Notes in Chapter_17:_Burns

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Published	07/07/2024	The Parkland formula is calculated as: {{c2::Total fluids in first 24 hours}} = {{c1::4cc/kg x weight (kg) x TBSA (%)}}
Published	07/07/2024	{{c1::Keraunoparalysis}} occurs after lightning strikes and usually presents with {{c2::paralyzed}} extremities
Published	07/07/2024	{{c1::Superficial}} 2nd degree burns involve the {{c2::papillary dermis}} dermis layer and do NOT require skin grafts
Published	07/07/2024	{{c1::Deep}} 2nd degree burns involve the {{c2::deep reticular}} dermis layer and DO require skin grafts
Published	07/07/2024	A {{c2::superficial}} 2nd degree burn has {{c1::intact}} sensation and {{c1::intact}} blood flow
Published	07/07/2024	A {{c2::deep}} 2nd degree burn has {{c1::decreased}} sensation and {{c1::decreased}} blood flow
Published	07/07/2024	{{c1::Deep 2nd}} degree burns (or greater) lacks hair follicles
Published	07/07/2024	{{c2::Extremely deep}} burns or {{c1::electrical}} burns can cause {{c3::rhabdomyolysis}}, which is treated with {{c4::agressive hydrat…
Published	07/07/2024	Burn admission criteria for patients <{{c1::10}} yo or >{{c1::50}} yo includes {{c2::2nd or 3rd}} degree burns covering >{{c3::10}}% bod…
Published	07/07/2024	Burn admission criteria for patients between {{c2::10}}-{{c2::50}} years old includes {{c3::2nd and 3rd}} degree burns covering >{{c1::20}}% body s…
Published	07/07/2024	Special scenarios where 2nd or 3rd degree burns <{{c4::10}}% that may require admission include: - Burns to the {{c1::face}}, {{c1::hands}}, a…
Published	07/07/2024	{{c2::3rd}} degree burns on any part of the body totaling >{{c3::5}}% BSA in {{c1::any}} age group should be hospitalized
Published	07/07/2024	{{c1::Electrical}} burns and {{c1::chemical}} burns should always be hospitalized
Published	07/07/2024	Burn hospital admission is indicated if there is concomitant: - {{c3::Inhalational}} injury - Patient has associated {{c2::mechanical t…
Published	07/07/2024	Children with minor burns should still be hospitalized if there are signs of {{c1::abuse}} or {{c1::neglect}}
Published	07/07/2024	The most common type of burns are {{c1::scald}} burns
Published	07/07/2024	After calculating the Parkland formula, give {{c2::50}}% of the fluids in the first {{c1::8}} hours
Published	07/07/2024	The preferred IV fluid for the first 24 hours of a burn patient is {{c1::LR}}
Published	07/07/2024	Burn patient urine output target in {{c2::infants (<6 months)::age}} is >{{c1::2}} cc/kg/hr
Published	07/07/2024	Burn patient urine output target in {{c2::adults::age}} is >{{c1::0.5}} cc/kg/hr
Published	07/07/2024	Burn patient urine output target in {{c2::children (>6 months)::age}} is >{{c1::1}} cc/kg/hr
Published	07/07/2024	The Parkland formula can only be used if: - BSA >{{c1::10}}% for children and elderly - BSA >{{c1::20}}% for adults - T…
Published	07/07/2024	The Parkland formula grossly {{c5::und}}erestimates the fluid volume in patients with {{c1::inhalational}} injury, {{c2::ethanol}} intoxication, …
Published	07/07/2024	The preferred IV fluid used after the first 24 hours varies depending on the patients condition and electrolyte concentrations, but in general it is m…
Published	07/07/2024	When calculating the Parkland formula for pediatric burns, also add {{c1::maintenance fluid}} and {{c2::dextrose}} to the total fl…
Published	07/07/2024	When calculating pediatric burn fluid requirements it may be more accurate to use the {{c1::Galveston}} formula
Published	07/07/2024	{{c3::Galveston}} formula uses body {{c2::surface area}} instead of body weight
Published	07/07/2024	The most common complications of fluid over-resuscitation in burn patients is {{c2::ARDS}} and compartment syndrome (abdominal, extremi…
Published	07/07/2024	Indications for {{c4::escharotomy}} include: - {{c1::Circumferential}} deep burns - Extremities with compromised {{c2::vascular supply (↓ pu…
Published	07/07/2024	Chest and torso burns may require {{c2::escharotomy}} if patient has difficulty {{c1::ventilating}}
Published	07/07/2024	Major social risk factors for burns include:L{{c1::ow socioeconomic status}}A{{c1::lcohol and drugs use}}V{{c1::iolence}}A{{c1::ge extremes}}S{{c1::mo…
Published	07/07/2024	What medical condition is associated with a higher risk of burns?{{c1::Epilepsy}}
Published	07/07/2024	The mechanism of {{c2::inhalational}} injury in burn patients is caused by {{c1::smoke toxicity}}
Published	07/07/2024	Burn inhalational injury is diagnosed with {{c1::bronchoscopy}}
Published	07/07/2024	Indications for burn patient intubation include upper airway {{c2::stridor}} or worsening {{c1::hypoxemia}}
Published	07/07/2024	Patients with mild inhalation injury (no stridor or hypoxemia) may still require intubation if they are getting {{c1::massive volume resuscitation}}
Published	07/07/2024	The most common infection and cause of death in patients with >{{c2::30}}% BSA burns is {{c1::pneumonia}}
Published	07/07/2024	The most common risk factor for {{c2::pneumonia}} in burn patients is {{c1::inhalation injury}}
Published	07/07/2024	{{c1::Hydrofluoric acid}} burns should treated with topical {{c2::calcium gluconate gel/powder}}
Published	07/07/2024	Neurological complications of electrical burns include {{c2::polyneur}}itis, quadriplegia, and {{c1::transverse myel}}itis
Published	07/07/2024	An ophthalmologic complication of electrical burns includes {{c1::cataracts}}
Published	07/07/2024	GI complications of electrical burns include {{c2::viscera perforation}}, {{c1::liver}} necrosis, and {{c1::pancreatic}} necrosis
Published	07/07/2024	Caloric intake for burn patients during the first week should be {{c1::25}} kcal/kg/day + {{c2::(30kcal x % BSA)}}
Published	07/07/2024	The best source of calories for burn patients is {{c1::glucose}}
Published	07/07/2024	Protein requirements for burn patients are {{c1::1}}g/kg/day + {{c1::(3g x % BSA)}}
Published	07/07/2024	Burn wounds should be excised in <{{c1::72}} hours, but not until after appropriate {{c2::fluid resuscitation}}
Published	07/07/2024	During burn wound excision, the best predictor of viability is {{c1::punctate bleeding}}, followed by color and texture
Published	07/07/2024	Wounds to the face, palms, soles, and genitals are deferred for the first {{c1::7 days::time frame}}
Published	07/07/2024	Ideal parameters for burn wound {{c3::excision}} include: - less than {{c1::1 liter}} of blood loss - less than {{c2::20}}% of ski…
Published	07/07/2024	Contraindications for burn wound skin grafts include {{c2::beta-hemolytic strep}} or {{c1::bacteria >105}}
Published	07/07/2024	Which type of skin graft has the best viability rates?{{c1::Auto}}grafts
Published	07/07/2024	{{c3::Split}} thickness grafts are regenerated from the {{c2::edges}} of the graft and from {{c1::hair follicles}}
Published	07/07/2024	Days {{c2::0}}-{{c2::3}} in skin graft healing are marked by {{c1::imbibition (water absorption)}}
Published	07/07/2024	Days {{c1::3}}-{{c1::4}} of skin graft healing is marked by {{c2::neovascularization}}
Published	07/07/2024	Skin grafts are least likely to survive on poorly {{c3::vascularized}} tissue such as {{c2::tendon}} and {{c1::bone without periosteum}}
Published	07/07/2024	The main use of {{c2::cadaveric homo}}grafts is for a {{c1::temporizing measure}} (up to {{c3::4}} week(s))
Published	07/07/2024	{{c1::Porcine xeno}}grafts last {{c2::2}} week(s) and do NOT vascularize
Published	07/07/2024	The most common reasons for skin graft loss include {{c1::seromas}} and {{c1::hematomas}}
Published	07/07/2024	{{c1::Meshed}} grafts are usually used to delay autografting such when there is an infection, not enough skin donor sites, or patient is unstable
Published	07/07/2024	Skin graft hematoma/seroma formation can be prevented by {{c1::applying pressure dressing}}
Published	07/07/2024	For areas like the {{c2::palms}} and {{c2::back of the hands}}, {{c1::full}} thickness grafts are preferred
Published	07/07/2024	{{c2::Full}} thickness grafts have {{c3::less}} {{c1::wound contraction}} during healing
Published	07/07/2024	Burn scar {{c2::hypopigmentation}} and scar irregularities can be improved with {{c1::dermabrasion}}
Published	07/07/2024	Facial burns are generally treated with {{c2::topical antibiotics}} during the {{c3::1st}} week, followed by {{c1::full thickness grafts}} for un…
Published	07/07/2024	{{c2::Superficial::depth}} {{c3::hand}} burns are generally treated with {{c1::range of motion exercises}}
Published	07/07/2024	If {{c2::superficial::depth}} {{c3::hand}} burns have too much {{c4::edema}}, treatment involves {{c1::splinting in extension::be speci…
Published	07/07/2024	{{c1::Deep::depth}} {{c2::hand}} burns are treated with {{c3::full thickness grafts}} followed by complete {{c4::immobilization in extension::be …
Published	07/07/2024	{{c4::Deep::depth}} {{c5::hand}} burns that have {{c1::unstable}} or {{c1::open}} {{c2::joints}} may require {{c3::wire fixation}}
Published	07/07/2024	{{c3::Deep::depth}} {{c4::hand}} burns require {{c1::physical therapy}} {{c2::after::before/during/after}} healing
Published	07/07/2024	{{c1::Genital}} burns are treated with {{c2::meshed}} {{c3::split}} thickness grafts
Published	07/07/2024	Burn wound infections increase as the burn {{c1::area}} increases
Published	07/07/2024	Immediately after the burn, the two antibiotics that are applied are {{c2::bacitracin}} or {{c1::Neosporin}}
Published	07/07/2024	The most common bacteria in burn wounds: - {{c1::Pseudomonas}} - {{c1::Staphylococcus}} - {{c2::E. coli}} - {{c2::Enterobacter}}
Published	07/07/2024	Due to increased use of antibiotics in burn patients, the incidence of {{c1::Candidal}} infections have increased
Published	07/07/2024	Burns impair cell-mediated immunity, specifically {{c1::granulocyte::WBC type}} chemotaxis
Published	07/07/2024	{{c2::Silver sulfadiazine::topical antibiotic}} can cause {{c1::neutropenia}} and {{c1::thrombocytopenia}}
Published	07/07/2024	{{c2::Silver sulfadiazine::topical antibiotic}} can impair {{c1::epithelialization}} during wound healing
Published	07/07/2024	{{c2::Silver sulfadiazine}} is effective against {{c1::Candida::pseudomonas or candida}}
Published	07/07/2024	{{c2::Silver nitrate::topical antibiotic}} can cause {{c1::electrolyte imbalances (low Na, Cl, Ca, K)::adverse effect}}
Published	07/07/2024	The two antibiotics that have {{c2::poor}} {{c3::eschar}} penetration are {{c1::silver sulfadiazine}} and {{c1::silver nitrate}}
Published	07/07/2024	The two main hematologic complications of {{c3::silver nitrate::topical antibiotic}} include {{c1::methemoglobinemia}} and {{c2::hemolysis}} in {{c2::…
Published	07/07/2024	{{c1::Mafenide::topical antibiotic}} is painful when applied topically
Published	07/07/2024	{{c1::Mafenide::topical antibiotic}} is preferred in burns overlying {{c2::cartilage}}
Published	07/07/2024	A serious side-effect of {{c2::mafenide}} is {{c1::metabolic acidosis}} due to {{c3::inhibition::inhibition or activation}} of {{c1::renal carbonic an…
Published	07/07/2024	Burn wound infections have {{c1::early::early or late}} separation of {{c2::eschars}}
Published	07/07/2024	Burn wound with a(n) {{c1::hemorrhage}} into the {{c3::scar}} is indicative of {{c2::infection}}
Published	07/07/2024	{{c1::Green}} fat indicates burn wound {{c2::infection}}
Published	07/07/2024	{{c1::Mupirocin::topical antibiotic}} is very effective against {{c3::MRSA::pseudomonas or MRSA}}; the down-side is that it is {{c2::expensive}}
Published	07/07/2024	Conversion to {{c2::2nd or 3rd}} degree burn wound indicates {{c1::infection}}
Published	07/07/2024	The most common cause of burn wound sepsis is {{c1::Pseudomonas}}
Published	07/07/2024	The most common viral infection of burn wounds is {{c1::HSV}}
Published	07/07/2024	Burn wound infections by gram {{c2::nega}}tive {{c2::rods}} are best treated with {{c1::mafenide::topical antibiotic}}
Published	07/07/2024	It is NOT considered a burn wound infection unless there are >10{{c1::5}} organisms
Published	07/07/2024	The best way to differentiate between burn wound {{c2::infection}} versus {{c2::colonization}} is to {{c1::biopsy the burn wound}}
Published	07/07/2024	True burn wound infections are surgically treated with {{c1::local excision}} and {{c1::allograft placement}}
Published	07/07/2024	In addition to surgical excision and allograft placement, burn wound infections are treated with {{c1::systemic antibiotics}}
Published	07/07/2024	If a burn wound just has {{c1::cellulitis}} around the burn, it is treated with {{c2::IV antibiotics (without excision)}}
Published	07/07/2024	Burn related {{c2::seizures::complication}} are usually due to {{c1::hyponatremia}}
Published	07/07/2024	Burn related peripheral neuropathy is caused by {{c1::small vessel}} injury and {{c2::demyelination}}
Published	07/07/2024	An ophthamologic complication of facial burns is {{c1::ectropion}} and is treated by {{c2::eye-lid release}}
Published	07/07/2024	The test for optical integrity with burns near the eyes is {{c1::fluorescein staining}}
Published	07/07/2024	Burns near the eyes are treated with topical {{c1::fluoroquinolone}} or {{c1::gentamicin}}
Published	07/07/2024	An ophthamologic complication of burns near the eyes is {{c2::symblepharon}} and is treated with {{c1::glass rod relsease}}
Published	07/07/2024	After burn injuries, {{c3::tendons}} can undergo {{c2::heterotrophic ossification}}, which is treated with {{c1::physical therapy}} or surgery
Published	07/07/2024	{{c1::Chronic non-healing}} burn wounds can develop {{c2::Marjolin's}} ulcers, which increases the risk of {{c3::squamous cell carcinoma}}
Published	07/07/2024	{{c2::Hypertrophic}} scars as a result of burn wounds are best treated with {{c1::steroid injection}} and should not be surgically modified for {…
Published	07/07/2024	Two factors that cause renal failure in burn patients are {{c1::volume loss (pre-renal azotemia)}} and {{c1::myoglobinuria}}
Published	07/07/2024	{{c2::Succinylcholine::drug}} should be avoided in burn patients if they have {{c1::hyperkalemia::renal}}
Published	07/07/2024	Patients with frostbite can be rewarmed {{c1::pass}}ively (blankets and insulating materials) or {{c1::act}}ively (circulating water or warm air)
Published	07/07/2024	Patients with hypothermia receiving active re-warming should be <{{c1::40o}} celcius
Published	07/07/2024	Hypothermic patients become extremely hyp{{c1::o}}tensive during rewarming
Published	07/07/2024	Frostbite patients should recieve {{c1::tetanus shot::prophylaxis}} and topical {{c2::silvadene}}
Published	07/07/2024	Stevens-Johnson syndrome covers <{{c1::10}}% of body surface area while toxic epidermal necrolysis covers >{{c1::30}}% of body surface area
Published	07/07/2024	Stevens-Johnson syndrome and TEN are treated with fluid resuscitation, topical antibiotics, and prevention of wound {{c1::desiccation}} with {{c1::Tel…
Published	07/07/2024	A drug that should be avoided in Stevens-Johnson syndrome is {{c1::steroids}}
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