Burns

Question 1

Burns : Acute management

Answer 1

1. < 20mins of injury : Irrigate with cool water for 10-30 minutes
2. Layer cling film over the burn

Question 2

Burns : Assessment of surface area

Answer 2

1. Wallace’s rule of nines
   head + neck = 9%,
   each arm = 9%,
   each anterior part of leg = 9%, each posterior part of leg = 9%,
   anterior chest = 9%, posterior chest = 9%,
   anterior abdomen = 9%, posterior abdomen = 9%
2. Lund-Browder chart } for small burns
   * palmar surface is roughly equivalent to 1% of total body surface area

Question 3

Burns : Assessment of Depth

Answer 3

1 . Superficial epidermal
* Red and painful, dry, no blisters

2 . Superficial dermal - Partial thickness
* Pale pink, painful, blistered
* Slow capillary refill

3 . Deep dermal - Partial thickness
* White
* Reduced sensation - painful to deep pressure

4 . Full thickness - extends to layers of subcutaneous tissue
* Waxy white /Brown/Black (charred)
* No pain

Question 4

Superficial epidermal Burn : Management

Answer 4

1. Cold compress
2. Emollient and simple analgesia

Question 5

Superficial dermal Burn : Management

Answer 5

1 . Management via district nurse
* > 48 hours : Dressing change and check for signs of infection
* 3-5 days : Dressing change

2 . Tetanus prophyxis : if wound is dirty

Question 6

Burn : Management - Criteria for 2nd care referral

Answer 6

1. All deep dermal and full thickness burns
2. Superficial burn of >3% in adults/>2% in children
3. Inhalation/Electrical/Chemical burn injury
4. Non accidental injury