Thermal Injuries

Question 1

2 major conditions that can bee seen in electrical burns

Answer 1

rhabdo and cadiac arrhythmias

Question 2

clinical indications of inhalation injury

Answer 2

face/ neck burns
singing of eyebrows/ nasal vibrissae
carbon deposits in mouth/ nose 
acute inflammatory changes in oropharynx
hoarseness
impaired mentation/ confinement in burning buildings

Question 3

Who requires fluid resuscitation with burns

Answer 3

> 20% total body surface area

Question 4

what type solution is preferred in resuscitation

Answer 4

lactated Ringer’s

Question 5

the palmar surface (including fingers) of the patient’s hand represents approx. ___ percent of the patient’s body surface

Answer 5

one percent

Question 6

burn with erythema, pain and no blisters. epidermis remains intact

Answer 6

first degree burn

Question 7

are first degree burns included in estimate of burn size

Answer 7

no

Question 8

burn that is dark and leathery, painless and dry. May be red and doesn’t blanch w/ pressure.

Answer 8

full thickness burn

Question 9

red or mottled burn with swelling and blisters. may be weeping or wet looking

Answer 9

partial- thickness burns

Question 10

patients with CO levels

Answer 10

20

Question 11

when should you assume CO exposure with a burn

Answer 11

when it happens in an enclosed area

Question 12

what is the half life of CO

Answer 12

4 hours (only 40 minutes with 100% oxygen)

Question 13

fluid needs for burn patients

Answer 13

2-4 mL of Ringer’s lactate x kg of body weight x percentage BSA of deep partial thickness and full thickness burns during first 24 hours (1/2 of this in the first 8 hours after burn injury)

Question 14

what is the target UOP fluids should be titrated to for burn patients

Answer 14

0.5mL/kg/hour in adults

1 ml/kg/hour for children

Question 15

for small children (

Answer 15

glucose to avoid hypoglycemia

Question 16

what is a naturally occurring toxin that may be inhaled in confined space fires

Answer 16

cyanide

Question 17

in burn patients what may be the first sign of hypoxia and electrolyte/ acid-base abnormalitites

Answer 17

cardiac dysrhythmias

Question 18

baseline labs for burn patients

Answer 18

CBC, type and cross match/ screen
ABGs w/ HbCO
serum glycose, electrolytes
preggo test

Question 19

a compartment pressure above what indicates escharotomy is needed

Answer 19

> 30 mm Hg

Question 20

if burns involve >20% BSA what should be inserted

Answer 20

gastric tube

Question 21

what type burns are painful when air currents pass over them

Answer 21

partial thickness.

cover the burn with clean sheets to relieve the pain

Question 22

what should you NOT do to burns

Answer 22

break blisters or appy antiseptic agents or apply cold compresses
no cold water if (>10% BSA)

Question 23

is there any indication for prophylactic antibiotics in the early post-burn period

Answer 23

No

Question 24

what type chemical burns are more serious

Answer 24

alkali because they penetrate more deeply

Question 25

tx for chemical burn

Answer 25

flush away the chemical with large amounts of water for at least 20-30 minutes

Question 26

how long doe alkali burns to the eye require continuous irrigation for

Answer 26

the first 8 hours after the burn

Question 27

criteria for transfer to burn center

Answer 27

partial/ full thickness burns >10% BSA
burns on face, eyes, ears, feet, genitals, perineum, over joints
any full thickness
inhalation injury, electrical, chemical burns (significant)

Question 28

mild cold injury. pain, pallor and numbness. is reversible w/ rewarming and no tissue loss

Answer 28

frostnip

Question 29

freezing of the tissue w/ intracellular ice crystal formation, microvascular occlusion and subsequent tissue anoia

Answer 29

forstbite

Question 30

degree of frostbite- full-thickness and subq tissue necrosis. commonly w/ hemorrhage vesicle formation

Answer 30

third degree

Question 31

degree of frostbite with hyperemia and edema. no skin necrosis

Answer 31

1st degree

Question 32

frost bite degree with large, clear vesicle formation that accompanies hyperemia and edema. partial thickness skin necrosis

Answer 32

2nd degree

Question 33

frost bite degree that has skin necrosis and includes muscle and bone w/ gangrene

Answer 33

4th degree

Question 34

tx for cold injury

Answer 34

replace damp clothing w/ warm blankets
give hot fluids by mouth
place injured part in circulating water at 104 degrees until pink color returns
do NOT rub or massage
give adequate analgesia and rewarm

Question 35

what constitutes hypothermia

Answer 35

core temp