burns

Question 1

43 y.o. fireman brought to A+E, has burns to his face, neck, scalp, around the wrists and hands.

(a) you are concerned he may also have an airway problem.

list 4 sx/signs that may indicate an airway problem in this man

Answer 1

1. stridor
2. soot in mouth/sputum/nares
3. dyspnoea
4. oro-facial/tongue swelling
5. hoarseness

Question 2

(b) you tell the nurse with you that you plan to admit the pt.

list 3 admission criteria for burns which may apply to this pt.

Answer 2

1. special site e.g. burns of face/hands
2. smoke inhalation injury
3. IV rx necessary
4. circumferential burns

Question 3

(c) how can you assess depth of burns to the skin?

Answer 3

1. appearance
2. sensation
3. capillary refill

^{partial thickness: painful / red / blister}

^{full thickness: painless / white / no perfusion}

Question 4

(d) you request an opinion from plastic surgery team. they decide an escharotomy is needed on the affected hand.

what is an escharotomy and why is it being done?

Answer 4

• cutting the eschar (thick rigid layer of burnt tissue)
• necassary for full-thickness circumferential burns of neck, thorax and extremities
• performed to prevent compartment syndrome restricting blood flow