Burn, Hazard, Decon

What is the pathophysiology of burns?

Burns cause massive fluid shifts, capillary leak, hypovolemia, electrolyte imbalance, and increased infection risk due to skin barrier loss.

What is the nursing focus in burn management?

Maintain airway, restore fluids, manage pain, and prevent infection through wound care and aseptic technique.

What medications are commonly used for burn patients?

IV opioids for pain, antibiotics to prevent infection, and tetanus prophylaxis to prevent tetanus.

What formula is used to calculate fluid resuscitation in the emergent phase of burns?

Parkland formula: 4 mL lactated Ringer's × body weight (kg) × % total body surface area burned.

When is fluid replacement most critical in burn patients?

During the emergent phase (0-48 hours after injury).

What are the fluid resuscitation priorities during the acute phase of burn recovery?

Continue fluids as needed, initiate nutrition support, and promote wound healing.

What are the goals during the rehabilitation phase of burn care?

Maintain hydration, encourage protein intake, and prevent contractures through mobility and splints.

What are signs of airway compromise in burn patients?

Hoarseness, singed nasal hairs, soot in sputum, and stridor.

What is the early intervention for airway compromise in burn injuries?

Early intubation, administer humidified oxygen, and monitor for airway edema.

What are the preferred pain management strategies for burn patients?

IV opioids before procedures and during dressing changes for rapid, reliable relief.

What type of nutrition should burn patients receive?

High-protein, high-calorie diet or enteral nutrition to promote wound healing and metabolic recovery.

What are the priority nursing interventions for smoke inhalation injury?

Assess for airway injury and carbon monoxide exposure; administer 100% oxygen; prepare for intubation; monitor carboxyhemoglobin levels.

What is the pathophysiology of carbon monoxide poisoning?

Carbon monoxide binds to hemoglobin, preventing oxygen transport and causing tissue hypoxia.

What are symptoms of carbon monoxide poisoning?

Headache, dizziness, confusion, cherry-red skin, and decreased LOC.

What is the treatment for carbon monoxide poisoning?

Administer 100% oxygen via non-rebreather mask or use hyperbaric oxygen therapy.

What are nursing responsibilities for patients with skin grafts?

Maintain immobilization of graft site, monitor for adherence, infection, and bleeding, and prevent shear or pressure.

What are key nursing considerations after a fasciotomy?

Monitor perfusion, distal pulses, and bleeding; maintain sterile dressing.

What is the purpose of an escharotomy?

To relieve pressure in circumferential burns and restore distal circulation; monitor for return of pulses.

What is wound debridement and why is it important?

Removal of necrotic tissue to prevent infection and promote healing; perform with aseptic technique.

What is the purpose of hyperbaric oxygen therapy in burn care?

Enhances oxygen delivery to tissues, promotes healing, and supports graft survival.

What patient teaching is important for compression garments?

Wear 23 hours per day to reduce scarring, support mobility, and prevent contractures; keep garments clean and replace when worn.

What is the purpose of splints in burn rehabilitation?

Prevent contractures, support functional positioning, and promote mobility during healing.

What psychological challenges might burn patients face during recovery?

Body image issues, anxiety, depression, PTSD, and role adjustment.

How can nurses support the psychological needs of burn patients?

Encourage open communication, provide emotional support, involve family, and refer to counseling or support groups.

What are key safety protocols for hazardous material exposure?

Follow emergency plans, wear PPE, evacuate safely, and isolate contaminated patients for decontamination before treatment.

What is the RACE acronym for fire safety?

Rescue, Alarm, Contain, Extinguish/Evacuate.

What is the PASS acronym for fire extinguisher use?

Pull the pin, Aim at base of fire, Squeeze the handle, Sweep side to side.

What are nursing roles in bioterrorism preparedness?

Recognize symptoms of exposure, report promptly, contain contamination, and participate in coordinated response protocols.

What should nurses do during a bomb threat or explosion?

Follow facility response plan, ensure personal safety, assist in evacuation, and prioritize critical patients.