Burn

Question 1

What chemical agent SHOULD NOT BE irrigated with water for 30 minutes?

Answer 1

LYE POWDER will be activated to AlOH with water!

Question 2

What is the depth of the burn?

Weeping blistering painful that requires excision and grafting

Answer 2

Deep partial thickness SECOND

Question 3

What is the depth of the burn?

Painless, hard and non blanching

Answer 3

Full thickness THIRD

Question 4

What is the depth of the burn?

Painful but no blistering

Answer 4

Superficial thickness FIRST

Question 5

What is the depth of the burn?

Affects underlying soft tissue

Answer 5

FOURTH

Question 6

What zone of Jackson has QUESTIONABLE VIABILITY?

Answer 6

Zone of stasis

Z of coagulation needs excision
Z of hyperemia usually heals because of increased blood flow

Question 7

What layer of the epidermis is composed of a multilaminar layer of cuboidal-like cells that are bound together by desmosomal junctions and produce keratin?

Answer 7

Spinosum

Question 8

Which type of burn may cause compartment syndromes and rhabdomyolysis?

Answer 8

Electrical burn

Question 9

Burning the entire head of an adult vs an infant how much TBSA

Answer 9

Adult 9% TBSA

Infant 18% TBSA

Question 10

Dfx the treatment for:
1 CO poisoning
2 Cyanide poisoning

Answer 10

1 100% O2

2 Sodium thiosulfate, hyrdoxycobalamin, 100% O2

Question 11

A 60 kg female had 10% deep partial thickness burns and 10% superficial thickness burns how will you give fluid according to Parkland formula?

Answer 11

4mg/kg x % TBSA
4 x 60 x 10 =2400L give 1200 over 8 hours and another 1200 over the next 16 hours

REMEMBER that First Degree burns are NOT counted

Question 12

After hydrating the patient you find that her MAP is already at 55 and her UO is already at 15cc/h what will you do then?

Answer 12

Hydrate more. Target is MAP 60 and UO 30cc/h in adults and 1-1.5cc/kg/h in pedia

Question 13

When do you give maintenance fluid with glucose in burn patients

Answer 13

children less than 20 kg

Question 14

When is silver sulfadiazine contraindicated for burn patients?

Answer 14

CONTRAINDICATED ON BURNS IN PROXIMITY TO NEWLY GRAFTED AREAS

Also it causes neutropenia

Question 15

A patient with massive trunk burns initially stable after hydration now presents with hypoventilation, decreased urine output and hemodynamic compromise, what is the dx and tx?

Answer 15

Abdominal compartment syndrome

Minimize fluid, do truncal escharotomy, decrease tidal volume IF NOT IMPVT

DECOMPRESSIVE LAPAROTOMY

Question 16

What should be done to prevent gastric ileus?

Answer 16

Enteral feeding within the first hew hours post admission

Question 17

When anticipating laryngeal edema from an inhalational burn what should you do?

Answer 17

SHORT COURSE protective intubation. edema usually manifests within the first 24 - 48 hours.