Plastics burns

Question 1

most common cause of burns in adults and children

Answer 1

adults - flames

children - scaleds

Question 2

Describe assessment of an epidermal burn

Answer 2

Red, no blisters, cap refill present, sensation present

Question 3

What depth of burns are not expected to heal?

Answer 3

Deep dermal and full thickness

some mid-dermal may not heal

Question 4

Describe assessment of a superficial dermal burn

Answer 4

Pale pink, small blisters, cap refill present, painful.

Question 5

What features are checked to assess the depth of a burn?

Answer 5

Color
Blisters
Cap refill
sensation

Question 6

Describe assessment of a mid dermal burn

Answer 6

Dark pink, large blisters, sluggish cap refill, painful ± sensation to light touch may be lost

Question 7

Describe assessment of a deep dermal burn

Answer 7

blotchy red fixed stain gin, sometimes blistering, cap refill absent, no sensation

Question 8

Describe assessment of a full thickness burn

Answer 8

White / leathery, no blisters, cap refill absent, sensation absent

Question 9

Burn is pink, with blisters, patient is in pain when wound is examined, can’t feel pin prick sensation. How deep is the burn?

Answer 9

Mid dermal

Question 10

estimated %TBSA of palm of hand

Answer 10

1%

Question 11

Most accurate measurement for estimating TBSA of burns

Answer 11

Lund and Browder chart

Question 12

% TBSA of perineum

Answer 12

1%

Question 13

% TBSA of child’s head?

Answer 13

18%

Question 14

% TBSA of adult back

Answer 14

18%

Question 15

% TBSA of adult hamstring and calf

Answer 15

9%

Question 16

% TBSA of adult forearm

Answer 16

4.5% including anterior and posterior

Question 17

% TBSA of adult head

Answer 17

9%

Question 18

% TBSA of back of child’s legs

Answer 18

7%

Question 19

% TBSA of child’s arm

Answer 19

9%

Question 20

% TBSA of child’s back

Answer 20

18%

Question 21

What are the principles of burn management

Answer 21

1. First Aid
2. Primary Survey
3. Secondary surgery
4. Further management

Question 22

What does primary survey involve?

Answer 22

Airway maintenance + C spine control
Breathing and Ventilation 
Circulation w/ haemorrhage control 
Disability 
Exposure + environmental control 
Fluid resuscitation

Question 23

What does secondary survey involve?

Answer 23

• Head to toe exam
• AMPLE
  Allergies, meds, past illnesses, last meal, events/environment related to injury
• Mechanism of injury

Question 24

Parkland formula for fluid resuscitation

Answer 24

3-4ml Hartmann’s x Bodyweight (kg) x %TBSA
Given in the first 24hrs after the burn (not from time of presentation)
Half in the first 8 hours from the burn, the other half over the next 16.

Question 25

What sort of fluid shift happens in burn victims?

Answer 25

( esp burns over 20-30% TBSA)
generalised process
intravascular hypovolaemia due to oedema and evaporative loss form the moist burn surface

Question 26

Fluid resuscitation for children

Answer 26

Maintenance fluids 5% glucose in 0.45% NaCl + resuscitation fluids
- 100ml/kg up to 10kg
+ 50ml/kg from 10-20kg
+ 20ml/kg for every kg over 20kg

Question 27

Distal ischaemia is a complication fo what type of burns.

Prevention

Answer 27

Full thickness and deep dermal
because of oedema, the skin can’t expand.
Manage by emergency escharotomy ( incision down to subcutaneous fat) to allow adequate ventilation and prevent ischaemia

Question 28

What are the wrist flexors and extensors?

Answer 28

Flexors = flexor carpi radialis and ulnaris
Extensors =  extensor carpi radialis brevis, extensor carpi radialis longus and extensor carpi lunaris

Question 29

Blood supply of the thumb and index finger

Answer 29

radial artery

Question 30

Blood supply to deep palmar arch

Answer 30

radial artery

Question 31

Blood to middle, ring and little fingers

Answer 31

Ulnar artery