SKIN - Burns (DEF & PATHO) - Burn Management

19 important questions on SKIN - Burns (DEF & PATHO) - Burn Management

What are the topical antibacterial drugs used in burns?

  • Silver Sulphadiazine 1% cream
  • Silver Sulphadiazine 1% + Chitosan (HILDERM CH Cream)
  • Silver nitrate 0.5% aqueous solution
  • Mafenide acetate 5% to 10%
  • Chlorhexidine and Cetrimide (Savlon)

Why is nutritional support important in burn treatment?

Nutritional support is of great importance as well (food rich in proteins).

What should be done when urine output increases on the 4th to 5th day post burn?

Administer DNS plus 20 KCL when urine output increases on the 4th to 5th day post burn. Monitoring of serial electrolytes and the patient’s weight is important.
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What is the goal of the initial phase of burn treatment?

The goal of the initial phase of burn treatment is ensuring fluid resuscitation whose goal is restoration of intravascular volume to ensure adequate tissue and organ perfusion.

How is pain managed in burn treatment?

Pain management includes Pethidine and Morphine administered every 1-3 hours.

What is the importance of topical wound care?

Topical wound care is crucial. Wash with plain soap and water, dry with a clean towel. Ruptured blisters should be removed. Management of clean, intact blisters is controversial.

What are the priorities during the emergent or immediate resuscitative phase of burn care?

  • First aid
  • Prevention of shock
  • Prevention of respiratory distress
  • Detection and treatment of concomitant injuries
  • Wound assessment and initial care

When might systemic antibiotics be necessary in burn treatment?

Systemic antibiotics may be necessary in severe cases.

How is the volume of fluid needed calculated in burn treatment?

To calculate the volume of fluid needed, Parkland’s formula is used: = 3ml x weight in kg x TBSA (children, in adults you use 4ml).

What should you do if you encounter blisters during wound care?

Do not attempt to manage blisters yourself; seek competent medical help. Apply antibiotic ointment after cleaning and before applying clean gauze dressing.

What factors must be considered when planning burn care?

Burn care must be planned according to the burn depth and local response, the extent of the injury, and the presence of a systemic response.

What is the duration of the acute phase in burn care?

The acute phase lasts from the beginning of diuresis to near completion of wound closure.

How is the fluid administered according to Parkland’s formula?

Half the volume of needed fluid is administered over the first 8hrs from time of injury and the second half over the following 16hrs.

What is the treatment for shock in burn patients?

In case of shock, administer normal saline at 25mls x body weight.

What are the three phases of burn care?

Burn care then proceeds through three phases:
  • Emergent/resuscitative phase (on the scene care)
  • Acute/intermediate phase
  • Rehabilitation phase (physiotherapy to prevent contractures/deformities)

List the priorities in the acute phase of burn care.

  • Wound care and closure
  • Prevention or treatment of complications, including infection
  • Nutritional support

What fluids are given during the initial phase of burn treatment?

With the initial phase, Ringer’s lactate is given, then dextrose 5%.

Describe the duration of the rehabilitation phase in burn care.

The rehabilitation phase lasts from major wound closure to return to the individual's optimal level of physical and psychosocial adjustment.

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

  • Prevention of scars and contractures
  • Physical, occupational, and vocational rehabilitation
  • Functional and cosmetic reconstruction
  • Psychosocial counseling

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