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DipIMC > Burns > Flashcards

Burns Flashcards

1
Q

Factors which influence the severity of a burn

A

• Cause of burn
• Duration of exposure
• Anatomical site
• Size of involved area
• Use of early first aid cooling

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2
Q

Types of burn

A

Thermal
Chemical
Electrical
Friction
Radiation

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3
Q

High voltage electrical shock can lead to:

A
  • Extensive deep tissue damage
  • Compartment syndrome
  • Myonecrosis
  • Rhabdomyolosis
  • Renal failure
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4
Q

High voltage vs low voltage

A

Low = <1000volts (usually domestic)
High = >1000volts (usually industrial)
Lightning = up to 300 million volts

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5
Q

Which electrical current is more likely to cause cardiac arrhythmias, Alternating or direct?

A

Alternating

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6
Q

Do acids or alkalines cause deep tissue burns?

A

Alkalines

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7
Q

In relation to electrical burns and electric shock, what is arcing?

A

Arcing occurs when electrical current jumps between two objects without a direct connection. This can result in a flash injury without electrical current passing through the individual.

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8
Q

What are the classifications of burn depth?

A

1) Superficial
2) Partial thickness/Dermal - Partial dermal
- Deep dermal
3) Full thickness

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9
Q

Characteristics of a superficial burn

A

Erythema/Redness
Painful

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10
Q

Characteristics of a superficial dermal burn

A

Blisters
Painful
Pink
Blanching

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11
Q

Characteristics of a deep dermal burn

A

Blisters
Sensation reduced
Prolonged CRT
Blotchy pink/red

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12
Q

Characteristics of a full thickness burn

A

Charred black or leathery white
‘Woody’ feel
Insensitive to light touch
Non-blanching

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13
Q

Water temperature for cooling a burn

A

Ideally between 8 - 15 degrees Celsius.

(Cool to dissipate the heat but not ice cold which could vasoconstriction and deepen the burn)

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14
Q

Signs of inhalation burn injury

A
  • Burns to face/neck
  • Swelling to mouth/oropharynx
  • Soot in nose or mouth
  • Singed nasal hair
  • Cough with black sputum
  • Hoarse voice or stridor
  • Wheeze on auscultation
  • Dyspnoea and hypoxia
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15
Q

Parkland formula

A

3ml x Patient weight (kg) x TBSA (%)
- This gives the total amount to be given in a 24 hour period
- First half of this to be given in the first 8 hours
- Second half to be given in the following 16 hours.

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16
Q

Carbon Monoxide (CO) has an affinity how many times more than oxygen to haemoglobin

A

240 times

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17
Q

Antidote for Cyanide poisoning

A

Hydroxycobalamin (Cyanokit)

Dicobalt editate

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18
Q

Half-life of CO

A

Breathing Air - 320 minutes

This can be reduced to 80 minutes breathing 100% oxygen

19
Q

Escharotomy

A
  • For Circumferential full thickness burns where there is restricted ventilation or vascular compromise.
20
Q

Burns referrals - Burns unit criteria for Adults

A

≥10%<40%
or
≥10%<25% with inhalation injury

21
Q

Burns referrals - Burns unit criteria for paediatrics

A

≥5% <30%
≥5% <15% if under 1 year old

22
Q

Burns referrals - Burns centre criteria for adults

A

> 40% TBSA
or
25% TBSA with inhalation injury

23
Q

Burns referrals - Burns centre criteria for paediatrics

A

> 30%TBSA
15% TBSA in under 1
20% TBSA if full thickness

24
Q

Burns centre vs Burns unit

A

Burn Centres – This level of in-patient burn care is for the highest level of injury complexity and offers a separately staffed, geographically discrete ward. The service is skilled to the highest level of critical care and has immediate operating theatre access.

Burn Units – This level of in-patient care is for the moderate level of injury complexity and offers a separately staffed, discrete ward.

25
Q

Where would an adult with 35% TBSA burns go?

A

Burns Unit

Burns unit criteria for adults:

≥10%<40%
or
≥10%<25% with inhalation injury

26
Q

Where would an adult with 30% TBSA burns and inhalation injury go?

A

Burns Centre

Burns Centre criteria for adults:
>40% TBSA
or
>25% TBSA with inhalation injury

27
Q

Where would a 2 year old with 10% TBSA burns go?

A

Burns unit

(Burns unit criteria for peads:
≥5% <30%
≥5% <15% if under 1 year old)

28
Q

Where would a 4 year old with 18% TBSA burns go?

A

Burns unit

(Burns unit criteria for peads:
≥5% <30%
≥5% <15% if under 1 year old)

29
Q

Where would a 5 year old with 25% full thickness TBSA burns go?

A

Burns Centre

Burns centre criteria for paeds:
> 30%TBSA
> 15% TBSA in under 1
> 20% TBSA if full thickness

30
Q

Treatment of chemical burn

A

Irrigate copiously

amphoteric irrigating agent if possible such as Diphoterine

Do not wrap in cling film

31
Q

Definition of major burns in Adults

A

> 20% TBSA

32
Q

Clinical features correlating with the need for early intubation in burns

A

Full thickness facial burns
Stridor
Respiratory distress
Swelling on laryngoscopy
Smoke inhalation
Singed nasal hairs

33
Q

Carbon monoxide severe poisoning

A

> 30%

34
Q

Optimal duration of burn cooling

A

20 mins

35
Q

Optimal water temp for burn cooling

A

12oC

36
Q

Optimal Flow rate of water for burn cooling

A

1-1.5 l/min

37
Q

Burn cooling effective up to _____ hours after injury

A

3

38
Q

Which burn type should we not apply cling film?

A

Chemical

39
Q

Which type of burns should irrigation be continued for as long as practicably possible?

A

Chemical

40
Q

In burns greater than ___% fluid resuscitation should be started pre-hospitally for both adults and children

A

20%

41
Q

Which drugs should not be administered for analgesia in burns patients requiring fluid administration?

A

NSAIDS

42
Q

Indications for hydroxycobalamin

A

Smoke inhalation with altered mental status or cardiovascular instability

43
Q

Intubation of a burns patient

A

Uncut tube
Largest tube possible
Avoid tie around the neck/face

44
Q

Normal CO levels in non-smokers, smokers and heavy smokers

A

Non-smokers = <3%
Smokers = <5%
Heavy smokers = <9%

DipIMC (27 decks)

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