Principles of Burn Management (1*)

Question 1

Assessment:
What should be found out in the history?

What should be examined?
→ How will these be affected in deep burns?

What are the 2 ways of measuring the location, size and extent of the burn?

Answer 1

➊ Causative agent, Time and duration of insult, First aid applied

➋ CRT, Sensation, If distribution is consistent with the hx
→ Both CRT and Sensation will be absent

➌ • Wallace Rule of Nines – may overestimate the affected area
• Lund and Browder Chart – more accurate

Question 2

Management:
What is the important thing to do for thermal burns?
→ Why shouldn’t ice cold water be used?
→ What should be done after this?

Why should the pt be kept warm?

What’s the worry with circumferential full thickness burns of the chest/limbs/digits?
→ What should therefore be done to avoid this?

Why should the affected area be elevated?

What should be given if there was an inhalation injury?

What else should be given?

Answer 2

➊ Irrigate the burn with cool/lukewarm water for 20-30 mins (use wet towels/compresses if not available)
→ It may cause vasoconstriction, therefore deepening the wound
→ Cover burn with cling film (wrapping around will cause vasoconstriction)

➋ Avoid hypothermia

➌ Can cause tourniquet effect which compromises limb circulation and respiratory function
→ Escharotomy

➍ Reduce risk of oedema

➎ HF O2

➏ Tetanus prophylaxis