EAC Burns and Scalds

Question 1

causes of:

Burns

Answer 1

Flame or radiation (thermal)
electricity
Friction
Corrosive chemicals

Question 2

causes of:

Scalds

Answer 2

Water
Steam
Fat
Hot liquid chemicals

Question 3

define:

Burn

Answer 3

Caused by dry heat

Question 4

define:

Scald

Answer 4

Caused by wet heat

Question 5

dangers related to:

Thermal burns

Answer 5

Shock caused by the loss of body fluids ie plasma

Infection of the exposed subcutaneous tissue or burst blisters

Damage to the respiratory tract caused by breathing in flames or hot air

Question 6

dangers related to:

Electrical Burns/Electrocution

Answer 6

be sure to safeguard your own safety before dealing with the patient:

Isolate any electrical current before touching patients or attempting to remove them from the source of the electricity

may cause Cardiac Diarrhythmias so bring a defib’

Treat as a normal burn

Surface area may be misleading. Deep layers may be affected more seriously than would be apparent from a small surface burn

Immobilise C-Spine if history of incident suggests risk of injury

Question 7

dangers related to:

Chemical Burns

Answer 7

destruction of tissues by chemical reaction.

The chemical may also be hot

Some chemicals can melt into the skin and tissues and then solidify

If possible identify the chemical

Remove all contaminated clothing

Irrigate freely with cold water

Applying an appropriate neutralising agent if available

Treating as for a normal burn

A phosphorus burn should be kept continually et; apple a wet dressing

Question 8

define:

Burn

Answer 8

A thermal insult which damages the skin and/or underlying structures

Question 9

Types of burn and scald

Answer 9

Flame or radiation (thermal)
Dry heat
Wet heat
Electricity
Friction
Corrosive chemicals

Question 10

depths of burns

Answer 10

Erythema (slight, superficial)

Partial thickness

Full thickness

Question 11

define:

Erythema (slight, superficial) burn

Answer 11

Reddening of the skin, sensation present

Question 12

define:

Partial Thickness burn

Answer 12

Reddening with blistering, sensation present

Question 13

define:

Full Thickness burn

Answer 13

Sever blistering accompanied by charring in the case of burns with an appearance of inflammation around the edge of the injury.

Underlying tissues will be damaged with coagulation of blood vessels in the skin and damage to nerve ending’s causing a loss of sensation

Question 14

how to asses area of burns

Answer 14

serial halving:

Half burnt/half not burnt approach to give burn area of 75%, 50%, 25%, 12.5%,

Question 15

points to remember hen assessing burns

Answer 15

Burns in the region of 10% of body area are serious and may produce severe shock.

The area burnt is more significant than the depth of the burn

Age of Pt. children shocked easier as they have less body fluid

Children and young adults may survive burns of 20%
Whereas infants and elderly may die from 10% burns

Superficial usually more painful then deep ones.

if age + % of burn >100 the prognosis is poor

Consider all burn area - do not differentiate

Question 16

Time critical features of burns

Answer 16

Any major ABCD problems
Any signs of airway burns, soot or oedema around the mouth and nose
History of hot air or gas inhalation - these patients may initially appear well but can deteriorate very rapidly
Evidence of circumferential burns of the chest or neck
Any significant facial burns
Adults with surface burns >25%
paediatric patients with surface burns >12.5%
presence of other major injuries

any of these features present? correct A and B problems and pre-alert, rapid transport to nearest suitable receiving hospital. continue management en-route

Question 17

complications of:

Burns and Scalds

Answer 17

Shock - clinical and psychological

Infection - don’t touch the injuries unnecessarily and wear sterile gloves

Respiratory tract damage

Question 18

management of:

Burns and Scalds

Answer 18

Put out fire here safe to do so
Ensuring an open airway, observing for burn marks or singeing around mouth or nose, this may indicate inhalation of hot gases.
Administering Entonox or high % O2
Removing and constrictions such as rings, necklaces, shoes
Removing clothing which is hot and wet and not adhering to the skin
Cover burn area with sheets of cling film - overlapping rather than bound. DO NOT use cling film on chemical burns
Applying sterile dressings
Treating for emotional and hypovolaemic shock
Not applying creams or lotions
Not bursting blisters

Question 19

management of:

Burns and Scalds with Respiratory Tract Damage

Answer 19

Ensuring open airway
Administering high % O2
Consider nebulisation with salbutamol where wheezing is apparent
Resuscitating if necessary
Removing to hospital as quickly as possible as rapid swelling can occur

Question 20

causes of:
Respiratory Tract Damage
(burns and Scalds)

Answer 20

Inhaling flame

Inhaling hot smoke, fumes or atmosphere

Swallowing hot liquids