BURNS

Question 1

silver sulfadiazine

Answer 1

1. Broad spectrum
2. Closed dressing

Question 2

Silvadene cream

Answer 2

1. Good penetration
2. Change twice daily
3. Residue cleaned

Question 3

Mafenide acetate

Answer 3

1. Broad spectrum (psuedomonas)
2. Rapid deep penetration
3. Closed dressing
4. Twice daily change
5. Clean residue

Question 4

0.5% silver nitrate solution

Answer 4

1. Broad spectrum
   2.bacteriostatic
2. Superficial penetration
3. Soak every 2 hr and change dialy

Question 5

Aquacel ag

Answer 5

Closed dressing for 10 days
Impregnated with silver

Question 6

Accuzyme ointment

Answer 6

For enzymatic debridement

Question 7

Calories in a burns patient

Answer 7

1.5 times BMR
2-3 GM/KG protein per day

Question 8

Other methods to reduce calorie requirement

Answer 8

1. Temperature support
2. Anxiolysis and pain management
3. Managing sepsis
4. Beta blocker

Question 9

Oxandrolone

Answer 9

0.1-0.2 mg/kg/day
Promote protien synthesis

> 50% or 3rd degree burns

Question 10

Side effect of sulfa drugs

Answer 10

1. Anaphylaxis
2. Leukopenia
3. Acid base disturbance ( ca inhibition activity of sulfacetamide)

Question 11

Inahalational injury - causes

Answer 11

1. Asphyxia
2. Co
3. Burns
4. Toxic fumes

Question 12

3 stages of inahalational injury

Answer 12

1. Co , asphyxia and obstruction
2. ARDS
   3 Pneumonia and pulmonary embolism

Question 13

Staging of CO toxicity

Answer 13

1. Mild < 20%
   headache, nausea, decreased vison and cerebellar signs
2. Moderate 20-40%
   Irritability, agitation, loss of vision
3. Severe >40%
   Ataxia, hallucination, coma, seizure

Question 14

Managing CO toxicity

Answer 14

1. 100% O2
2. No (5-30 ppm)

Question 15

Drugs for pain management in burns

Answer 15

1. Morphine
   PO/PR 0.3-0.6 mg/kg q4h
   IV 0.05-0.1 mg/kg Q2H
   Or 0.05 mg/kg/hr
2. Lorazepam
   0.05-0.1 mg/kg q8h
3. Midazolam
   0.01-0.02 mg/kg (non intubated)
   0.05-0.1 mg/kg intubated
   Q10 min

Question 16

Complications of electric burns

Answer 16

1. Cardiac - arrythmia
2. Renal- rhabdo
3. CNS- cerebral edema, bleed

Question 17

Indication for admitting burns patient

Answer 17

1. 3rd degree burns
2. > 15% bsa
3. High voltage electric burns
4. Inahalational injury
5. Chemical burns
6. Abuse/neglect
7. Poor quality at home
8. Pregnancy
9. Co morbidities
10. Associated trauma including fracture

Question 18

First aid

Answer 18

1. Roll child
2. Check airway
3. Remove clothes
4. Rub off chemical
5. Irrigation and decontamination
6. Use mineral oil for tar
7. Cover in clean cloth
8. Wet compress (exp >15%)

Question 19

Estimating BSA

Answer 19

1. Lund browder chart
2. Shriner hospital for children in Boston
3. Rule of palm (<10%)
4. Rule of 9 [>14 yrs]

Question 20

Rule of palm

Answer 20

1% is from wrist crease to finger crease

Question 21

Minor burns management

Answer 21

1. No tt / pencillin
2. Bacitracin (face), silver sulfadiazine
3. Donot open blister
4. Debride opened blister