Burns

Question 1

The effects of burns depend on:

Answer 1

1) Degree of heat applied
2) Duration of exposure
3) Size/extent of body surface affected
4) Site
5) Age
6) Sex
7) History of natural disease, or concomitant trauma

Question 2

When the burn surface involves ___ of the body surface are or more (__-__%), the result is nearly always fatal

Answer 2

1/3; 30-50%

Question 3

What are the immediate causes of death in burns?

Answer 3

1) Primary or neurogenic shock (from pain or fright)

2) Asphyxia (Smoke inhalation/falling)

3) Smoke/heat induced laryngeal spasm

4) Respiratory arrest

5) Vagal reflex- caused cardiac arrest

Question 4

What are the delayed causes of death in burns?

Answer 4

1) Hypovolemic burns (secondary shock)

2) Acute edema of glottis (from inhalation of smoke or hot gases with or without pulmonary edema

3) Respiratory failure

4) Toxemia

5) Sepsis (MOST IMPORTANT!)

6) Infective complications

Question 5

What are the sequelae of burns?

Answer 5

1) Scars
2) Keloids
3) Marjolin’s ulcer
4) Curling’s ulcer
5) Corneal capacity
6) Obliteration of external auditory meatus
7) Joint deformity or ankylosis

Question 6

What causes the pugilistic attitude?

Answer 6

Heat stiffening due to coagulation of proteins of muscles and dehydration = contraction

Question 7

What is the surest sign of antemortem burns?

Answer 7

Carbon and soot particles in the airways and mucosal congestion with frothy mucus secretions

Question 8

What are the three types of scald burns?

Answer 8

1) Immersion burns
2) Splash/Spill burns (Accidental)
3) Steam burns

Question 9

What are the three degrees of scald burns?

Answer 9

1) Erythema/Reddening by vasoparalysis
2) Vesication/Blistering due to increased permeability of the capillaries
3) Necrosis of the dermis when deeper layers of skin is involved

Question 10

Electricity exerts two major effects on the body:

Answer 10

1) Cellular depolarization of nerves and muscles
2) Heat production

Question 11

Electricity results in which types of injuries?

Answer 11

1) Low tension
2) High tension

Question 12

The pattern of electrical injury depends on:

Answer 12

1) Kind of current (AC worse than DC)
2) Amount of current
3) Path of current
4) Duration of exposure
5) Resistance (Less resistance = worse)
6) Site of contact

Question 13

List the least to most resistant tissues

Answer 13

1) Blood vessels
2) Nerves
3) Muscles
4) Skin
5) Tendons
6) Fat
7) Bones

Question 14

What are the local effects of electrical burns?

Answer 14

1) Joule burns
2) Exit marks
3) Flash/spark burns
4) Wounds

Question 15

What are the systemic effects of electrical burns?

Answer 15

1) Immediate death
2) CNS
3) Eye (Cataract)
4) Suspended animation

Question 16

What are the causes of death in electrical burns?

Answer 16

1) V.fib (MOST COMMON)
2) Respiratory muscle paralysis (asphyxia)
3) Infection
4) Mechanical injuries
5) Brainstem injury

Question 17

What is diagnostic for an electric burn?

Answer 17

Joule burn at entry site

Question 18

What are the petechiae in electrocution caused by?

Answer 18

Venous congestion (from cardiac arrest) + Sudden rise in BP (due to muscle contractions)

Question 19

What is the acro-reaction test?

Answer 19

Micro-chemical test for metals at the site of electrical entry. Finds metals soluble in HCL or HNO3.