4303 Burns

Question 1

Pertinent Environmental Findings

Answer 1

Source: Electrical, thermal, chemical

Question 2

Pertinent Hx

Answer 2

MOI
Associated trauma
Inhalation injury
1st, 2nd, or 3rd degree burns
BSA
Time of event
Bystander treatment
SAMPLE

Question 3

Pertinent Physical Findings

Answer 3

1st- superficial, red, sometimes painful
2nd- Skin may be red, blistered, swollen. very painful
3rd- whitish, charred, translucent, decreased sensation

Adult rule of nines- Head 9%, Arms 9% each, Torso 36%, Genitalia 1%, Legs 18% each
Infants rule of nines- Head 18%, Arms 9% each, Torso 36%, Genitalia 1%, Legs 14 % each

Question 4

Differential Diagnoses

Answer 4

Critical Trauma
Suspected inhalation injury
Airway involvement
Thermal, Electrical, Chemical, 1st, 2nd, or 3r
BSA
Involves face, hands, feet, genitalia, major joints, fractures, circumferential

Question 5

Thermal burns less than 20% BSA

Answer 5

Cool with wet dressing, follow with dry non-adherent dressing

Question 6

Thermal burns greater than 20% BSA

Answer 6

Apply dry, clean, non-adherent dressing

Question 7

Chemical burns

Answer 7

Brush off dry chemicals
Dilute excess liquid chemicals
Wash pt with mild soap and water
Rinse and flush with large amounts of water

Consult MSDS

Question 8

Electrical Burns

Answer 8

Consider possibility of spinal trauma, C-Spine stabilization

Question 9

Eye burns

Answer 9

Flush contaminated eyes with saline for 15 mins or more
Check for contacts
Patch eyes

Question 10

Tar Burns

Answer 10

Cool with water
Do not remove tar
Apply petrolatum gauze dressing

Question 11

Treatments for significant burns

Answer 11

NS bolus

Fentanyl for pain

Question 12

Disposition

Answer 12

Burns with airway involvement go to closest

Burns with critical trauma criteria go to trauma center

BH for all of the following
2 degree greater than 30%
3 degree greater than 10%
2 or 3 including face, hands, feet, genitals/ perineum, major joints, fractures, or circumferential
High voltage electrical
Burns in combination with significant pre-existing medical conditions

Prehsopital transport to burns center requires BHO