Burns

Question 1

How are burns classified?

Answer 1

Superficial - affects the epidermis only
Superficial dermal - epidermis and upper dermis
Deep dermal - epidermis, upper and deep dermal layers
Full thickness - extension to the subcutaneous tissues

Question 2

What is the classification of a severe burn?

Answer 2

> 10% BSA in a child
15% BSA in an adults

Question 3

What methods are available for assessing the extent of burns?

Answer 3

Wallace ‘rule of nines’
Lund-browder chart
Palmar 1% rule
Mersy Burns app

Question 4

What are the clinical features of an epidermal burn?

Answer 4

Red
Dry
Blanching
No blisters

Question 5

What are the clinical features of a superficial dermal burn?

Answer 5

Pale pink
Painful
Blistered
Slow cap refill

Question 6

What are the clinical features of a deep partial thickness burn?

Answer 6

Cherry red/white
Non-blanching
Reduced sensation
Painful to deep pressure

Question 7

What are the features of a full thickness burn?

Answer 7

White/brown/black
Non-blanching
No blisters
No pain

Question 8

What investigations are used in the diagnosis of burns?

Answer 8

Examination and calculation of BSA affected
Fluid status assessment
ABG
U&E - fluid loss and pre-renal AKI

Question 9

What is the initial management of a burns patient?

Answer 9

ABCDE assessment
Remove source of heat
Irrigate burn with cool water
Cover burn using cling film, layered
Fluid resuscitation (using Parkland equation)
Analgesia

Question 10

What is the risk to the airway with smoke inhalation?

Answer 10

Smoke inhalation can cause airway oedema
Early intubation should be considered

Question 11

What is the Parkland formula?

Answer 11

Total BSA of the burn X weight (kg) X 4
- Half of the fluid is administered in the first 8 hours

Question 12

What are the complications of burns?

Answer 12

Infection and sepsis
Hypovolaemic shock
Inhalation injury
Carbon monoxide poisoning
Scar formation
Limb ischaemia
Hypothermia
Psychological trauma