Burns & Soft Tissue Injuries

Question 1

Pressure injuries

Answer 1

occur when a patient is bedridden or when pressure is applied for a prolonged period in an unconscious patient or a patient immobilized on a backboard

Question 2

Tetanus

Answer 2

caused by an infection with an anaerobic bacterium (clostridium tetani) which causes the body to produce a toxin resulting in painful muscle contractions that are strong enough to fracture bones

Question 3

Necrotizing fascitits

Answer 3

incolves the death of tissue from bacterial infection (staphylococcus aureus and hemolytic streptococci), rare but the mortality rate ranges from 70-80%

Question 4

Abrasion

Answer 4

uperficial wound that occurs when the skin is rubbed or scraped over a rough surface and part of the epidermis is lost, typically ooze small amounts of blood and may be quite painful

Question 5

Laceration

Answer 5

cut inflicted by a sharp instrument (ie knife or razor blade) that produces a clean (incision) or jagged (laceration) incision through the skin surface and underlying structures

Question 6

Avulsion

Answer 6

occurs when a flap of skin is torn loose partially or completely

Question 7

Crush Syndrome

Answer 7

when an area of the body is trapped for longer than 4 hours and arterial blood flow is compromised.

Question 8

Compartment Syndrome

What are the 6 Ps?

Answer 8

develops when edema and swelling result in increased pressure within soft tissues. presents with the 6 Ps:

• Pain, paresthesia, paresis, pressure,
  pulselessness, pallor

Question 9

Blast Injuries : Primary Phase

Answer 9

pressure wave rapidly develops, this tremendous but concentrated pressure results from air displacement and heat originating from the centre of the blast.

EX; Damages air filled cavities

Question 10

Blast Injury - Secondary Phase

Answer 10

a blast wind occurs as combustible gases move across the affected area, less forceful than the pressure wave but longer lasting (heat)

EX: Flying debris may cause blunt and penetrating injuries

Question 11

Blast Injury - Tertiary Phase

Answer 11

injuries arise from displacement away from the blast site or from collapse of the surrounding structure (body hits ground, etc.)

EX. Person is thrown against rigid surfaces, risk of entrapment, falling structures

Question 12

Blast Injury - Quaternary Phase

Answer 12

Injuries resulting from miscellaneous events occurring during an explosion

EX: debris hitting the person

Question 13

Burn Shock

Answer 13

occurs because of fluid loss across damaged skin and a series of volume shifts within the rest of the body

Question 14

What is the Parkland Burn Formula and what is it used for?

Answer 14

The Parkland formula estimates the fluid requirements for critical burn patients in the first 24 hours after injury

4ml x TBSA burned % x weight (kg) / 2

Question 15

How long to irrigate on scene

1. ALkali burns
2. acidic burns
3. Unknown burns

Answer 15

1. Up to 20 Mins
2. Up to 10 mins
3. Up to 20 mins

Question 16

Electricity-Related Burns

1. Type 1
2. Tyep 2
3. Type 3

Answer 16

1. Type 1 (contact): the true electrical injury, the current is most intense at the entrance and exit sites
2. Type 2 (flash): electrothermal injury caused by the arcing of electric current
3. Type 3 (flame): when electricity ignites a person’s clothing or surroundings

Question 17

Radiation Burns

1. Alpha
2. Beta
3. Gamma

Answer 17

1. alpha: stopped by clothing and skin = very minimal penetration injury, only dangerous if inhaled
2. beta: more powerful than beta, enter the body by penetrating the damaged skin, ingestion/inhalation
3. gamma: extremely powerful, dangerous, penetrating - internal/external injuries

Question 18

What is the Zone of Coagulation

What is Zone of Stasis

What is Zone of Hyperemia

Answer 18

Zone of Coagulation: central area of the skin which suffers the most damage

Zone of Stasis: peripheral area surrounding the zone of coagulation that has decreased blood flow and inflammation, under goes necrosis within 24-48hrs after the injury, especially if perfusion is compromised

Zone of Hyperemia: area least affected by the thermal injury, cells here with typically recover in 7-10days

Question 19

First Degree Burns

S/S

Answer 19

First degree (superficial) burn: involves the epidermis only

Skin is red and when touched the colour will blanch and return, blisters are not present, patients experience pain because nerve endings are exposed to the air

Question 20

Second Degree Burns

S/S

Answer 20

Second degree (partial-thickness) burn: involves the epidermis and varying degrees of the dermis

Superficial: skin is red, when touched the colour will blanch and return, usually there are blisters or moisture present and the patient may experience extreme pain, hair follicles remain intact

Question 21

Third Degree Burns

S/S

Answer 21

Third degree (full-thickness) burn: involves destruction of both layers of the skin, including the basement membrane of dermis that produces new skin cells

Skin is white and pale, brown and leathery or charred

Dry and leathery skin is referred to as eschar

No capillary refill occurs with this type of burn because the capillaries have been destroyed, sensory nerves are destroyed as well so there is no paid

Question 22

Treatment of Burns

Answer 22

1st Degree/2nd Degree (<10-15%)
- wet, sterile dressings or a clean wet sheet

2nd Degree (>15%) / 3rd Degree
         - dry, clean sheet (sterile if available)

Wrap digits individually
Cover affected eyes with moist dressings