Causes of burns Right Ans - scalding
flame
chemical
electrical
radiation
friction
Scalding Right Ans - -water or grease
-young or elderly--> esp those with compromised sensation
-patterns
Have water heater regulated at 120 degrees
In children:
-over head cause pulled something
-burn pattern typically downward with splash marks from accidental burns
-if circumferential tends to be abuse
Insensate pts:
-circumferential burns on feet and ankles from bath water
Will continue to burn until the source is removed and the skin cooled down
Flame Right Ans - inhalation injury
explosion
Pattern deps on what victim was wearing and the accelerant of the burn
-non-flame resistant clothes stick and create deeper burns
Inhalation the heat gen from combustion can cause sig thermal injury to the
upper airway
-soot can mech clog and irritate the airways causing reflex
bronchoconstriction
-lung damage
,Will continue to burn until the source is removed and the skin cooled down
-need to know what caught on fire: clothes vs actual skin
chemical Right Ans - -antifreeze
-household cleaning agents
-commerical agents
Results when skins comes in contact with a strong acid, alkaline, or corrosive
material
-everyday household cleaners
Never apply butter to a burn: acts as an insulator and trap the heat
Will continue to burn until the source is completely flushed away from
neutralized
-eye wash stations
Electrical Right Ans - pattern of least of resistance
-travels through nerves and vessels
-most serious damage occur along this pathway
--> heart could dev arrhythmias
--> damage to the eye from the electrical arc
--> thermal burns from clothes catching
Lightening: kills more than all natural disasters every year
-look like a feather: lichtenburg
Will see an entry/exit wound
Household voltage: 1000 V
Job related voltage: 1000+ V--> results in loss of limb or life
Radiation Right Ans - sunburn
Radiation therapy
Sunburn Right Ans - a form of erythema in which skin cells are damaged by
exposure to the ultraviolet rays in sunlight
,Damage it does over time!!!
-delayed UV induced redness by increase in BF to the affected area
-peaks at 8-24 hours following exposure
-caused by direct/indirect damage to spec cellular targets from photchem
reactions and prostaglandins leading to vasodilation and edema
-biologic response modifiers released by both keratinocytes and lymphocytes
play role
-redness= total failure of sun protection
1st= pink
2nd= blister
Radiation therapy Right Ans - caused by acute or chronic effects of ionizing
radiation
may involve:
-skin
underlying soft tissue
even deep structures such as bone
Friction or mechanical Right Ans - road rash
-MVA, bikes, motorcycles, skate boards
-abrasion of the skin: minor--> very painful
More common in younger people
Need moist wound healing to relieve discomfort and heal faster
Typically stays in 2nd
Old vs. new burn depth classification Right Ans - old: degrees
new: thickness
Defined by # of layers involved
Superficial burn = 1st degree Right Ans - epidermis only
, Dry, erythema and pain: nerve irritation and inflammed
Surface is typically dry it heals in sev days to weeks
EX: sunburn without blisters
Not included in total surface burn assessment
Partial thickness burn = 2nd degree Right Ans - characteristics:
-epidermis and dermis
-superficial partial and deep partial
Superficial partial thickness burn Right Ans - characteristics:
-epidermis and papillary dermis
-erythema, serous blisters
-blanchable, painful: exposure to sensory nerves
Surface can be moist
Heals in 14-21 days by epithelialization with minimal to no scarring
Deep partial thickness burn Right Ans - characteristics:
-epidermis and reticular dermis
-mottled white to pink
-less blanchable, painful
Hallmark:
-destruction of dermal vascular plexus: greatly diminished capillary return
with no or sluggish blanching when pressure is applied to the wound bed
Nerve endings are damaged = reduced sensation
Deeper burns tend to be dry with diminished fluid exudate compared with
more superficial burns
Heal time: weeks or progress to 3rd degree which would require grafting
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