456: Burns

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created 12 days ago by brandibyler
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1

A burn that affects the epidermis only, causes erythema w/o blistering. Sunburn.

1st degree

2
  • Burns through epidermis into dermis. Pink/red, moist and painful.
  • Scarring and hyperpigmentation
  • Grafting may be necessary

2nd degree

3

How long does it take for a 2nd degree burn to heal?

3-6 weeks

4

Which burn type is described as full thickness, leathery, dry, waxy. Pain is typically not present bc destruction of nerves

3rd degree

5

T/F: Healing of 3rd degree burns may occur without grafting.

False

6

What are the top 3 common causes of burns?

  • Flame (33%)
  • Scald (30%)
  • Contact (15%)
7

What is the estimation of burn SA for adults?

Rule of 9s

8

What is the estimation of burn SA for kids?

Lund Browder diagram

9

What burns should not be self treated?

  • If larger than 3 in.
  • If multiple large burns
  • If there is high risk of infection
  • If burn is on hands, feet, face, groin, butt, over major joint
10

Why should aspirin be avoided for burns?

  • Risk of Reyes in kids
  • GI upset
  • Potential to cause bleeding
11

Why is tylenol not a great first choice for burns?

No anti-inflammatory effect

12

What are the immediate goals for treating a burn?

  1. Stop the burning process
  2. Cool burn w/ cool tap water (no ice)
  3. Clean area if skin is broken
  4. Provide pain relief PO or topical
  5. Cover burn to help relieve pain
  6. Select dressings
13

What can you cool a burn with?

  • Wet compresses
  • Running water
  • Immersion into tub
14

What should you clean the area with (if the skin is broken?)

  • Soap and warm water
  • Antibact. hand soap
15

T/F: If there are blisters present in the burned area, break the blister with w/ a sterilized needle to relieve pressure.

False

16

How long should a burn be cooled down for?

10-15 min

17

What can be used for pain relief for burns?

  • Cooling
  • Cover
  • Oral NSAIDs
  • Oral acetaminophen
  • Topical/local anesthetics
18

T/F: If the skin is broken, use a lower concentration of a topical/local anesthetic.

True

19

How long does pain relief from topical/local anesthetic last?

15-45 min

20

T/F: Maximum use of topical/local anesthetic is 4-5 times per day.

False

21

List some examples of topical/local anesthetic.

  • Benzocaine 5-20%
  • Lidocaine 0.5-4%
  • Pramoxine 1%
  • Phenol
  • Benzyl alcohol
  • Menthol 1% or less
22

High concentrations of Menthol are used as ____________

Counterirritants

23

What is an example of esters?

Benzocaine 5-20%

24

What is a disadvantage of benzocaine?

Sensitive skin/allergies = rash will form

25

What is the max amount of lidocain available OTC?

4%

26

If you need a spray, what product will you not be able to use?

Praxomine 1%

27

What is a disadvantage of lidocaine?

Systemic toxicity w/ overuse; only recommend for small, minor burns

28

What is the most popular example of pramoxine?

Caladryl Clear

29

What are symptoms of lidocaine toxicity?

  • Irreg. heartbeat
  • Seizures
  • Drowsiness
  • Ringing in ears
  • Double vision
  • Decreased HR
  • Weak, shallow, slow breathing
  • Confusion
  • Tremors/shaking
  • Feeling hot/cold
  • Loss of consciousness
  • Decreased BP
30

T/F: Hydrocortisone is FDA approved for burns

False

31

What concentration of HC is used for burns, esp. sunburns?

0.5%-1%

32

What should you caution about using topical steroids?

  • Can increase risk of infection/impair healing
  • Can be applied to re-epithelialized wounds to decrease itching
33

When choosing a covering for a burn, what qualities would you look for?

  • Sterile preffered
  • non-adherent
34

What is the purpose of skin protectants?

  • Reduce pain
  • Prevent drying and irritation
35

List some examples of skin protectants

  • Petrolatum, Shark liver oil, A&D oint.
  • Cocoa butter
  • OTC topical antibiotics (unless allergy)
36

T/F: Topical antibiotics are not necessary for minor burns w/ intact epidermis.

True

37

What is a complementary therapy for burns?

Aloe gel for cooling effects

38

What dose of Iburofen would you recommend for a sunburn?

400 mg (1-2 tabs q 6 to 8 hr)

39

What dose of Acetaminophen would you recommend for pain from a burn?

500 mg (2 tabs q 6 hr)

40

A pt has a sunburn over both arms, chest, and back. What topical agent would you recommend?

Pramoxine or Benzocaine

41

A pt obtained a quarter sized burn on her arm from setting her arm down on a quarter that had been held over an open flame (idk. ppl do weird things.). This pt informs you she has sensitive skin. What topical product would you recommend?

Lidocaine, Pramoxine

42

What oral agent would you suggest for a minor burn for a pt who has a history of peptic ulcers and CV disease?

Tylenol