Burn

Question 1

What are the qualifications to transfer to a burn center?

Answer 1

->10% TBSA partial thickness burns
-partial thickness burns or deeper to the face, hands, feet, genitalia, perineum, and joints
-third degree burns
-burns in patients w/significant comorbidities
-pts when advanced rehab needs
-burns in children

Question 2

airway damage from burn exposure is caused by?

Answer 2

inhaled toxins

Question 3

is singed facial hair have high sensitivity to predict inhalation injury

Answer 3

no

Question 4

what quantifies mild hypothermia?

Answer 4

90-94 degrees F
shivering and mild mental changes
maybe some tachycardia to increase cardiac output

Question 5

what quantifies moderate hypothermia?

Answer 5

94-89 degrees F or 28.9-31.7 C
agitated or combative
muscle spasticity, dilated pupils, slowing of respirations, afib, hypotension, decreased vascular resistance

Question 6

what quantifies severe hypothermia?

Answer 6

70-84 F or 21.1 - 28.9 C
EKG changes (prolonged QRS or Osborn waves), flaccid/comatose, ventricular fibrillation, death

Question 7

what is profound hypothermia?

Answer 7

<70F or <21.1 C
loss of vital signs, cardiac activity, and EEG tracings

Question 8

what is the first treatment for hydrofluoric acid burn?

Answer 8

2.5% calcium gluconate gel to burned areas, if burn persists can use 5% calcium gluconate can be injected intradermally around The affected areas

Question 9

what does hydrofluoric acid burn cause?

Answer 9

life threatening hypocalcemia because the HF acid binds calcium and can lead to cardiac arrest

Question 10

what is characteristic of a full thickness burn?

Answer 10

non blanching white, leathery, painless

Question 11

what is a fourth degree burn?

Answer 11

extends through entire skin into the underlying fat, muscle, and bone

looks dry, black, charred, with eschar

Question 12

what is a deep second degree burn

Answer 12

Depth to the reticular dermis
Dry, yellow or white, less blanching, insensate, may be slightly painful

Question 13

what is a superficial second degree burn

Answer 13

depth to the papillary dermis
moist, redness with clear blisters, blanches with pressure, painful

Question 14

what is a first degree burn

Answer 14

depth to epidermis
dry, red, without blisters, painful

Question 15

what is a side effect of bacitracin?

Answer 15

nephrotoxicity and anaphylaxis

Question 16

which topicals can penetrate eschar?

Answer 16

Mafenide acetate and silver nitrate

Question 17

which topical to use with exposed cartilage?

Answer 17

Mafenide acetate

Question 18

what topical should you used for superficial MRSA

Answer 18

Mupirocin

Question 19

which topical can cause methemoglobinuria?

Answer 19

silver nitrate

Question 20

which topical is painful?

Answer 20

mafenide acetate

Question 21

does silver sulfadiazine penetrate eschar?

Answer 21

no

Question 22

when doing an escharotomy, do you incise the muscle fascia?

Answer 22

no - that would be a fasciotomy

Question 23

what does frost nip look like

Answer 23

ice crystal formation on surface of the skin, no tissue damage

treat with rewarming, no long term sequelae

Question 24

what does a first degree frost bite look like?

Answer 24

injury limited to the epidermis, edema, white plaque formation

treat with rewarming, +/- topical ointment
sensory loss may take time to recover, no permanent tissue loss

Question 25

what does second degree frost bite look like?

Answer 25

injury extends to the dermis, clear blisters

rewarm and wound care +/- skin grafting
blister may form an esher that eventually sloughs off
no permanent tissue loss

Question 26

what does a third degree frost bite look like?

Answer 26

injury extends to subcutaneous tissue, hemorrhagic blisters, black eschar

rewarming, intensive wound care, permanent tissue loss is possible, skin or tissue grafting is necessary, may need amputation

Question 27

what does a fourth degree frost bite look like?

Answer 27

extends to muscle, bone
complete necrosis, mummification

Rewarming and intensive wound care
Will need amputation

Question 28

what is the Parkland formula?

Answer 28

4 ml x weight (kg) x TSBA (%)

first half of volume given over first 8 hours then second half over next 16 hrs