Chapter 33 Flashcards
A person who is exposed to cement:
• experiences immediate pain and inflammation to the area because of the calcium oxide in the cement.
• may not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat.
• often does not experience a burn unless they are exposed to the cement for longer than 2 hours.
• typically only experiences burns to the epidermal layer because calcium oxide is a weak chemical.
May not notice a skin burn for hours because cement penetrates through clothing and reacts with sweat
The onset of which of the following symptoms soon after exposure to radiation is a predictor of poor outcomes?
• Hair loss
• Vomiting
• Tachycardia
• Confusion
Vomiting.
You are caring for a 41-year-old man who was trapped in his burning house before being rescued by fire fighters. He has full-thickness burns to his head and anterior trunk, and mixed partial- and full-thickness burns to both anterior upper extremities. What percentage of his total body surface area has been burned?
• 27%
• 18%
• 45%
• 36%
36%
A burn patient with a history of chronic obstructive pulmonary disease:
• should only be given high-flow oxygen if signs of hypoxia are grossly present.
• may be triaged as a critically burned patient, even if the burn injury is small.
• often requires prophylactic beta-2 agonist drugs to prevent respiratory arrest.
• is at a higher risk for infection than a patient without any medical problems.
May be triaged as a critically burned patient, even if the burn injury is small
The severity of a thermal burn correlates directly with:
• the duration of exposure, the physical size of the patient, and the presence of concomitant traumatic injuries.
• the temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure.
• the body’s ability to effectively dissipate significant heat energy and the patient’s general state of health.
• the presence of any underlying medical problems, the duration of exposure, and the temperature of the heat source.
The temperature of the heat source, the amount of heat energy possessed by the object or substance, and the duration of exposure
Which of the following burn injuries would most likely require transport to a burn specialty center?
• Burns that involve the hands, feet, or genitalia
• Partial-thickness burns to more than 5% of the body
• Any burn that occurs in a child younger than 5 years of age
• Superficial burns to more than 40% of the body
Burns that involve the hands, feet, or genitalia.
A 52-year-old man sustained superficial and partial-thickness burns to his left arm approximately 15 minutes ago when he opened the radiator cap on his car. He is conscious, alert, and in severe pain. His blood pressure is 138/76 mm Hg, pulse is 110 beats/min and strong, respirations are 22 breaths/min and regular, and oxygen saturation is 97% on room air. He denies any other injuries. Initial management for this patient involves:
• applying cool, wet dressings to the burn and elevating his arm.
• starting an IV of normal saline and administering 2 mg of morphine.
• administering oxygen and applying an anesthetic cream to the burn.
• applying ice to the burn to provide immediate pain relief.
applying cool, wet dressings to the burn and elevating his arm.
The peripheral area surrounding the zone of coagulation, which has decreased blood flow and inflammation, is called the zone of:
• coagulation.
• hyperemia.
• liquefaction.
• stasis.
Stasis.
A superficial burn is:
• characterized by reddened skin with varying degrees of pain.
• painful, but will heal spontaneously, often with scar formation.
• a second-degree burn that is characterized by blister formation.
• usually painless because the nerve endings are not exposed.
characterized by reddened skin with varying degrees of pain.
According to the rule of nines, an adult with partial- and full-thickness burns to their head, face, and anterior chest has burns to what percentage of their total body surface area?
• 18%
• 36%
• 45%
• 27%
18%
Which of the following burn injuries or patterns should make you the most suspicious for abuse?
• Burns to the forearm
• Burns with formed shapes
• Splash burns to a leg
• An arc burn to the hand
Burns with formed shapes.
A 24-year-old woman was struck by lightning. Bystanders moved the patient to an area of safety but did not provide any other care before your arrival. Your primary assessment reveals that the patient is pulseless and apneic. You begin CPR and apply the cardiac monitor, which reveals asystole. After requesting a backup paramedic unit, the most appropriate treatment for this patient involves:
• continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary.
• continuing CPR, providing full spinal precautions, intubating her trachea, and ventilating her at a rate of 20 to 24 breaths per minute.
• performing adequate BLS, following standard ACLS protocol, and considering terminating your efforts if asystole persists after 10 minutes.
• instructing your partner to resume one-rescuer CPR, establishing an IV of normal saline, and reassessing her cardiac rhythm in 5 minutes.
continuing CPR, protecting her spine while ventilating, reassessing her cardiac rhythm after 2 minutes of CPR, and defibrillating if necessary.
The application of ice to partial-thickness burns:
• is not necessary because such burns are painless.
• often negates the need to administer a narcotic.
• offers excellent pain relief and minimizes swelling.
• can exacerbate tissue injury and should be avoided.
Can exacerbate tissue injury and should be avoided
Unlike partial-thickness burns, full-thickness burns:
• are characterized by reddened, moist skin and large fluid-filled blisters.
• destroy the base membrane of the dermis that produces new skin cells.
• often heal spontaneously over a long period of time with massive scarring.
• extend completely through the epidermis and produce severe pain.
Destroy the base membrane of the dermis that produces new skin cells
A patient has partial-thickness burns to both lower extremities and blisters have formed. What should you do?
• Administer 2 L of fluid within 45 minutes.
• Administer half the usual dose of IV analgesia.
• Elevate the extremities to reduce edema.
• Carefully rupture the blisters and irrigate the burn.
Elevate the extremities to reduce edema
Chemicals such as Lewisite and phosgene oxime:
• are most commonly found in drain and oven cleaners.
• are vesicant agents that produce cutaneous blisters rapidly.
• damage the body by extracting water from the tissues.
• are strong alkalis that cause liquefaction necrosis.
are vesicant agents that produce cutaneous blisters rapidly.
Specific treatment for a hydrofluoric acid burn is:
• viscous lidocaine gel.
• calcium chloride.
• magnesium sulfate.
• sodium bicarbonate.
Calcium chloride.
The appropriate treatment for most chemical burns is:
• application of a dry, sterile dressing.
• neutralization with an alkaline substance.
• flushing with copious amounts of water.
• application of a moist, sterile dressing.
flushing with copious amounts of water.
Unlike chemical burns, radiation burns:
• may appear hours or days after exposure.
• are typically confined to the epidermis.
• generally extend into the dermal layer.
• are immediately apparent after exposure.
may appear hours or days after exposure.
According to the Lund-Browder chart, one-half of a 5-year-old child’s head accounts for what percentage of the body surface area?
• 8.5%
• 18%
• 6.5%
• 9%
6.5 %
Which of the following chemicals causes a painless burn and can result in significant damage before it is identified?
• Potassium hydroxide
• Sulfur mustard
• Phenol
• Sulfuric acid
Phenol
You are transporting a conscious but confused 29-year-old man after he was electrocuted. The patient is on high-flow oxygen, has an IV line of normal saline in place, is on a cardiac monitor, and has his spine fully immobilized. During transport, it is especially important for you to:
• reassess his vital signs every 15 minutes and treat any fractures or dislocations.
• thoroughly assess and clean the entry and exit wounds to prevent an infection.
• remain alert for lethal cardiac dysrhythmias and be prepared to defibrillate.
• administer at least 2 L of normal saline solution to prevent renal failure.
remain alert for lethal cardiac dysrhythmias and be prepared to defibrillate.
Which of the following statements regarding sodium metal chemical burns is correct?
• They react violently with oil and should only be flushed with sterile water.
• Sodium metal burns should be covered with oil after irrigating with water.
• Do not flush with water as doing so may produce heat and cause an explosion.
• Applying baking soda to the wound effectively neutralizes sodium metals.
do not flush with water as doing so may produce heat and cause an explosion
Many of the physiologic changes caused by acute radiation syndrome:
• are a direct result of beta particles and are usually life threatening.
• can be reversed if chemotherapy is administered within 24 hours.
• manifest with lethal cardiac dysrhythmias and sudden cardiac arrest.
• occur over time and will not be apparent in the prehospital setting.
Occur over time and will not be apparent in the prehospital setting
