burns Flashcards
What should be administered if the patient has suspected carbon monoxide poisoning due to smoke inhalation?
Oxygen
Refer to the ‘poisoning from gases’ guideline for more information.
How long should burns be cooled?
At least 20 minutes
What actions should be taken if burns are due to chemical exposure?
Remove all clothing and decontaminate the patient
How long should chemical burns to the eye be irrigated?
At least 30 minutes
What should be done to burns after cooling?
Cover burns with cling film
What IV solution should be administered if the patient shows signs of hypovolaemia or has burns greater than 20%?
0.9% sodium chloride IV
What is the recommended IV fluid volume for an adult with significant burns?
1 litre
What is the recommended IV fluid volume for a child with significant burns?
20 ml/kg
What should be administered if bronchospasm is prominent?
Nebulised bronchodilators
What should be administered if stridor is present?
Nebulised adrenaline
Under what circumstances should RSI be considered?
Immediate concerns for airway compromise or extensive burns on the face/head with prolonged transport time
When should backup from a CCP be requested?
If the patient has airway burns or is unable to obey commands
To which facility should a patient with burns greater than 10% TBSA in an adult be transported?
Regional burn centre
What is the TBSA threshold for transporting a child to a regional burn centre?
Greater than 5% TBSA
What should be done if a patient has major trauma in addition to a burn injury?
Transport to a major trauma hospital
What should be done if there are signs of airway compromise in a burn patient?
Transport to the closest hospital with personnel able to perform RSI
What is the preferred method for cooling burns?
Cool (not ice cold) running water
What should be avoided during cooling, particularly in small children or large burns?
Hypothermia
What is acceptable for burns greater than 40% in terms of cooling duration?
Shorten the duration if it risks causing hypothermia
What should be done for chemical burns of the eye?
Irrigation for at least 30 minutes
What type of burns are usually not associated with airway burns?
Superficial ‘flash’ burns
What are the signs of airway burns?
Burns in the mouth/nose, loss of nasal hair, stridor, voice change
What are the signs of inhalational injury?
Hypoxia, respiratory distress, bronchospasm, black sputum
What is the most appropriate form of decontamination for chemical burns?
A shower of approximately three minutes’ duration
What should be avoided when decontaminating a patient with burns?
High pressure showers
What is the preferred method for estimating burn size?
Using a piece of paper the same size as the patient’s hand
What type of burns do not count in the estimation of burn size?
Superficial burns
What is a common complication following electrical burn injuries?
Significant muscle and nerve damage
What monitoring is required for patients with electrical injuries?
Continuous ECG monitoring
When does shock from fluid loss following burns typically develop?
Several hours after the injury
What should be investigated if a patient with burns shows signs of shock?
Alternative causes
presentation of superficial burns
Superficial burns do not have blisters and are red and painful like sunburn.
presentation of partial thickness burns
Partial thickness burns have blisters, weep fluid and are painful
presentation of full thickness burns
full thickness burns are charred, white, leathery and usually painless.
best way to relay burns information to other crews/cas call?
exact location of buns and what thickness they appear rather then percentage
red flag areas for burns
joints, genitals, full way around chest, fingers or any airway involvement
temture of water for cooling and why
room temperature, do not want it to be too cold, it will vasoconstrict and inhibit healing in future
what is the priority in chemical burns
remove the substance by rinsing it off as much as possible
