Burns

Question 1

What are the main causes of burns?

Answer 1

• Thermal
• Chemical
• Electrical

Question 2

What simple measures can be taken to manage a burn?

Answer 2

• Stop the burning process
• Cool the burn
• Cover the burn

Question 3

What methods can you use to stop the burning process?

Answer 3

• Remove source of burning
• Remove burnt clothes if possible
• Remove contrictive jewellery
• Douse chemical burns with large amounts of water

Question 4

What simple measures could you use to cool a burn?

Answer 4

Douse with water for approx 20 minutes

Question 5

What simple measures could you use to cover a burn?

Answer 5

Take a photo before hand

• If blistered - covered with dressing/plastic film to keep clean

Question 6

What is important to remember when dressing a burn?

Answer 6

Do not wrap circumferentially - allow room for tissue swelling

Question 7

What airway problems can occur due to burns?

Answer 7

• Swelling of soft tissue of the neck and oropharynx
• Inhalation injury

Question 8

What are features of an inhalation injury?

Answer 8

• Soot around face
• Singed nasal hairs
• Facial/neck burns
• Mechanism of injury
• Hoarse voice
• Stridor

Question 9

How might you manage airway problems caused by burns?

Answer 9

• High flow humidified O2 (15L/min)
• Intubation may be necessary (are they unconscious?)

Question 10

What breathing problems may occur due to burns?

Answer 10

• Full thickness chest burns
• Circumferential burns

Question 11

How might you manage breathing problems caused by burns?

Answer 11

• Escharatomies - decompress the chest
• High flow O2

Question 12

Why should pulse oximetry be used with caution in burns victims?

Answer 12

Carbon monoxide toxicity will not be detected on pulse oximetry

Question 13

What are important things to consider doing when managing C as part of an ABCDE assessment in a burns victim?

Answer 13

IV access + ANALGESIA + FLUIDS

Question 14

What are important things to assess as part of your exposure assessment in a burns victim?

Answer 14

• Assess extent of the burns - estimate percentage
• Temperature

Question 15

Why are individuals who have been burned at risk of hypothermia?

Answer 15

They lose vast amounts of heat through their broken skin

Question 16

When should adults with burns be given fluid resuscitation?

Answer 16

Those with > 20% surface area burns

Question 17

When should children with burns be given fluid resuscitation?

Answer 17

>10% surface area burns

Question 18

How many attempts should be taken to cannulate a burns patient?

Answer 18

2 - if fail go straight to IO to try to minimise delay to definitive care

Question 19

In terms of time to definitive care, what threshold should be used to determine whether to start fluid treatment for a burns victim?

Answer 19

If greater than 1 hour away from definitive care, start fluids

Question 20

What are the main depths of burns?

Answer 20

• Epidermal/superficial
• Superficical partial thickness
• Deep partial thickness
• Full thickness

Question 21

What are the different methods used to determine the total body surface area affected by a burn?

Answer 21

• Wallace rule of 9’s
• Lund and Browder chart
• Palmar surface

Question 22

When using the palmar surface area method for determining burn surface area, what percentage body surface area dose one palm represent?

Answer 22

1% - very crude measurement

Question 23

What is the most accurate method for measuring burns surface area?

Answer 23

Lund and browder method