Burns

Question 1

Admissions criteria for burn patients

Answer 1

• Patients <10 or > 50 years old with 2nd and 3rd degree burns over >10% of the body
• Patients of any age with 2nd and 3rd degree burns over > 20% of the body
• 2nd and 3rd degree burns to significant portsions of hands, face, feet, genetalia, perineum, or skin overlying major joints
• Electrical or chemical burns
• Concominant inhanlation injury or mechanical traumas
• Injuries with special social conditions (e.g. concern for neglect)

Question 2

Parkland Formula

Answer 2

• use for burns (at least 2nd degree burns) covering at least 20% of the body
• give 4 cc/kg/%burn LR for first 24 hours (1/2 within first 8 hours)
• Goal is to achieve urine output of 0.5 cc/kg/hr in adults 1.0 cc/kg/hr in children and 2 cc/kg/hr in infants

Question 3

Treatment for hydroflouric acid burns

Answer 3

Spread calcium on the wound

Question 4

Treatmet for tar burns

Answer 4

Allow to cool and then wipe away with lipophilic solvent (e.g. glycerol or adhesive remover)

Question 5

Caloric need for burn patients

Answer 5

25 kcal/kg/day + (30 kcal x % burn)

Glucose as most important source of calories

Question 6

Protein need for burn patients

Answer 6

1 g/kg/day + (3g x % burn)

Question 7

Side effects of Silvadene

Answer 7

Neutropenia and thrombocytopenia

Sulfa allergies

Limited eschar penetration and epitheliazation

Ineffective against Pseudomonas (effective for Candida)

Question 8

Silver Nitrate side effects

Answer 8

Electrolyte Imbalances (hyponatremia,chloremia,kalemia,calcemia)

Discoloration

Limited eschar penetration

Ineffective against Pseudomonas and GPCs

Question 9

Sulfamylon (mafenide sodium)

Answer 9

Pain with application

Metabolic acidosis

Good eschar penetration

+ Coverage of Pseudomonas and GNRs