Trauma - Surface & Thermal

Question 1

Estimate Extent of Burn

Answer 1

• rule of 9s: arms 9% each, legs 18% each, torso 18%, back 18%, head 9%
• in children head accounts for 18%, legs 14% each

Question 2

Classifications of Burns

Answer 2

• superficial: 1st degree
• superficial, partial thickness: 2nd degree
• deep partial thickness: 2nd degree
• full thickness: 3rd degree

Question 3

Burn Pathophysiology

Answer 3

• local leakage at the site
• release of inflammatory mediators that cause cardiac depression
• hyperdynamic state caused by activation of sympathetic nervous system

Question 4

electrical burns have a ______ fluid requirement than thermal burns

Answer 4

-higher

Question 5

inhalation injury - S/S

Answer 5

• singed facial/nasal hair
• bronchoconstriction
• stridor
• dysphagia
• voice changes
• carbonaceous deposits

Wet air causes lower airway injury.

Question 6

carboxyhemoglobin

Answer 6

• binds to hemoglobin, shifts curve to the left
• SpO2 will read normal
• treatment: O2

Question 7

inhalation injury - anesthetic concerns

Answer 7

• increased fluid requirement
• smaller ETT
• loss of hypoxic pulmonary vasoconstriction

Question 8

thermal injuries: pharmacologic concerns

Answer 8

• decreased albumin binding sites

- increased alpha 1 glycoprotein (diminished effect of NMB)

Question 9

burns: fluid resuscitation based on the Parkland formula.

Answer 9

• 4mL/kg/TBSA burn (total)
• half in first 8 hours
• half in next 16 hours