Term
|
Definition
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|
Term
| Guidelines for who should be referred to a burn center |
|
Definition
# 2nd or 3rd degree burns of greater than 10% TBSA in pts < 10 yo or > 50 yo
# 2nd or 3rd degree burns > 20% TBSA in any age group
# 3rd degree burns > 5% TBSA in any age group
# Any burns to face, hands, feet, genitalia, perineum or major joints
# inhalational injury |
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|
Term
| P:F ratio threshold for endotrachial intubation in a burn victim |
|
Definition
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|
Term
| Hard signs of inhalational injury |
|
Definition
# copious sputum production
# carbonaceous sputum |
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|
Term
| Lab evaluation for possible endotrachial intubation |
|
Definition
| # ABG and Carbon Monoxide levels |
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|
Term
| Percentage of burned TBSA above which the release of pro-inflammatory cytokines causes SIRS |
|
Definition
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|
Term
| Indications for placing routine central lines in burn patients |
|
Definition
# > 50% TBSA
# for pts with significant comorbidities |
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|
Term
| Ideal location for IV lines for > 40% TBSA burns to arms and legs |
|
Definition
| # AC fossa even if it means going through burned skin or eschar |
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|
Term
|
Definition
# Each upper extremity = 9%
# Each lower extremity = 18%
# Ant and post trunk = 18% each
# Head and neck = 9%
# perineum = 1%
# a person's hand is approximate 1% of their TBSA |
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|
Term
|
Definition
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|
Term
| Fluid resucitation in pediatric burn pts |
|
Definition
# children < 20 kg need glucose added
# 6 ml/kg/% TBSA
# UOP goals: 1.0-1.5 ml/kg body WEIGHT/hr)
# threshold for aggressive fluid resuscitation is 10-20% |
|
|
Term
| Additional IV med that can reduce fluid volume requirements and edema |
|
Definition
|
|
Term
| Best form of IVF resuscitation and why |
|
Definition
| Crystalloid; LR because the large volumes that are required will cause hyperchloremia and metabolic acidosis with NS |
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|
Term
| Times to consider using colloid and why |
|
Definition
| Consider adding albumin in pts with massive burns requiring massive volumes of resuscitation because it has been shown to reduce the increase in intra-abdominal pressure involved in massive fluid resuscitation and therefore could theoretically reduce risk of abdominal compartment syndrome |
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|
Term
| Topical burn antibiotic agent with anti-fungal properties |
|
Definition
|
|
Term
| Topical burn antibiotic agent that does not penetrate eschar |
|
Definition
|
|
Term
| Only topical burn antibiotic agent that penetrates eschar |
|
Definition
|
|
Term
| Drawbacks of mafenide acetate |
|
Definition
# metabolic acidosis (it is a carbonic anhydrase inhibitor)
# painful application |
|
|
Term
| Drawbacks of silver nitrate |
|
Definition
# hyponatremia (common), hypochloremia, hypocalcemia and hypokalemia
# causes discoloration
# does not penetrate eschar
# ineffective against pseudomonas and some GPCs |
|
|
Term
| Drawbacks of silver sulfadiazine |
|
Definition
# neutropenia and thrombocytopenia
# can't use in patients with sulfa alergy
# no eschar penetration
# ineffective against Pseudomonas and some GNRs
# Can cause methemoglobinemia (contraindicated in G6PD deficiency) |
|
|
Term
| UOP goals in burn patients |
|
Definition
# 0.5-1.0 ml/kg/hr for adults
# 1.0-1.5 ml/hg/hr for children > 6 mo
# 2-4 ml/kg/hr for children < 6 mo |
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|
Term
| MC type of infection in burn patients |
|
Definition
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|
Term
| MC cause of death after inhalational injury |
|
Definition
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|
Term
| Management of acid burns and type of damage caused by them |
|
Definition
| Copious water irrigation and coagulation necrosis |
|
|
Term
| Management of alkali burns and type of damage caused by them |
|
Definition
| Copious water irrigation and liquefactive necrosis |
|
|
Term
| B/w acid and alkali burns, which one produces deeper burns |
|
Definition
| Alkali because of liquefactive necrosis |
|
|
Term
| Management of hydrofluoric acid burns |
|
Definition
| spread calcium on the wounds |
|
|
Term
| Management of powder burns |
|
Definition
| wipe off powder prior to irrigation |
|
|
Term
|
Definition
| Cool then wipe away with lipophilic solvent |
|
|
Term
| important monitoring for electrical burns |
|
Definition
|
|
Term
| MC organism in burn wound infx |
|
Definition
| Pseudomonas (followed by Staph, E. coli and Enterobacter) |
|
|
Term
| Topical agents indicated immediately in all burns |
|
Definition
|
|
Term
| Topical burn antibiotic best for burns over joints |
|
Definition
|
|
Term
| Topical burn antibiotic with best anti-pseudomonas properties |
|
Definition
|
|
Term
| Topical burn antibiotic with broadest GNR coverage |
|
Definition
|
|
Term
|
Definition
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|
Term
| MC viral infection in burn wounds |
|
Definition
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|
Term
| Way to diagnose a burn wound infection |
|
Definition
| need biopsy and must have > 10^5 organisms |
|
|
Term
| Common causes of Toxic Epidermal necrolysis |
|
Definition
| Dilantin, bactrim, PCN and viruses |
|
|
Term
| management of toxic epidermal necrolysis |
|
Definition
# supportive
# prevent dessication with topical antimocrobials and xenografts;
# no steroids |
|
|
Term
| Pathology seen in toxic epidermal necrolysis |
|
Definition
| separation of dermis and epidermis |
|
|
Term
| Only indication for abx in toxic epidermal necrolysis |
|
Definition
| if caused by staph (then it's called staphylococcal scalded skin syndrome) |
|
|
Term
| Common causes of Stevens-Johnson syndrome |
|
Definition
| # dilantin, PCN, bactrim and viruses |
|
|
Term
| Pathology seen in Stevens-Johnson syndrome |
|
Definition
# Subepidermal bullae
# epidermal cell necrosis
# dermal edema |
|
|
Term
| Management of Stevens-Johnson syndrome |
|
Definition
# supportive
# prevent dessication with topical antimocrobials and xenografts;
# no steroids |
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