injuries, what should you look for?

Back 67

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

Front 68

When listening to airway sounds, which is the most alarming?

Back 68

Stridor

Front 69

High O2 percentages can reduce the half life of carbon monoxied by how much?

Back 69

Up to 2/3

Front 70

Intubation of a burn pt often requires RSI. Why would you use caution while administering Sux, or not use it at all?

Back 70

Sux may worsen the hyperkalemia associated with severe burns

Front 71

In cases of severe airway burns, ____________________ early!

Back 71

intubate

Front 72

__________ evaluation tells more about the pts condition than any other aspect of pt assessment.

Back 72

Skin

Front 73

What should be done if burned clothing adheres to the burn or resists removal?

Back 73

You should cut around it as necessary

Front 74

True or false: The entire body surface area, both anterior and posterior, should be examined for anyone who has been burned.

Back 74

False. However, this is true of all burn pts except for those with very localized burns.

Front 75

Burns to the ________, ___________, ________, ____________, _____________, and ________________________ burns are of special concern.

Back 75

face, hands, feet, joints, genetalia, circumferential

Front 76

What are the things you should particularly take note of while doing your initial assessment?

Back 76

Percentage of BSA affected by burns
Depth of the burns
Area(s) affected

Front 77

Ongoing assessment of burn pts should include what?

Back 77

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

Front 78

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%?

Back 78

Cooling a large surface area may cause hypothermia

Front 79

The benefits of immersion into cold or cool water are effective if done within what timeframe?

Back 79

1-2 minutes. Immersion has some effect on reducing pain and may limit the depth of the burning process if done immediately.

Front 80

Cover extensive partial and full thickness burns with _______ ______________ dressings, keep the pt _________, and initiate fluid resuscitation.

Back 80

dry sterile, warm

Front 81

Dry sterile dressings should be used for pts with partial thickness burns of more than ____% BSA and full thickness burns of more than ____%.

Back 81

15, 5

Front 82

True or false: Use of soft, non-adherent dressings between burned areas (such as between fingers and toes) is recomended to prevent further damage.

Back 82

True. Without this precaution, the disrupted and wet wounds would stick together adn cause further damage when pulled apart.