Chapter 6 - Burn Trauma Flashcards
1
Q
T/F - The incidence of burn injury has been on the decline over the past decade.
A
pg 123
True
2
Q
A preventive action that will reduce the incidence of scalding injuries is
A
pg 123
lowering the water heater temperature to 120°F.
3
Q
The layer of skin that is made up of mostly dead cells and provides the waterproof envelope
that contains the body is the
A
pg 123
epidermis.
4
Q
Which of the following is NOT a function of the skin?
A. Protecting the body from bacterial infection
B. Protecting the body from excessive fluid loss
C. Allowing for joint movement
D. Preventing all heat loss
E. Insulating from trauma
A
pg 124
D. Preventing all heat loss
5
Q
T/F - Burns result from the disruption of the proteins found in cell membranes.
A
pg 125
True
6
Q
The area of a burn that suffers the most damage is generally the
A
pg 125
zone of coagulation.
7
Q
The theory of burns that explains the burning process is
A
pg 125
Jackson’s theory of thermal wounds.
8
Q
The order in which the phases of the body’s response to a burn would normally be expected to
occur is
Place in correct order
hypermetabolic, fluid shift, emergent
A
pg 126
fluid shift, emergent, hypermetabolic
9
Q
What skin type has the greatest resistance to the passage of electrical current?
A
pg 126
Calluses
10
Q
Electrical injury is likely to cause
A
pg 127
Serious injury in which the electricity enters the body
Serious injury in which the electricity exits the body
Damage to nerves
Damage to blood vessels
11
Q
T/F - Prolonged contact with alternating current may result in respiratory paralysis.
A
pg 127
True
12
Q
T/F - Chemical burns involving strong alkalis are likely to be deep because of coagulation necrosis.
A
pg 128
False
13
Q
What radiation types is the most powerful type of ionizing radiation?
A
pg 128
Gamma
14
Q
What type of radiation is present only inside nuclear reactors and bombs?
A
pg 128
Neutron
15
Q
To protect themselves from radiation exposure, EMS personnel should
A
pg 128
limit the duration of exposure.
increase the shielding from exposure.
increase the distance from the source.
ensure that the patient is decontaminated.
16
Q
The radiation dose that is lethal to about 50 percent of those exposed is
A
pg 130
4.5 Grays.
17
Q
T/F - As radiation exposure increases, the signs of exposure become less evident and only reappear
later in the course of the disease.
A
pg 130
False
18
Q
What signs are commonly associated with inhalation injury?
A
pg 131
Carbon monoxide poisoning
Subglottic injury
Toxic inhalation
Supraglottic injury
19
Q
Which type of circumstance is most likely to cause subglottic thermal burn injury?
A
pg 131
Inhalation of superheated steam
20
Q
What percentage of burn patients who die have associated airway burn injury?
A
pg 131
60 percent
21
Q
The burn characterized by erythema, pain, and blistering is the
A
pg 132
partial-thickness burn.
22
Q
The burn characterized by discoloration and lack of pain is the
A
pg 136
full-thickness burn.
23
Q
An adult has received burns to the entire anterior chest and to the entire left upper extremity,
circumferentially. Using the rule of nines, the percentage of body surface area (BSA)
involved is
A
pg 133
18 Percent
24
Q
A child has received burns to the entire left lower extremity and the genitals. Using the rule of
nines, the percentage of the body surface area involved is
A
pg 133
14 1/2 percent.
25
An adult has received burns to the entire left lower extremity and the genitals. Using the rule of nines, the percentage of the body surface area involved is
pg 133
19 percent.
26
A child receives burns to his entire head and neck and upper back. What percentage of body
surface area is involved?
pg 133
27 percent
27
What systemic complications should you suspect with all serious burns?
Pg 133
Hypothermia
Eschar formation
Hypovolemia
Infection
28
What conditions would increase the impact a burn has on a patient?
pg 133
Being very young
Emphysema
Being very old
Having the flu
29
Which of the following should NOT be removed from any burned area of a patient?
## Footnote
A. Nylon clothing such as a windbreaker
B. Small pieces of burned fabric lodged in the wound
C. Shoes and socks
D. Rings, watches, and other articles of jewelry
E. Leather belts
pg 136
B. Small pieces of burned fabric lodged in the wound
30
T/F - When considering intubation of the patient with suspected airway injury due to inhalation of
the by-products of combustion, you should have several smaller-than-normal endotracheal
tubes ready.
pg 137
True
31
T/F - In severe inhalation injury due to airway burns, it may be necessary to perform a
cricothyrotomy to secure an adequate airway.
pg 137
True
32
High-concentration oxygen therapy is very helpful in cases of carbon monoxide poisoning
because it will then be carried in sufficient quantities in the plasma to maintain life.
pg 136
False
33
Your assessment reveals an area of burn that is reddened, painful, and just beginning to
display blisters. What burn classification would you give this burn?
pg 132
Partial-thickness bum
34
The patient you are attending has her entire left upper extremity seriously burned. The forearm
and hand are very painful and reddened, while the upper arm is relatively painless and a dark
red color. What percentage of the BSA and burn depth would you assign this patient?
pg 133
41/2 percent partial-thickness and 41/2 percent full-thickness burn
35
Your assessment reveals a burn patient with superficial burns to 27 percent of the body. What
classification of burn severity would you assign her?
pg 139
Minor
36
Your assessment reveals a burn patient with full-thickness burns to the entire left thigh and
calf. What classification of burn severity would you assign him?
pg 139
Critical
37
Your assessment reveals a burn patient with partial-thickness burns to all of both lower
extremities. What classification of burn severity would you assign her?
pg 139
Critical
38
Your assessment reveals a burn patient with partial-thickness burns to her entire lower
extremities and a suspected femur fracture. What classification of burn severity would you
assign her?
pg 139
Critical
39
Cool water immersion may reduce the depth and significance of small burns if applied within
pg 140
1 to 2 minutes.
40
T/F - The patient with any full-thickness burn should be considered for administration of tetanus
toxoid because the wound is an open one.
pg 140
True
41
In general, moderate to severe bums should be covered with
pg 140
dry, sterile dressings
42
T/F - Adjacent full-thickness bums, such as those affecting the fingers and toes, should be held
together without dressings to ensure rapid healing.
pg 140
False
43
The Parkland formula for fluid administration calls for administration of 4 mL of fluid to a
patient multiplied by the patient's BSA involved. What other factor(s) determines the total
fluid administered in the first 24 hours?
pg 141
Patient's weight
44
hich of the following is the preferred fluid for resuscitation of the severely burned patient?
pg 140
Lactated Ringer's solution
45
Which of the following drugs may be given to the patient with severe bums in the prehospital
setting?
## Footnote
Ipratropium D. Furosemide
B. Fentanyl E. Haloperidol
C. Epinephrine
pg 141
B. Fentanyl
46
Which of the following may be appropriate when a forming eschar is restricting distal blood
flow to an extremity?
## Footnote
A. Elevating the extremity
B. Incising the eschar to relieve the pressure
C. Wrapping the extremity in dry sterile dressings
D. Administering morphine
E. Immersing the limb in cold water
pg 141
Incising the eschar to relieve the pressure
47
A patient was found unconscious in a burning mobile home. Your assessment discovers severe
dyspnea, no airway restriction, chest pain, altered mental status, and some seizure activity.
What condition would you suspect?
pg 141
Cyanide poisoning
48
If an IV line is not yet established in a patient with suspected cyanide poisoning, you should
administer which of the following?
pg 142
Amyl nitrite
49
In addition to the entrance and exit wounds normally expected with the passage of electrical
current through the human body, the paramedic should expect
pg 142
ventricular fibrillation.
smoldering clothing.
cardiac irritability
internal damage.
50
In the United States, lightning strikes hit about how many people per year?
pg 143
300 people
51
T/F - The patient who is unresponsive, apneic, and pulseless due to a lightning strike is not a likely
candidate for successful resuscitation.
pg 143
False
52
In general, **caustic** chemical contamination should be cared for by
pg 144
cool water irrigation.
53
The chemical phenol is soluble in
pg 144
alcohol.
54
Which chemical agent reacts vigorously with water?
pg 71
Sodium
55
T/F - Known antidotes and neutralizers for chemical contamination and burns will reduce the injury
caused by the agent if administered immediately
pg 144
False
56
How long should you irrigate a patient's eye contaminated with chemicals of an unknown
nature?
pg 144
Up to 20 minutes
57
When chemicals are splashed into the eye of the patient wearing contact lenses, the contacts
should be removed to ensure irrigation will remove all of the agent.
pg 144
True
58
If the source of radiation cannot be contained or moved away from the patient, then
pg 145
the patient should be brought to you.
59
Which action can be used to reduce rescuer exposure to a radiation source?
## Footnote
A. Increase the distance from the source
B. Decrease the time exposed to the source
C. Increase the shielding between the rescuer and source
D. Protect against inhalation of contaminated dust
E. All of the above
pg 145
E. All of the above
60
T/F - Once exposed to a significant radiation source, the patient will become a source of radiation
that the rescuer must then protect himself against. No amount of decontamination will reduce
this danger.
pg 160
False
61
T/F - The incidence of burn injury has been on the increase over the past decade.
pg 123
False
62
The layer of skin with capillary beds and sensory nerve endings is the
pg 123
dermis.
63
Which of the following is NOT a function of the skin?
## Footnote
A. Protecting the body from bacterial infection
B. Aiding in temperature regulation
C. Permitting joint movement
D. Encouraging fluid loss in cold weather
E. Accommodating body movement
pg 124
D. Encouraging fluid loss in cold weather
64
Place the following phases of the body's burn response in the order in which they would be
expected to occur.
## Footnote
A. Emergent, fluid shift, hypermetabolic, resolution
B. Fluid shift, hypermetabolic, resolution, emergent
C. Fluid shift, resolution, emergent, hypermetabolic
D. Hypermetabolic, fluid shift, emergent, resolution
E. Emergent, resolution, hypermetabolic, fluid shift
pg 126
A. Emergent, fluid shift, hypermetabolic, resolution
65
The area of a burn that is characterized by reduced blood flow is generally the zone of
pg 125
stasis.
66
What skin type has the least resistance to the passage of electrical current?
pg 126
Mucous membranes
67
T/F - Electrical arc or flash burns may be hot enough to vaporize body tissue.
pg 127
True
68
T/F - Burns due to strong acids are likely to be less deep than burns due to strong alkalis because acids
produce liquefaction necrosis.
pg 128
False
69
Which radiation type is least powerful?
pg 128
Alpha radiation
70
T/F - As radiation exposure increases, the signs of exposure become more evident and occur sooner.
pg 130
True
71
Carbon monoxide has an affinity for hemoglobin that is how many times greater than the affinity
of oxygen for hemoglobin?
pg 131
200 times
72
T/F - Thermal airway bums occur more frequently than toxic inhalation injuries
pg 131
False
73
The bum characterized by erythema and pain only is the
pg 132
superficial burn.
74
The burn characterized by discoloration and lack of pain is the
pg 132
full-thickness bum.
75
A child patient has received bums to the entire anterior chest and to the entire left upper
extremity circumferentially. Based on the rule of nines, what is the percentage of body surface
area (BSA) involved?
pg 133
18 percent
76
An adult patient receives bums to his entire head and neck and upper back. Based on the rule of
nines, what is the percentage of BSA involved?
pg 133
18 percent
77
What are systemic complications that you should suspect with all serious burns?
pg 133
Hypothermia
Eschar formation
Hypovolemia
Infection
78
T/F - Once the suspected inhalation injury patient displays any signs of airway restriction, intubation
should not be attempted because it will traumatize the airway tissue, increase swelling, and
further restrict the airway.
pg 137
False
79
T/F - High-concentration oxygen (100 percent) will reduce the half-life of carbon monoxide in the
blood by up to two-thirds.
pg 136
True
80
The patient you are attending has her entire left lower extremity seriously burned. The leg and
foot are very painful and reddened, while the thigh is relatively painless and a dark red color.
What percentage of the BSA and burn depth would you assign this patient?
pg 137
9 percent partial-thickness and 9 percent full-thickness burn
81
Your assessment reveals a burn patient with partial-thickness burns to 27 percent of the body.
What classification of burn severity would you assign her?
pg 139
Moderate
82
Your assessment reveals a burn patient with superficial burns to more than half of the body. What
classification of burn severity would you assign her?
pg 139
Moderate
83
Your assessment reveals a burn patient with partial-thickness burns to the face, though you have
ruled out inhalation injury. What classification of burn severity would you assign her?
pg 139
Critical
84
Which of the following burns would NOT be considered a critical burn?
## Footnote
A. Circumferential third-degree burn to the chest
B. Superficial facial burns with sooty residue
C. 10 percent superficial and partial-thickness burns
D. Full-thickness burns to the elbow and hand
E. 25 percent partial-thickness burns in the geriatric patient
pg 139
C. 10 percent superficial and partial-thickness burns
85
Local and minor burns (superficial and partial-thickness) may be cared for with
pg 140
immediate cool water immersion.
86
In general, moderate to severe burns should be cared for with
pg 140
dry sterile dressings.
87
T/F - Nonadherent padding should be placed between full-thickness burns of the fingers and toes to
prevent adhesion and damage when they are separated.
pg 140
True
88
T/F - Even though there are no other intravenous sites available on a patient, you should not introduce
an intravenous catheter through a region that has partial-thickness burns.
pg 140
False
89
What special facility/service might benefit the patient with carbon monoxide poisoning?
pg 141
Hyperbaric chamber
90
The cyanide antidote kit contains which of the following?
## Footnote
A. Amyl nitrate
B. Sodium nitrate
C. Sodium thiosulfate
D. All of the above
E. None of the above
pg 141
D. All of the above
91
T/F - The paramedic can presume that a high-tension electrical line is not energized when it no longer
sparks or gives off a blue glow.
pg 142
False
92
Lightning strikes account for approximately how many deaths per year?
pg 143
100 Deaths per year
93
Which chemical burn should be covered with the oil used to hold the agent that caused it?
pg 144
Sodium
94
T/F - When chemicals are splashed into the eyes of the patient with contacts, the contacts should be left
in place because they will protect the underlying corneas.
pg 144
False
95
If it is necessary to enter a radiation zone to remove a patient, which provider is the best candidate
to perform the maneuver?
pg 145
The oldest care provider
