Approach To A Patient With Burn

Question 1

Alkali or acids cause more damage to the skin?

Answer 1

Alkali

Question 2

A burn has 3 zones, what are they?

Answer 2

Coagulation, stasis, and perfusion

Question 3

Which burn zone occurs at maximum damage, and has irreversible tissue loss?

Answer 3

Zone of Coagulation

Question 4

Which burn zone is characterized by decreased tissue perfusion?

Answer 4

Zone of Stasis

Question 5

Which burn zone is outermost and has increased perfusion?

Answer 5

Zone of Hyperaemia

Question 6

Explain the TBSA burn classification for adults

Answer 6

10% minor, 10-20% moderate, 20%+ is severe

Question 7

What TBSA percentage is needed to administer children and adults to the burn unit?

Answer 7

10% children, 20% adult

Question 8

A few special sites also necessitate burn unit admin if 2nd degree +, what are they?

Answer 8

Hands face feet joints and genitalia

Question 9

Carbon monoxide poisoning is a great cause of inhalational burn, what signs do we see?

Answer 9

History of a flame burn in closed space, and physical signs, like burns, soot, hoarseness

Question 10

What is Carbinacious sputum?

Answer 10

A black looking sputum, obv a sign of monoxide poisoning

Question 11

What is the best method for venous access

Answer 11

Short peripheral wide bore cannulas in unburned skin

Question 12

Superficial veins are often unavailable, so how do we get venous access?

Answer 12

Central venous catheter

Question 13

Parkland’s formula is quintessential to resuscitation, explain the formula

Answer 13

4ml/kg x body weight x TBSA

Question 14

So how is the fluid admin spaced out?

Answer 14

Half in the first 8 hours of injury, and next half in the next 16 hours

Question 15

What is the fluid used for resuscitation?

Answer 15

Ringer’s lactate (crystalloid)

Question 16

After the first 24 hours, what changes in regards to the fluid we give?

Answer 16

Colloid + Crystalloid

Question 17

Parkland formula is only given to patients meeting a certain TBSA, what is it?

Answer 17

20% adult, 10% children

Question 18

What is the cause for an escharotomy

Answer 18

When the burn surrounds the circumference of the extremity, hence compromising blood flow

Question 19

Explain the escharotomy briefly

Answer 19

Release of the burn eschar by incising the lateral and medial aspects of the extremity via scalpel

Question 20

Dressing of choice for 2nd degree burns?

Answer 20

Gauze or elastic wraps

Question 21

Dressing of choice for deep 2nd and 3rd degree wounds?

Answer 21

Skin grafts

Question 22

Why do we feed the patients a huge ton when they get a burn injury?

Answer 22

Burns cause hyper metabolism