Burns

Question 1

Layers of skin from superficial to deep?

Answer 1

Epidermis, dermis, and subcutaneous

Question 2

Burns are categorized into what categories?

Answer 2

First degree (superficial epidermis)
Second degree (superficial partial thickness or deep partial thickness)
Third degree (full thickness)
Forth degree (involves bone, tendon, or underlying tissue)

Question 3

Third degree burns are characterized by?

Answer 3

No sensation, no spontaneous healing (heal by grafts)

Question 4

What rule is used to quantify surface area burned?

Answer 4

Rule of 9s

Question 5

Explain the rule of 9s.

Answer 5

Head 9% BSA
Each arm 9% BSA
Chest 9%
Abd 9%
Upper back 9%
Lower back 9%
Front of each leg 9%
Back of each leg 9%
Genitals 1%
=100%

Question 6

Best treatment for any burn?

Answer 6

Cool water and drape

Question 7

Should you use ice to cool down a burn?

Answer 7

No

Question 8

Burn patients may need what vaccination?

Answer 8

tetanus

Question 9

Second degree full thickness burns of 20% BSA or more and third degree burns need?

Answer 9

IV fluids

Question 10

Choice and amount of fluids given to treat burn patients?

Answer 10

Lactated ringers

Use parkland formula (on MDcalc, uses BSA and weight)

Question 11

Wound care for intact blisters of <48 hours?

Answer 11

Leave them alone

Question 12

Wound care for ruptured blisters?

Answer 12

Debride

Question 13

Wound care for intact blisters >48 hours?

Answer 13

Debride large blisters

Question 14

What is the correct order for dressing a burn?

Answer 14

Clean/cream/xeroform/fluff and snug

Question 15

What should burns be cleaned with?

Answer 15

Chlorohexidine

Question 16

It is “super important” to do this to burned extremities.

Answer 16

Elevation

Question 17

Patients with singed facial hairs involved in a flash burn need what on physical exam?

Answer 17

Need to view airway

Question 18

List some concerning signs/symptoms after a inhalation injury.

Answer 18

Hoarse voice
stridor
Carbonaceous sputum
Drooling

Question 19

What lab level should be checked in patients coming in after a house fire?

Answer 19

CO levels

Question 20

What do voltage burns of >1000 volts cause?

Answer 20

Deep tissue injury

Question 21

What do voltage burns of <1000volts cause?

Answer 21

Cardiac arrhythmias

Question 22

Patients with these burns need discussion/transfer to a specialist.

Answer 22

2nd degree circumferential and 20%BSA burns (10% in children)
2nd degree on face, hands, feet, ear, and perineum
Electric burns
Third degree burns
Known inhalation

Question 23

What procedure is done for a burn patient with tight skin around check and difficulty breathing?

Answer 23

Escharotomy

Question 24

A patient dumps hot tar onto their hands. What do you do?

Answer 24

Use an emulsifier such as a polysorbate based triple antibiotic cream to remove it.
Dress the burns and bring them back the next day