Thermal Burn

Question 1

increased risk of fire-related injuries and death

Answer 1

children ≤4 years of age, 
adults ≥65 years of age, 
African Americans and Native Americans, 
persons living in rural areas, 
persons living in manufactured homes or substandard housing, and 
persons living in poverty

Question 2

Local effects of thermal injury

Answer 2

liberation of vasoactive substances,
disruption of cellular function,
and formation of edema

Question 3

systemic response alters the neurohormonal axis

Answer 3

histamine, 
kinin, 
serotonin, 
arachidonic acid metabolites, 
and free oxygen radicals

Question 4

systemic response alters the neurohormonal axis

Answer 4

histamine, 
kinin, 
 serotonin, 
arachidonic acid metabolites, 
and free oxygen radicals

Question 5

factors may influence prognosis,

Answer 5

the severity of the burn, 
the presence of inhalation injury, 
associated injuries, 
the patient’s age, 
comorbid conditions, 
and acute organ system failure are most important.

Question 6

Cell damage occurs at temperatures of

Answer 6

> 45°C

Question 7

tissue is irreversibly destroyed with thrombosis of blood vessels;

Answer 7

zone of coagulation

Question 8

stagnation of the microcirculation

become progressively more hypoxemic and ischemic if r tion is not adequate

Answer 8

zone of stasis

Question 9

there is increased blood flow

minimal damage to the cells and spontaneous recovery is likely

Answer 9

zone of hyperemia

Question 10

Epidermis

No blisters, painful

7d healing

Answer 10

Superficial (first degree)

Question 11

Epidermis and superficial dermis

Blisters, very painful

14–21 d, no scar healing

Answer 11

Superficial partial-thickness (superficial second degree)

Question 12

Epidermis and deep dermis, sweat glands, and hair follicles

Blisters, very painful

3–8 wk, permanent scar healing

Answer 12

Deep partial-thickness (deep second degree)

Question 13

Entire epidermis and dermis charred, pale, leathery; no pain

Months, severe scarring, skin grafts necessary healing

Answer 13

Full-thickness (third degree)

Question 14

Entire epidermis and dermis, as well as bone, fat, and/or muscle

Months, multiple surgeries usually required healing

Answer 14

Fourth degree

Question 15

Major burn = Burn Center Treatment

Answer 15

Partial-thickness >25% BSA, age 10–50 y
Partial-thickness >20% BSA, age <10 y or >50 y
Full-thickness >10% BSA in anyone
Burns involving hands, face, feet, or perineum
Burns crossing major joints
Circumferential burns of an extremity
Burns complicated by inhalation injury
Electrical burns
Burns complicated by fracture or other trauma
Burns in high-risk patients

Question 16

Moderate burn = hospitalization

Answer 16

Partial-thickness 15%–25% BSA, age 10–50 y
Partial-thickness 10%–20% BSA, age <10 y or >50 y
Full-thickness burns ≤10% BSA in anyone
No major burn characteristics present

Question 17

Minor burn = outpatient treatment

Answer 17

Partial-thickness <15% BSA, age 10–50 y
Partial-thickness <10% BSA, age <10 y or >50 y
Full-thickness <2% in anyone
No major burn characteristics present

Question 18

American Burn Association Burn Unit Referral Criteria

Answer 18

• Full-thickness/third-degree burns in any age group
• Partial thickness burns >10% total body surface area
• Burns involving the face, hands, feet, genitalia, perineum, or major joints
• Electrical burns, including lightning injury
• Chemical burns
• Inhalation injury
• Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
• Burn injury in any patients with concomitant trauma (e.g., fractures) in whom the burn injury poses the greatest risk of morbidity or mortality
• Burn injury in children in hospitals without qualified personnel or equipment to care for children
• Burn injury in patients who will require special social, emotional, or long-term rehabilitative intervention
• Burn injury in children <10 y and adults >50 y of age