Burns

Question 1

Cause of thermal burn

Answer 1

Direct contact with hot object/steam

Question 2

What is the severity of an electrical burn based on? (2)

Answer 2

Duration of contact

Strength of voltage

Question 3

Which is a worse chemical burn - acid or alkali?

Answer 3

Alkali

Question 4

What determines the severity of a burn? (3)

Answer 4

Depth of burn
Amount of skin involved
Associated clinical features

Question 5

What is a partial thickness burn

Answer 5

Epithelial elements are spared

Question 6

What features suggest a partial thickness burn? (3)

Answer 6

Erythema that blanches on pressure
Retains pinprick sensation
Bleeds on irritation

Question 7

Further 3 classifications partial thickness burn

Answer 7

Superficial erythema
Superficial partial thickness
Deep partial thickness

Question 8

Features superficial erythema burn (3)

Answer 8

Blanching erythema (b/c cap dilation) 
\+/- blistering 
Germinal layer = intact

Question 9

How long does it take for superficial erythema burns to heal?

Answer 9

Within days

Question 10

Features superficial partial thickness burn

Answer 10

Through epidermis –> germinal layer
Dermal appendages remain intact
Intense blistering and sloughing skin

Question 11

How long does superficial partial thickness burn take to heal?

Answer 11

> 2w

Question 12

Features deep partial thickness burn

Answer 12

Extends into germinal layer

Destroys dermis + appendages

Question 13

Def of full thickness burn

Answer 13

Complete destruction of the skin and germinal layers

Question 14

how do most full thickness burns heal?

Answer 14

By dense scar tissue with contracture and deformity

Question 15

Clinical features full thickness burn (3)

Answer 15

Non-blanching
Doesn’t bleed on needle test
No sensation

Question 16

What chart allows for accurate estimation of a burn SA?

Answer 16

Lund + Browder chart

Question 17

What is the rule of 9’s

Answer 17

9% :
H+N
Each arm
Front of each leg 
Back of each leg 
18%: 
Front of trunk 
Back 
1%
Perineum

Question 18

Features suggesting inhalation injury (6)

Answer 18

Hx of enclosed fire 
stridor 
Incr RR or SOB 
Singed nasal hair 
Facial burns 
Cough/sputum

Question 19

Why do you get hypovolaemia from burns injury?

Answer 19

Loss of epidermis + plasma exudation through capillaries –> loss of plasma
—> intravascular depletion + shock

Question 20

Why do you get anaemia from burns injury?

Answer 20

Destruction of RBC

Question 21

Is pain more in superficial or deep burns?

Answer 21

Superficial

Question 22

Immediate 1st aid Mx burns

Answer 22

Remove overlying clothes
Apply cool water to area
Cling film

Question 23

Systemic Mx burns

Answer 23

IV opiates
Fluids
Manage nutrition

Question 24

Mx partial thickness burns

Answer 24

Simple non-adherent dressings

Question 25

If hands are involved in superficial partial burns, what extra treatment should be done?

Answer 25

Cover in sulfadiazine cream

Place in polythene bag

Question 26

Mx full thickness burn

Answer 26

Total excision wound

+ skin grafting

Question 27

Mx circumferential burn

Answer 27

Incision w/ escharotomy

Question 28

Early complications burns (2)

Answer 28

Sepsis

Wound contractures

Question 29

Causative agent <1 week spesis of burns

Answer 29

S. pyogenes

Question 30

Causative agent >1 week burns

Answer 30

Pseudomonas

Question 31

Late complications burns (4)

Answer 31

Sepsis
Acute peptic ulcer
AKI
Psychological

Question 32

What is the Parkland Formula

Answer 32

used to calc vol of Hartman’s in 1st 24hrs
4ml x SA burn x kg
1/2 in 1st 8h
1/2 in other 8-24hr

Question 33

When should grafting be performed on burns?

Answer 33

<5 days

Question 34

Indications - Specialist Burns centre referral

Answer 34

Burn >30% TBA
Circumeferential burn 
Inhalation injury 
Chemical or electrical burn 
Extremes of age