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What is the pathophysiology of a Burn?
tissue destruction can cause many local and systemic problems including fluid and protein losses, sepsis, and disturbance of the metabolic, endocrine, respiratory, cardiac, hematologic and immune systems.
What are the 5 types of burns?
Partial-thickness * superficial and deep
Full thickness (escar develops)
Deep full-thickness
Describe a superficial burn
pink to red color, mild edema, no blisters. EX: sunburn, flash burn
Describe Partial-thickness superficial
*Pink to red skin, moist
*Mild to moderate edema
* intense Pain
*approx 2 wks to heal
EX: scalds, flames
Describe Partial-thickness deep burn
*deeper into the dermis
*red to white skin,waxy without vesicles
*Moderate edema
* blood supply < = vasoconstriction
* may progress to deeper involvement
*2-6 wk healing
*grafts might be used
*EX: scalds, flames, tar, grease, chemicals
Describe Full-thickness burns
* enditre epidermal and dermal layers involved.
*black, brown, yellow, white or ered skin
*No epidermal tissue
* servere edema
* pain
*eschar Must be removed for healing
*weeks to months to heal
Skin grafts required (>12-16)
Escharotomy/or Fasciotomy may be necessary
Descrobe Deep Full thickness burns
Extend into fasica/tissues/bones
black skin
Eschar present
Weeks to months to heal
Grafts required
EX: flames, electricity, grease , tar, chemicals
why are there vascular changes resulting from burns?
Damaged macrophages within the tissue realease chemicals that intially preoduce vasoconstriction. Following vasoconstriction the vesels dilate.Which causes increased capillary premeability.
What is third spacing?
leaking of plasma from the intravascular space into the interstitial space. Resulting in a decreased colloidal osmotic pressure in the vascular space. This caused edema.
As a result of 3rd spacing what can you see imbalances of?
F & E ,
metabolic acidosis,
The Inflammatory response gradually subsides within ...
24-36 hrs. the fluids shift back into the circulation. thus called Remobilization
What phase will you usually see hyponatremia, anemia, and hypoKalemia?
Fluid Remobilization. as inflammatory responses decrease. Na lost through wounds, K returns to intracellular compartment, anemia as a reult of hemodilution.
Pulmonary changes are a major couse of morbidity T or F?
What is a Curlings ulcer and where is it
GI ulcer may develp within 24 hr after a severe burn injury.
What drugs are used to decrease chances of developing Curlings ulcer?
Taament, Zantac or Carafate
What are some metabolic changes you will see with burns?
hypermetabolic state requiring > calories and protein up to 5000. these req peak 4-12 days after burn and can last months
* > body core tem, low-grade T
* > oxygen requirements
The Sympathetic nervous system response is a compensatory response describe this.
evident in cardiovasuclar, respiratory and GI system.
when is the emergent phase and what do you assess?
1st hr
airway important
limit extent of injury
Maintain Vital organ functions
obtain hx

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