Burns

Question 1

Burn classifications based on

Answer 1

depth, surface area, location

Question 2

superficial burns

Answer 2

only involve epidermis
pain and swelling subsides in 48 hours
healed in 7 days

Question 3

partial burns

Answer 3

destruction of epidermis and superficial dermis

appears blistered

Question 4

superficial partial thickness burns

Answer 4

bright red and moist, very sensitive, heal in 2-3 weeks, minimal scarring

Question 5

deep partial thickness burns

Answer 5

dark red or yellow white, more than 3 weeks to heal, hypertrophic scarring occurs

Question 6

full thickness burns

Answer 6

involves epidermis and dermis including dermal appendages
appears charred or pearly white, brown or black colours. dry and leathery
normally without sensation
healing only occurs with scarring or skin grafts

Question 7

Minor burns

Answer 7

less than 10% TBSA in adults, less than 5% in young or eldery, less than 2% full thickness burns

Question 8

Moderate burns

Answer 8

10-20% TBSA adult, 5-10% young or eldery, 2-5% full thickness

Question 9

Major burns

Answer 9

greater than 10% in young or eldery, greater than 20% in adults, full thickness greater than 5%

Question 10

thermal burns

Answer 10

soft tissue is burned when exposed to greater than 45 degrees causing coagulation of soft tissue

Question 11

coagulation of soft tissue leads to:

Answer 11

soft tissue temp increase, capillary permeability increase, fluid loss, plasma viscosity increase, microthrombi formation

Question 12

zones of injury

Answer 12

zone of coagulation - centre of wound
zone of stasis - surrounds critically injuried area
zone of hyperamia - at periphery of wound

Question 13

Acids cause:

Answer 13

coagulation, formation of tough eschar that can limit further damage

Question 14

Alkalis cause:

Answer 14

liquefactive necrosis, deeper penetration

Question 15

Thickness of chemical burns

Answer 15

superficial: itching, burning, pain
Partial: tissue oedema, bullae
full: damage to dermis, extent depends on chemical and duration

Question 16

Treatment of chemical burns

Answer 16

if liquid, irrigate with copious fluids

if powder, dust of pt and remove clothing

Question 17

Electrical injuries

Answer 17

low voltage
high voltage
lightening strikes

Question 18

High voltage burns can cause:

Answer 18

flash burns: significant electrical charge causes combustible substances to ignite
Direct contact burns: deep muscle damage may occur under apparently normal skin and may be very extensive and life threatening

Question 19

Lightening strikes

Answer 19

signigicant injury especially with exit burns to feet

Question 20

Severity of electrical burns related to:

Answer 20

current type, voltage, intensity, resistance, area, duration of contact, environmental factors

Question 21

Symptoms of electrical burns

Answer 21

contact burns, thermal heating, flash arc and flame thermal burns, blunt trauma, prolonged muscle tetany, skin injury does not correlate with underlying damage, low V = VF, high V = asystole, dysrhythmias can occur up to 24-48 hours later

Question 22

Non accidental injury

Answer 22

delay in call, vague or inconsistent history, presence of other trauma, certain patterns of injury, info should be passed into recieving hospital

Question 23

Stop the burning process

Answer 23

sover burn with clean cool cloth soaked in cool water, continue cooling with running water, remove clothing not adhered to pt, cover burn with a clean sterile dressing or cling wrap

Question 24

haemodynamic Instability

Answer 24

Hypovolaemic shock assoc with decreased venous return and CO, increase vascular resistance
renal failure may occur due to haemolysis or rhabdo

Question 25

Resp system involvement

Answer 25

inhalation burns, pulmonary injury and airway burns should be considered in presence of history of fire, facial burns, carbonaceous sputum, oedema to face, hoarse voice, stridor, obvious resp distress

Question 26

Hyper-metabolic response

Answer 26

stress of the burn increases nutritional and metabolic needs of the body
characterised by increased O2 need, increased glucose need, protein and fat wasting

Question 27

Fluid replacement

Answer 27

% of BSA x weight over 2 hours