Burns

Question 1

First Degree Burns

Answer 1

Dry, red, no blisters, involves epidermis only

Question 2

Second Degree Burns

Answer 2

Partial thickness: moist, blisters, extends beyond epidermidis

Question 3

Third Degree

Answer 3

Full thickness: dry, leather, black, pearly, waxy; extends from epidermis to dermis to underlying tissues, fat, muscle, and or bone

Question 4

Measuring Extent of Burn injury

Answer 4

Each Arm 9%
Each Leg 18%
Thorax: front 18%, back 18%
Head 9%
Perineum 1%

1% is approximately the palm of the hand

Question 5

BurnS: fluid resuscitation

Answer 5

** Parkland formula: 4ml/kg x TBSA %
1/2 in the first 8 hours
Start resuscitation at the time of the burn injury
Hyperkalemia in the first 24-48 hour, then hypokalemia

Question 6

Indications for prophylactic intubation

Answer 6

Laryngeal edema is a common in quick complication of sunburns
Burns to the face
Singed nares or eyebrows
Dark soot/mucus from nares and our mouth

Question 7

Burn Management Pearls

Answer 7

1. Submerse the injured area in clean water as soon as possible
2. Do not use ice, lotions, toothpaste, lard, butter or other products
3. Wrap the area in a clean dry towel and transport to the nearest hospital
4. Sterile normal saline is used in initial treatment
5. Affected areas are wrapped or covered with sterile towels
6. Maintain normal temperature: * very important
7. Following stabilization, pain management with IV fentanyl or morphine with optional use them for sad for memory impairment
8. Special needs: tar burn injury; use pretroleum based products to remove burning tar
9. Silver sulfadiazine a common topical antibacterial/antifungal used to treat second and third-degree burns

Question 8

American Burn Association: Burn Center Referral Criteria

Answer 8

1. Partial thickness burns greater than 10% total body surface area
2. Ferns that involve the face, hands, feet, genitalia, perineum, or major joints
3. Third-degree burns in any age group
4. Electrical burns, including lightning injury
5. Chemical burns
6. Inhalation injury
7. Burn injury in patients with pre-existing medical disorders that could complicate management, prolong recovery, or affect mortality
8. Burned children in hospitals without qualified personnel or equipment for the care of children
9. Any patient with burns or, concomitant trauma
10. Burn injury in patients who will require special social, emotional, or rehabilitative intervention