Burn Patients

Question 1

Partial-thickness (second-degree) burns involve which layers of tissue?

Answer 1

Epidermis and dermis

Question 2

Movement of fluid occurring shortly after a burn describes which phase of the body’s response to a burn?

Answer 2

Fluid shift phase

Question 3

Superficial (first-degree) burns involve which layer of tissue?

Answer 3

Epidermis

Question 4

What is the opioid of choice in management of pain for burn patients?

Answer 4

Morphine is the most common drug for burn patients. Some clinicians do choose fentanyl and hydromorphone.

Question 5

What are the four phases of the body’s response to burns?

Answer 5

Emergent phase, fluid shift phase, hypermetabolic phase, resolution phase

Question 6

Scar tissue in laid down and remodeled, allowing rehabilitation to begin in this phase of the body’s response to a burn.

Answer 6

Resolution phase

Question 7

What time frame is the fluid amount of the Parkland Formula delivered?

Answer 7

Half the amount over the first eight hours from the time the burn occurs, then the other half over 16 hours

Question 8

What equipment/interventions should the critical care paramedic anticipate when transporting burn patients?

Answer 8

Oxygen/ventilatory adjuncts, intravenous fluids, adequate dressings, and pain medications

Question 9

Which body response phase to burns occurs immediately after a burn?

Answer 9

Emergent phase

Question 10

Full-thickness (third-degree) burns involve which layers of tissue?

Answer 10

Epidermis, dermis, and subcutaneous tissue

Question 11

Burns involving the front of both legs of a child is calculated to be how much total body surface area?

Answer 11

14%

Question 12

Burns greater then 10% percent of TBSA should be covered with what type of dressing?

Answer 12

Dry sterile dressing

Question 13

How is the Parkland Formula calculated?

Answer 13

4 mL X the patient’s weight in kg X TBSA%

Question 14

What occurs to the lower airways below the glottis when inhalation burns cause injury?

Answer 14

Edema, hypersecretion, bronchospasm, impaired immune defenses, airway mucosal ulcerations, and impaired mucociliary elevator

Question 15

The response phase of burns in which the burn heals.

Answer 15

Hypermetabolic phase

Question 16

What crystalloid solutions are preferred in burn trauma?

Answer 16

Lactated Ringer’s or normal saline

Question 17

What is the fluid resuscitation requirement for a 70 kg patient suffering from 27% burns?

Answer 17

7,560 mL

Question 18

Why is pulse oximetry of little value during evaluation of a patient exposed to carbon monoxide?

Answer 18

Carbon monoxide has 200 times more affinity to hemoglobin than oxygen and therefore provides a false positive result

Question 19

What signs and symptoms would indicate that an escharotomy or fasciotomy was necessary?

Answer 19

Circumferential burns, deep burns, deep tissue pain, delay or absence of pulses, progressive parasthesias

Question 20

The Parkland Formula is the standard of care for fluid resuscitation of which types of burns?

Answer 20

Partial and full-thickness burns

Question 21

A burn involving the head and neck of an adult patient is calculated to be how much total body surface area?

Answer 21

9%