Trauma Burns

Question 1

What is the timeline that is most important for treating burns?

Answer 1

48 hours

Question 2

What are the 3 zones of 3rd degree burns?

Answer 2

• Zone of coagulation
• Zone of stasis
• Zone of hyperemia

Question 3

What zone has the greatest destruction resulting in Necrosis and not capable of repair?

Answer 3

Zone of coagulation (central zone)

Question 4

What is the outermost zone?

Answer 4

Zone of hyperemia

Most inflammation

Question 5

What layer of the skin do superficial burns involve?

Answer 5

EPIDERMIS ONLY

Question 6

Do you calculate body surface burns when it comes to superficial burns?

Answer 6

No

Question 7

What layers of the skin does partial thickness burns involve?

Answer 7

Epidermis and DERMIS

Zone of necrosis (coagulation) involved in the epidermis

Question 8

How do partial thickness burns present?

Answer 8

Blisters with wet or glistening appearing base

Question 9

How do full thickness burns present?

Answer 9

thick, dry, white, and leathery

leathery damaged skin referred to as eschar

Question 10

What do you cover burns with?

Answer 10

Clean, dry sheet

Question 11

What do you cover burns with associated with white phosphorus?

Answer 11

Moist saline soaked dressing

Question 12

What IV solution are we using for burn patients?

Answer 12

LR

Question 13

Rule of 9s? *****

40%**

Answer 13

Head - 9%
Upper Arm - 9%
Torso - 36%
Lower Leg - 18%
Perineum - 1%

** Divide by 2 for anterior vs posterior

** Double percentage for bilateral (except head and perineum)

Question 14

How to estimate initial hourly infusion rate for burns?

Answer 14

%BSA Burn x 10ml/hr

Question 15

Which zone of burn has irreversible tissue damage?

Answer 15

Zone of coagulation

Question 16

What percent burns are considered burn center referral criteria?

Answer 16

Partial Thickness greater than 10%

Question 17

Additional burn center criteria?

don’t spend much time on this

Answer 17

• 3rd degree burns
• Burns of face, hands, feet, genitals, perineum, major joints
• electrical
• Chemical
• Inhalation

Question 18

What is used for decompression of gastric Ileus in patients with over 20% BSA?

Answer 18

NG decompression

Question 19

What is the single most reliable indicator of adequate resuscitation?

Answer 19

Urinary output

Question 20

Target urinary output?

Answer 20

.5cc/kg/hr

Question 21

What if urinary output is less than target?

Answer 21

Increase infusion rate by 25%

** If greater than target, then decrease by 25%

Question 22

What are complications of over infusion?

Answer 22

Pulmonary edema, compartment syndrome

Question 23

Burn wound care topical treatments?

Answer 23

(a) Topical antibiotics agents after cleaning
(b) Silver nylon dressings which provide antimicrobial coverage
(c) Topical antimicrobial solution or creams

Question 24

What is done for burn extremities hourly?

Answer 24

• Exercise
• Evaluate pulses and neuro
• Elevate

Question 25

To review, what % of TBSA burns require fluid resuscitation?

Answer 25

20%