Burns

Question 1

What are the three main factors that correlate with increased mortality with burn injury?

Answer 1

Advanced age
Burn size
Inhalational injury

Question 2

Burn classification which involves the upper layers of the epidermis; the skin is painful and appears red and slightly edematous, much like a sunburn.

Answer 2

Superficial burns

Question 3

Burn classification which extends downward into the deeper layer of the dermis. Edema is marked, and sensation is altered.

Answer 3

Deep partial-thickness burns

Question 4

Burn classification which affects every body system and organ. This extends through the epidermis and dermis and into the subcutaneous tissue layer.

Answer 4

Full-thickness and subdermal burns

Question 5

Burn classification which occurs when tissue damage extends into the superficial layer of the dermis, which is still lined with intact epithelium that proliferates and regenerates new skin. These burns develop blisters and have red or whitish areas that are very painful.

Answer 5

Superficial partial-thickness burns

Question 6

This burn phase begins about 48 hours after injury and involves increased blood flow to organs and tissues. Geriatric patients may have a delayed or nonexisting second phase. Hypertension of unknown cause develops and may be quite extensive.

Answer 6

Metabolic phase

Question 7

Which pulmonary phase includes adult respiratory distress syndrome.

Answer 7

Delayed injury (2-5 days after)

Question 8

This phase include carbon monoxide (CO) poisoning and direct inhalation injury and can lead to airway obstruction and pulmonary edema.

Answer 8

Early phase (0-24 hours)

Question 9

The two most common complications of burn injury are?

Answer 9

1. Pneumonia

2. Respiratory failure

Question 10

How do burns affect the gastrointestinal tract?

Acute ulceration of the stomach or duodenum, referred to as __________, may lead to gastrointestinal bleeding.

Answer 10

Curling’s ulcer

Question 11

Because burn patients have depleted catecholamine stores, this drug should be avoided since exerting its direct effects cause cardiac depression.

Answer 11

Ketamine

Question 12

Iis a leading cause of morbidity and mortality and remains one of the most demanding concerns for the burn team.

Answer 12

Infection

Question 13

1st week pathogens causing infections

Answer 13

Gram (+)

Question 14

2nd week pathogens causing infections

Answer 14

Gram (-)

Question 15

Take note

Answer 15

Prophylactic antimicrobial therapy is only recommended if the burn wound must be excised or grafted in the operating room.

Question 16

Burns cause a generalized increase in capillary permeability, with loss of fluid and protein into interstitial tissue; this loss is greatest in the first?

Answer 16

12 hours

Question 17

What is a parkland formula?

Answer 17

4ml x TBSA (%) x body weight (kg)

1/2 first 8 hours & then next 16 hours

Question 18

Study rule of nines

Answer 18

Head and neck 9%
Upper extremities 9% each
Chest (anterior and posterior) 9% each
Abdomen 9%
Lower back 9%
Lower extremities 18%
Perineum 1%

Question 19

How must the use of muscle relaxants be modified for a burned patient?

Answer 19

Can use sux less than 24 hours

Non-depolarizing (use 2-5 x the normal dose)