Burns

Question 1

Are acid or alkali chemical burns more serious?

Answer 1

ALKALI in general.

Body cannot buffer the alkali.

Question 2

Why are electrical burns so dangerous?

Answer 2

Most of the destruction is internal.

Cardiac dysrythmias, myoglominuria, acidosis and renal failure are common.

Question 3

Treatment for myoglobinuria

Answer 3

To avoid renal injury, think “HAM”.
Hydration
Alkalization with IV HC03
Mannitol diuresis

Question 4

Epidermis only

Answer 4

First degree

Question 5

Epidermis and varying levels of dermis

Answer 5

Second degree

Question 6

Full thickness

All layers of the skin including the entire dermis

Answer 6

Third degree

Question 7

Burn into bone or muscle

Answer 7

Fourth

Question 8

Painful dry, red areas that do not form blitsters(sunburn)

Answer 8

First degree

Question 9

Painful, hypersensitive, swollen, mottled areas with blisters and open weeping surfaces

Answer 9

Second degree

Question 10

Painless, insensate, swollen, dry, mottled, white, charred areas; DRY LEATHER

Answer 10

Third degree

Question 11

What is the major clinical difference between second and third degree burns?

Answer 11

Third degree burns are painless

Second are painful

Question 12

Which measure is burn severity determined?

Answer 12

Depth and TBSA affected by second and thired degree burn

Question 13

Treatment of second degree burns

Answer 13

Remove blisters, apply antibiotic

Silver ion dressings

Question 14

Third degree burn treatment

Answer 14

Early excision of eschar( within first week of postburn) and STSG

Question 15

what prophylaxis should the burn patient get in the ER?

Answer 15

Tetanus

Question 16

What is used to evaluate the eyes after third degree burn?

Answer 16

Fluorescein

Question 17

Diagnostic imaging used for smoke inhilation

Answer 17

bronchoscopy

Question 18

Lab test for smoke inhilation

Answer 18

Carboxyhemoglobin

Question 19

Loss of fluid from the intravascular space as a result of burn injury, which causes “leaking capillaries” that require crystalloid infusion

Answer 19

burn shock

Question 20

What is the Parkland Formula

Answer 20

TBSA x wt in kg x 4
1/2 in first 8
1/2 in the next 16 hours

Question 21

Adult urine output goal for burn.

Answer 21

30-50cc

Question 22

Why is glucose-containing IVF contraindicated in burn patients in the first 24 hours?

Answer 22

Serum glucose will be elevated on its own because of the stress response

Question 23

Minimal urine output for burn patients

Answer 23

Adults 30cc; children 1-2 cc/kg/hr

Question 24

Best monitoring tool for volume status

Answer 24

Urin output

Question 25

Why do most severely burned patients require nasogastric decompression?

Answer 25

Patients with >20% TBSA burns usually develop paralytic ileus –> vomiting –> aspiration risk –> pneumonia

Question 26

What stress prophylaxis must be given to burn patients?

Answer 26

PPI to preven burn stress ulcer

Question 27

What is the most common sign of burn wound infection?

Answer 27

discoloration of burn eschar

Question 28

What are the common organisms found in burn wound infection?

Answer 28

Staph, Psudomonas, strep, candida

Question 29

Why are systemic IV antibiotics contraindicated in fresh burns?

Answer 29

Bacteria live in the eschar, which is avascular (the systemic antibiotic will not be delivered to the eschar); thus, apply topical antimicrobial agents

Question 30

Are prophylactic antibiotics administered for burns patients including inhalational injury?

Answer 30

NO

Question 31

Circumferential, full-thickness burns to the extremities are at risk for what complication?

Answer 31

distal neurovascular impairment

Question 32

What is the major infection complication in burn patients?

Answer 32

Pneumonia, central line infection

Question 33

From which burn wound is water evaporation highest?

Answer 33

Third-degree

Question 34

Can infection convert partial-thickness injury to a full thickness injury?

Answer 34

YES

Question 35

How is carbon monoxide inhalation overdose treated?

Answer 35

100% O2

Question 36

Which electrolyte must be closely followed acutely after a burn?

Answer 36

Na

Question 37

What is the name of the gastric/duodenal ulcer associated with burn injury?

Answer 37

Curling’s ulcer

Think: CURLING iron