Burn and Wound Care

What are the mechanisms of burn injuries?

Flame, contact, scald, smoke, chemical, electrical, radiation.

What is the immediate treatment for any suspected smoke inhalation?

Immediate intubation, regardless of the patient's stability.

What are the medical treatments for smoke inhalation injuries?

Albuterol, N-acetylcysteine, and heparin.

What is the treatment for carbon monoxide poisoning?

Hyperbaric oxygen therapy.

When is hyperbaric oxygen therapy indicated in carbon monoxide poisoning?

When Carboxyhemoglobin is checked and is 10% or more.

What are the clinical signs of cyanide inhalation?

Elevated lactate, decreased arteriovenous oxygen difference, elevated venous oxygen.

What agent is included in the cyanide kit for treatment?

Hydroxocobalamin: A chelating agent that binds cyanide.

What should be done for chemical burns?

Flush the affected area with copious amounts of water for at least 20 minutes.

What is the treatment for hydrofluoric acid burns?

Calcium gluconate.

What should be done in the case of chemical ingestion like bleach?

Do not induce vomiting; give the patient water or milk to dilute and call poison control.

What is the initial management for electrical injuries?

Immediate EKG, myoglobin, CK, and troponin tests.

What must be done for an electrical burn to the face, neck, and mouth?

Intubation is required.

What is the Rule of 9s for assessing burn surface area?

Head and Neck: 9%, Each Arm: 9%, Each Leg: 18%, Anterior Trunk: 18%, Posterior Trunk: 18%, Perineum: 1%.

What is the fluid resuscitation requirement for an adult with burns?

2 cc/kg/% burn for adults.

What is the recommended urine output goal during fluid resuscitation?

0.5 to 1.0 cc/kg/hr.

What are eschars and their potential complication?

Big scabs that can constrict skin and underlying tissues, leading to impaired circulation and further tissue damage.

What are the 5 Ps of compartment syndrome?

Pain, pallor, paresthesia, paralysis, pulseless.

What should be done if a patient exhibits symptoms of compartment syndrome?

Proceed to fasciotomy if tightness is observed.

How are superficial burns treated?

With cool compresses and antibiotic ointments.

What is the treatment for full thickness and deep partial thickness burns?

Excision, with smaller wounds getting full excision and larger wounds requiring tangential excision.

What are the total caloric requirements for burn patients?

Much higher than normal due to increased metabolic demand.