Burns

Question 1

Prognostic variables for survival

Answer 1

age, size and depth of burn, inhalation injury, other trauma

Question 2

Prognosis numbers, expected to survive or not

Answer 2

<120 is expected to survive, >140 is not expected to survive

Question 3

thermal burn

Answer 3

burns due to an external heat source

Question 4

How do thermal burns affect the skin

Answer 4

raise the temperature of the skin and tissues, causing cell death and/or charring

Question 5

When are skin grafts used with thermal burns

Answer 5

2nd or 3rd degree burns

Question 6

What does the severity of a thermal burn depend on

Answer 6

the temperature, duration of contact, if in an enclosed space

Question 7

Radiation burn

Answer 7

burns due to prolonged exposure to ultraviolet rays of the sun or other sources of radiation

Question 8

Chemical burn

Answer 8

burns due to strong acids, alkalis, detergents, or solvents

Question 9

Electrical burns

Answer 9

burns from electrical current, either alternating (AC) or direct (DC)

Question 10

Why are most electrical burns not apparent with the naked eye

Answer 10

most travel underneath the skin

Question 11

When should cooling of burns occur to get results

Answer 11

within 2-4 minutes of burn

Question 12

Should water/wet dressings be used

Answer 12

no, it will make the patient hypothermic which causes more problems for the patient

Question 13

When can continued cooling be used

Answer 13

thick fluids, burns less then 10% BSA

Question 14

Should we be cooling burn patients or keeping them warm

Answer 14

keeping warm

Question 15

What does burned facial hair tell us

Answer 15

increased risk of airway damage

Question 16

s/s of impacted airway

Answer 16

signed nasal hair, blistering around mouth, soot on tongue or in pharynx, carbonaceous sputum, hoarse voice, difficulty swallowing, labored respirations, restlessness, confusion, combative behavior

Question 17

When are patients immediately intubated

Answer 17

burned hair, full skin thickness burn

Question 18

Why is carbon monoxide dangerous

Answer 18

it will stick to hemoglobin instead of oxygen, no oxygen getting to the body

Question 19

What burn patients get oxygen

Answer 19

all

Question 20

How do burns affect breathing

Answer 20

skin loses compliance not allowing air to be drawn into the lungs, we don’t know how to treat injured lungs

Question 21

Fluids of choice for burn patients

Answer 21

crystalloids, lactated ringers, normal saline (only up to 3L)

Question 22

Should there always be a pulse in burn patients

Answer 22

yes, if no pulse start CPR

Question 23

what to assess for disability

Answer 23

alertness, voice, pain, responsiveness

Question 24

How should burn patients be acting

Answer 24

alert and yelling

Question 25

How to assess exposure

Answer 25

remove all clothing and jewelry quickly to look at patient’s skin, protect from hypothermia, look for other additional life-threatening injuries

Question 26

What is treated first: burns or other traumas

Answer 26

other life-threatening traumas are treated before burns

Question 27

What is calculated to get fluid resuscitation needs

Answer 27

burn size and depth

Question 28

What burn patients get the most fluid

Answer 28

children, electrical burns

Question 29

What is the primary goal of fluid resuscitation

Answer 29

preserve and restore tissue perfusion to prevent ischemia

Question 30

Importance of dry weight

Answer 30

want to get patient back to dry weight within 48 hours

Question 31

What is the frequency of resuscitation assessment

Answer 31

continuous

Question 32

What is the frequency of emergent assessment

Answer 32

every 15 minutes

Question 33

What is the frequency of urgent assessments

Answer 33

every 30 minutes

Question 34

What is the frequency of non-urgent assessments

Answer 34

every 120 minutes

Question 35

What is the purpose of a primary survey

Answer 35

focuses on stabilizing life-threatening conditions (ABCDE)

Question 36

How does shivering affect the body

Answer 36

increases metabolic demand

Question 37

What is the purpose of a secondary survey

Answer 37

Complete a head to toe assessment, gather health history and chief complaint information