Management and Pathophysiology of Burn Injuries

Vocabulary-style flashcards based on lecture notes covering hypothermia, hypovolemia, inhalation injuries, radiation types, fluid resuscitation formulas (Parkland and Consensus), electrical and chemical burn pathophysiology, and Jackson's Theory of Thermal Wounds.

Hypovolemia in Burns

Occurs when damaged blood vessels cannot retain plasma, causing fluid and electrolytes to shift into burned tissue, which decreases the body's ability to move fluids from healthy tissues.

Hyperkalemia (in Burn patients)

A condition caused by the release of potassium into the bloodstream from tissue destruction in thermal and electrical burns, potentially leading to cardiac arrhythmias.

Eschar

Burned skin that becomes hard and leathery, constricting the site and increasing pressure, which can occlude distal blood flow or impair ventilation in thoracic burns.

Escharotomy

A hospital procedure performed to treat burned skin that has become hard and leathery (eschar) to relieve pressure and restore blood flow or ventilation.

Carbon Monoxide (CO)

A tasteless and odorless gas with a high affinity for hemoglobin that kicks oxygen off hemoglobin and attaches to myoglobin in muscles, decreasing available oxygen.

Cyanide Poisoning

A byproduct of burning plastics and carpets that prevents the body from utilizing oxygen, leading to hypoxia; treated with CyanoKit (Hydroxocobalamin).

Hydroxocobalamin (CyanoKit)

A medication that binds to cyanide to treat poisoning resulting from the inhalation of smoke from burning plastics or carpets.

Supraglottic Structures

Upper airway structures that absorb heat to help prevent lower airway burns, though they are at high risk for swelling and airway constriction.

Alpha Radiation

A weak energy source that is easily stopped by clothing or paper and cannot penetrate the epidermis, but poses a risk if inhaled or ingested.

Beta Radiation

A mild to moderate energy source that can penetrate clothing layers and the integumentary system, posing a risk for internal injury to tissues and organs.

Gamma Radiation

A strong energy source, such as X-rays, that can penetrate through the entire body.

Neutron Radiation

A very strong energy source only encountered with nuclear reactors or nuclear bombs.

Parkland Formula

A formula used to calculate fluid resuscitation: $Weight\,(kg) \times (TBSA\,\% \times 4\,mL)$, with the first half administered over the first $8\,h$.

Consensus Formula

A fluid resuscitation calculation: $Weight\,(kg) \times (TBSA\,\% \times 2-4\,mL)$, where the specific volume depends on age and the type of burn (e.g., $4\,mL$ for electrical burns).

Alternating Current (AC)

The type of electricity supplying homes, which is more dangerous than DC because it causes severe muscle contractions that may prevent a patient from letting go of the source.

Rhabdomyolysis Assessment

Suspected when muscle breakdown releases potassium and myoglobin; management may include the administration of sodium bicarbonate.

20 mA

The electrical current level that can cause respiratory muscle paralysis.

50 mA

The electrical current level that can lead to ventricular fibrillation and cardiac arrest.

Coagulation Necrosis

The process by which acids create a thick, insoluble mass at the burn site, helping to minimize the depth of the burn.

Liquefaction Necrosis

The process by which alkaline substances destroy cell membranes and surrounding tissue, allowing the solution to penetrate deeper into the tissue.

Saponification

The process that occurs during alkali burns where fats are dissolved as proteins and collagen denature.

Dry Lime (Calcium Oxide)

A chemical that reacts with water to cause thermal and chemical burns; it must be brushed off before rinsing with cool water.

Phenol

An industrial cleaner that should be dissolved with alcohol before being rinsed with cool water.

Zone of Coagulation

The area nearest the heat source that undergoes the most damage, where cell membranes rupture and blood coagulates.

Zone of Stasis

The inflamed area directly adjacent to the zone of coagulation where blood flow is decreased.

Zone of Hyperemia

The region furthest from the heat source characterized by erythema (red skin) and minimal inflammation.

Emergent Phase

The stage of the burn response starting immediately after the injury, characterized by catecholamine release, tachycardia, and tachypnea.

Fluid Shift Phase

The phase occurring with burns over $15-20\,\%$ TBSA where fluid moves from intravascular to extravascular space, peaking within $8\,h$ of the injury.

First-Degree Burn

A superficial burn involving the epidermis and upper dermis, presenting with pain, edema, and erythema.

Second-Degree Burn

A partial thickness burn involving the epidermis and dermis, presenting with pain, edema, erythema, and blisters.

Third-Degree Burn

A full thickness burn extending into or beyond the subcutaneous layer; it is often painless due to destroyed nerve endings and appears charred or leathery.

Rule of Palms

A method of estimating BSA where the patient's palm, including fingers, is approximately $1\,\%$ of their total body surface area.