Burns

Question 0

Inhalation burn – confirm diagnosis with? Management?

Make sure to monitor? If elevated, give?

Answer 0

Fiber-optic bronchoscopy; based on blood gases, respiratory support

Carboxyhemoglobin; 100% oxygen to shorten half life

Question 1

Describe high-voltage electrical burns? Management may require? Associated injuries?

Answer 1

Deeper and worse than appear

Massive debridement or amputations + Osmotic diuretics and urine alkalinizing agents

Myoglobulinemia, myoglobulinuria-renal failure, injuries secondary to massive muscle contractions, demyelination, cataracts

Question 2

Danger of circumferential burn? Management?

Answer 2

Cut off the blood supply has edema accumulates underneath eschar

Escharotomy done at bedside without anesthesia

Question 3

Formula for Burns – name? Actual formula?

Answer 3

Parkland

Day 1: Weight x %Burn (Max 50) x 4 cc RL + 2000 mL D5W

Infuse first half over eight hours, next half over 16 hours

Day 2: Half of above

Question 4

Alternative for using formula to calculate fluid infusion after burn?

Answer 4

1000 mL per hour of auto on anyone with Burns >20%.

Then adjust as needed

Question 5

In burn patient, avoid infusing fluid with? Why?

Answer 5

Sugar – avoid inducing osmotic diuresis from glucosuria

Question 6

Patient with burn. Other than fluid infusion and topical agents, other care?

Answer 6

#Tetanus prophylaxis
#NG suction for 1-2 days followed by high calorie/high nitrogen diets
#After 2-3 weeks, graft non-regenerating areas

Question 7

Topical agents for burns?

Answer 7

Silver sulfadiazine or mafenide acetate (latter used for deep penetration, but painful)

Near the eyes, use triple antibiotic ointment

Question 8

When to do early excision and grafting for burns?

Answer 8

Under 20%, obviously third-degree