Integumentary: Burns - PowerPoint PPT Presentation

Loading...

PPT – Integumentary: Burns PowerPoint presentation | free to download - id: 4d1e43-OGU4N



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Integumentary: Burns

Description:

... burns of the extremities can cause circulatory compromise Patients may also develop compartment syndrome Phases of Burn Management Prehospital care Emergent ... – PowerPoint PPT presentation

Number of Views:88
Avg rating:3.0/5.0
Slides: 47
Provided by: Marnie85
Learn more at: http://www.austincc.edu
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Integumentary: Burns


1
Integumentary Burns
  • Marnie Quick, RN, MSN, CNRN

2
Skin layers, hair follicle, nerves, sweat glands
3
Types of burns
  • Thermal
  • Chemical
  • Smoke and inhalation
  • Electrical
  • Radiation

4
Thermal burn
5
Cool burn with cold water until pain is relieved-
Do not apply to more than 20 body surface-
hypothermia may occur
6
Chemical burn from sulfuric acid
7
Smoke Inhalation Which is this?- CO injury
above glottis below glottis

8
Electrical burns
9
Depth of Burn
10
Depth of burn Superficial partial (old 1st)
Deep partial-thickness
(old 2nd)
Full-thickness (old 3/4th)
11
Deep partial-thickness burn- note blisters
12
Partial-thickness (Second degree burn)
13
(No Transcript)
14
Full-thickness
15
Extent of Burn calculate total burn with rule
of 9s-- ½ of ant trunk9 and ¼ of arm3
TOTAL area burn12 Rule of Nines
Lund Browder- age
16
Location of Burn
  • Location of the burn is related to the severity
    of the injury
  • Face, neck, chest ? respiratory obstruction
  • Hands, feet, joints, eyes ? self-care
  • Ears, nose ? infection
  • Circumferential burns of the extremities can
    cause circulatory compromise
  • Patients may also develop compartment syndrome

17
Phases of Burn Management
  • Prehospital care
  • Emergent (resuscitative- fluid)
  • Acute (wound healing)
  • Rehabilitative (restorative)

18
Emergent/resuscitative
  • Onset injury to successful fluid resuscitation
  • Major concern- Fluid Resuscitation- prevent
    hypovolemic shock
  • 2 large bore IVs in unburned area to restore bl
    vol due to inc capillary permeabilitygt 3rd
    spacing
  • Guidelines burns gt20 TBSA- Parkland formula or
    Modified Brooke formula
  • Need Weight and TBSA burned to calculate

19
  • Lactated Ringers solution 1st 24 hrs then add 5
    Dextrose to crystalloid fluid
  • 50 of formula volume in first 8 hrs rest over
    next 16 hrs then maintain urinary output
  • Hourly output 30-50 cc/hr (foley) heart rate
    less than 120/min SBPgt 90hemodynamic monitoring
  • Elevate edematous part escharotomy

20
(No Transcript)
21
Effects of Burn Shock
22
Third spacing
23
Burn with escarotomy
24
Escarotomy
25
Elevate arms to decrease swelling also note
escarotomy of arms and chest- assess CMS
(circulation/motor/sensory)
26
Before the escharotomy, how would this eschar
affected his respirations?
27
What are the Priorities in this patient???
Meet criteria for Burn Unit Referral?
28
  • What do you assess for here???

29
Complications in emergent phase
  • Cardiovascular
  • Respiratory
  • Upper/inhalation/lower
  • Urinary
  • Renal blood flow/GFR decrease causing release ADH
  • Myoglobinurea- dark urine may block renal tubules

30
Summary
31
Acute Phase
  • Start of diuresis and ends with closure of burn
  • Major concern in this stage- infection
  • Most common cause infection- pts own GI track
  • Wound management-
  • hydrotherapy, debridement of eschar
  • topical antimicrobial creams (open/closed method)
  • splints/exercise prevent contractures
  • Excision/grafting of 3rd degree (temporary cover
    2nd )

32
Decreasing of third spacing- Note
edema of the face decreasing
33
Hydrotherapy Hubbard Tank
34

Clean/debridement
Rt tank or Lt surgery
35
Topical broad spectrum antimicrobials
Open method
36
Separate skin use of splints
Closed method
37
Skin will grow together if not separated
38
Several patients utilizing closed method Who is
that nurse with white stockings cap?

39
Removal of necrotic tissueEschar removed until
viable tissue
40
Donor sitesafter harvesting healed donor
site
41
Grafting (Lewis 498 Table 25-13)
  • Permanent- if no infection
  • Autograft
  • CEA
  • Integra/AlloDerm
  • Temporary grafts
  • Homograft- cadaver
  • Heterograft- animal
  • Synthetic

42
Grafting
43
Application of Cultured
Epithelial Autograft
  • Cultured epithelial autografts
  • Grown from biopsies obtained from the patients
    own skin
  • Used in patients with a large body surface burn
    area or those with limited skin for harvesting

44
Pressure garments
45
What are your assessment findings?
46
What are your nursing priorities for this patient?
About PowerShow.com