Burn Baby Burn

Question 1

Indications of hospitalization in burns (10)

Answer 1

1. Burns affecting >10% of
2. BSA Burns >10–20% of BSA in adolescent/adult 3rd-degree burns
3. Electrical burns caused by high-tension wires or lightning 4. Chemical burns Inhalation injury, regardless of the amount of BSA burned
4. Inadequate home or social environment
5. Suspected child abuse or neglect
6. Burns to the face, hands, feet, perineum, genitals, or major joints
7. Burns in patients with preexisting medical conditions that may complicate the acute recovery phase
8. Associated injuries (fractures)
9. Pregnancy BSA

Question 2

Acute treatment of burns (8)

Answer 2

1. First aid, including washing of wounds and removal of devitalized tissue
2. Fluid resuscitation
3. Provision of energy requirements
4. Control of pain
5. Prevention of infection—early excision and grafting
6. Prevention of excessive metabolic expenditures
7. Control of bacterial wound flora
8. Use of biologic and synthetic dressings to close the wound

Question 3

True or false:
Oxygen inhalation via mask Children with facial burns or burn sustained in an enclosed space will suffice.

Answer 3

FALSE!

Ensure and maintain an adequate airway, and provide humidified oxygen by mask or endotracheal intubation (Fig. 92.1). The latter may be needed in children who have facial burns or a burn sustained in an enclosed space, before facial or laryngeal edema becomes evident. If hypoxia or CO poisoning is suspected, 100% oxygen should be used (see Chapters 81 and 89).
P615 NELSON 21ST ED
- aggresive decision for intubation in these burn cases before laryngeal and facial edema ensues!

Question 4

What are the 4 phases of Burn care?

Answer 4

1. Inititial evaluation and resuscitation (0-72hr)
2. Initial wound excision and. Iologic closure (d1-7)
3. Definitive wound closure (d7-week6)
4. Rehabilitation, reconstruction and reintegration day 1 through discharge

Question 5

True or false
All burn patients require anti tetanus

Answer 5

FALSE!
Burns >=10% only needs anti tetanus immunization

Question 6

When is the earliest time to start oral supplementation on admitted burn patients?

Answer 6

48 hrs after the burn.

Question 7

FLuid products that might be needed by burn patients?

Answer 7

1. Albumin infusion - maintain desired 2g.dL
2. PRBC 0 if hct < 24, or <30 if toxic
   or hgb <8 or <10 if toxic
3. FFP if with deficiency of clotting
   factors
4. Na supplementation if >20# TBSA and silver nitrate is used
5. K supplementation if serum K <3

Question 8

Recommended antibiotics for burn patients

Answer 8

CRYSTALLINE PEN G for 5 days
Alternative: Erythromycin

Question 9

True or false:
Early excision and grafting lessens energy expenditure in burn patients

Answer 9

Tchrue

Question 10

Topical agents used for burn

Answer 10