Adult Burns

Question 1

Ketamine Indications

Answer 1

Intubation
Analgesia
Sedation:
- Agitation
- Patient movement during CPR

Question 2

Ketamine Contraindications

Answer 2

Suspected non-traumatic brain injury with severe hypertension (SBP > 180)

Question 3

Ketamine Precautions

Answer 3

May exacerbate cardiovascular conditions (e.g. uncontrolled hypertension, stroke, recent MI,
cardiac failure) due to effects on HR and BP.

Question 4

Ketamine Side Effects

Answer 4

CV: hypertension, tachycardia
CNS: emergence reactions (e.g. vivid dreams, restlessness, confusion, hallucinations, irrational
behavior); increased skeletal muscle tone (may resemble seizures)
Respiratory: transient respiratory depression and apnoea (rare)
GI: nausea and vomiting
Other: injection site pain, lacrimation, hypersalivation, diplopia, nystagmus

Question 5

Signs and symptoms of airway burns

Answer 5

evidence of burns to upper torso, neck and face
facial and upper airway oedema
sooty sputum
burns that occur in enclosed space
singed facial hair (nasal hair, eyebrows, eyelash, beards)
respiratory distress (dyspnoea +/- wheeze and associated tachy/stridor)
hypoxia (restlessness, irritability, cyanosis, decreased GCS)

Question 6

Burn cooling

Answer 6

aim for 20/60 - stop if pt shivering or temp ≤35 degrees
water temp 5-15º or room temp if possible
remove clothing where appropriate - do not remove clothing adhered to skin - remove jewellery

Question 7

Wallace rule of 9’s

Answer 7

Head 9%
Torso 18% (abdo and chest)
Back 18%
Arm 9% (each)
Leg 18% (each)
Groin (1%)

Question 8

Mgx of partial/full thickness burns

Answer 8

Pts >15yrs with >15%TBSA
Fluids vol = % TBSA x Pt wgt (kg) - Admin over 2hrs from time of burn

Pts 12-15yrs >10%TBSA
Fluids vol = 3 x %TBSA x Pt wgt (kg) - admin 24hrs from time of burn - first half in first 8hrs

Question 9

Types of burns

Answer 9

Superficial
Patrial
Full Thickness