Chapter 10: Burns Flashcards
A 42-year-old is admitted to the burn unit 8 hours after sustaining 60% TBSA full-and deep partial- thickness burns involving his face, upper extremities including his hands, his torso and left thigh in a house fire. He is intubated and receiving intravenous fluid according to the Concensus formula. Which one of the following best describes the most appropriate rehabilitation for his patient?
Should be directed to restoring patients to functional status by preventing scar contractures and immobility
A 37-year-old man is admitted to the burn unit 6 hours after sustaining 40% TBSA full-and deep partial- thickness burns involving his torso, arms, and thighs. His clothes caught on fire when he was starting a charcoal grill with gasoline. He is intubated and receiving intravenous fluid according to the Consensus formula ((4wt (in kg))%TBSA). He is receiving sedation and pain medication. His wounds were cleansed and dressed. Which one of the following is the best choice for preventing burn wound sepsis in this patient?
Excision and grafting within 5-7 days of the injury
A 44-year-old woman is brought to the Emergency Department because of burns sustained in a house fire. She fell asleep while smoking, setting in an upholstered chair on fire. She was rescued by a fireman and paramedics. Upon arrival, she is somnolent, has burns to her face with carbonaceous debris in her nose and mouth and respiratory stridor. There are full-thickness circumferential burns on both arms, forearms and her torso and thighs. Her O2 sat is 98% on 2L of nasal Oxygen. What is the next best step in management?
Intubate the patient and administer 100% oxygen (ABCs)
A 25-year-old man is brought to the ER after being involved in a high-speed motor vehicle accident during which his vehicle burst into flames. He is unresponsive, on a back board, with a cervical collar on. His blood pressure is 85/45 mm/Hg, pulse is 133 beats/minute, and he has an obvious third-degree burn to a majority of his body. What is the correct sequence of treatment for his patient?
Secure his airway, obtain two large bore IVs, bolus 2L LR, examine the patient CT scan the head and abdomen, calculate the TBSA, start the condense formula, treat the burns with silvadine.
A 23-year-old woman is brought into the Emergency Department with third-degree burns involving her entire posterior trunk, half her anterior trunk, her circumfrontal right thigh, and her circumferential left upper extremity. What is the size of her burn as a %TBSA (percent total body surface area)?
45% TBSA
See picture
A 23-year-old woman is brought to the Emergency Department after being rescued from a house fire. She ran into a burning room and reached into flames to rescue her cat. There are some superficial burns with redness and blisters on her face. There are deep partial thickness burns on her legs and arms and full thickness burns to her hands and forearms. Her thighs are red and blanch with compression. She is in severe pain. Which area of burn injury is most likely to be the least painful in this patient?
Hands
A 30-year-old woman is brought to the ER because of partial thickness burns to her chest, arms, and abdomen when a pressure cooker explodes while she is canning tomatoes. Her wounds are bright red, moist, and blanch on direct pressure and involve 22% of her TBSA. She has severe pain. Which one of the following in the best pain management for this patient?
Intravenous narcotics initially, with transition to oral narcotics and non-steroidals.
A 32-year-old man was admitted to the burn unit 12 hours ago with a 45% TBSA third-degree burn. His entire right leg is circumferentially burned. After 12 hours of Consensus formula resuscitation the nurse calls you with a report of no pulse in the right foot. What is the most appropriate next step in management.
Confirm the presence of vascular compromise, and then perform lateral and medial escharotomies of the right lower extremity from the hip to the ankle.
A 56-year-old man intensive care unit is being treated for 80% TBSA burns involving his trunk, face, and all four extremeties. Allograft skin will be used in order to optimize healing and cover his wounds. Which one of the following statements best describes an allograft?
A skin graft taken from a human cadaver
A 38-year-old woman is being treated in the hospital for burns sustained to her left arm when her sleeve caught on fire when she was burning brush. She has third degree burns of circumferential forearm extending just above the elbow. Which of the following treatments will provide the best functional and cosmetic outcome for this patient?
Tangential excision and full-thickness grafting
