burns

Question 1

What should be administered if the patient has suspected carbon monoxide poisoning due to smoke inhalation?

Answer 1

Oxygen

Refer to the ‘poisoning from gases’ guideline for more information.

Question 2

How long should burns be cooled?

Answer 2

At least 20 minutes

Question 3

What actions should be taken if burns are due to chemical exposure?

Answer 3

Remove all clothing and decontaminate the patient

Question 4

How long should chemical burns to the eye be irrigated?

Answer 4

At least 30 minutes

Question 5

What should be done to burns after cooling?

Answer 5

Cover burns with cling film

Question 6

What IV solution should be administered if the patient shows signs of hypovolaemia or has burns greater than 20%?

Answer 6

0.9% sodium chloride IV

Question 7

What is the recommended IV fluid volume for an adult with significant burns?

Answer 7

1 litre

Question 8

What is the recommended IV fluid volume for a child with significant burns?

Answer 8

20 ml/kg

Question 9

What should be administered if bronchospasm is prominent?

Answer 9

Nebulised bronchodilators

Question 10

What should be administered if stridor is present?

Answer 10

Nebulised adrenaline

Question 11

Under what circumstances should RSI be considered?

Answer 11

Immediate concerns for airway compromise or extensive burns on the face/head with prolonged transport time

Question 12

When should backup from a CCP be requested?

Answer 12

If the patient has airway burns or is unable to obey commands

Question 13

To which facility should a patient with burns greater than 10% TBSA in an adult be transported?

Answer 13

Regional burn centre

Question 14

What is the TBSA threshold for transporting a child to a regional burn centre?

Answer 14

Greater than 5% TBSA

Question 15

What should be done if a patient has major trauma in addition to a burn injury?

Answer 15

Transport to a major trauma hospital

Question 16

What should be done if there are signs of airway compromise in a burn patient?

Answer 16

Transport to the closest hospital with personnel able to perform RSI

Question 17

What is the preferred method for cooling burns?

Answer 17

Cool (not ice cold) running water

Question 18

What should be avoided during cooling, particularly in small children or large burns?

Answer 18

Hypothermia

Question 19

What is acceptable for burns greater than 40% in terms of cooling duration?

Answer 19

Shorten the duration if it risks causing hypothermia

Question 20

What should be done for chemical burns of the eye?

Answer 20

Irrigation for at least 30 minutes

Question 21

What type of burns are usually not associated with airway burns?

Answer 21

Superficial ‘flash’ burns

Question 22

What are the signs of airway burns?

Answer 22

Burns in the mouth/nose, loss of nasal hair, stridor, voice change

Question 23

What are the signs of inhalational injury?

Answer 23

Hypoxia, respiratory distress, bronchospasm, black sputum

Question 24

What is the most appropriate form of decontamination for chemical burns?

Answer 24

A shower of approximately three minutes’ duration

Question 25

What should be avoided when decontaminating a patient with burns?

Answer 25

High pressure showers

Question 26

What is the preferred method for estimating burn size?

Answer 26

Using a piece of paper the same size as the patient’s hand

Question 27

What type of burns do not count in the estimation of burn size?

Answer 27

Superficial burns

Question 28

What is a common complication following electrical burn injuries?

Answer 28

Significant muscle and nerve damage

Question 29

What monitoring is required for patients with electrical injuries?

Answer 29

Continuous ECG monitoring

Question 30

When does shock from fluid loss following burns typically develop?

Answer 30

Several hours after the injury

Question 31

What should be investigated if a patient with burns shows signs of shock?

Answer 31

Alternative causes

Question 32

presentation of superficial burns

Answer 32

Superficial burns do not have blisters and are red and painful like sunburn.

Question 33

presentation of partial thickness burns

Answer 33

Partial thickness burns have blisters, weep fluid and are painful

Question 34

presentation of full thickness burns

Answer 34

full thickness burns are charred, white, leathery and usually painless.

Question 35

best way to relay burns information to other crews/cas call?

Answer 35

exact location of buns and what thickness they appear rather then percentage

Question 36

red flag areas for burns

Answer 36

joints, genitals, full way around chest, fingers or any airway involvement

Question 37

temture of water for cooling and why

Answer 37

room temperature, do not want it to be too cold, it will vasoconstrict and inhibit healing in future

Question 38

what is the priority in chemical burns

Answer 38

remove the substance by rinsing it off as much as possible