TRAUMATIC BURN INJURIES

Question 1

True/False
BURNS MAY REPRESENT ONLY ONE OF THE CASUALTIES INJURIESESPECIALLY IF AN EXPLOSION WAS THE PRIMARY MECHANISM.

Answer 1

true

Question 2

The most challenging time in the resuscitation of a burn patient is typically the first __ hours

Answer 2

48

Question 3

full thickness (or 3rd degree) burn has what 3 zones of tissue injury?

Answer 3

1) Zone of coagulation
2) Zone of stasis
3) Zone of hyperemia

Question 4

What zone of a full thickness burn?
Region of greatest destruction resulting in Necrosis and not capable of repair

Answer 4

Zone of coagulation – central zone

Question 5

What zone of a full thickness burn?
adjacent to zone of necrosis, immediately after injury blood flow is stagnant

Answer 5

Zone of stasis

Question 6

What zone of a full thickness burn?
Minimal cellular injury and characterized by increased blood flow secondary to inflammatory reaction initiated by the burn injury.

Answer 6

Zone of hyperemia – outermost zone

Question 7

Withhold final judgement of depth of a burn until how long after injury.

Answer 7

48 hours

Question 8

What type of burn?
(a) May have several appearances.
(b) Most often appear thick, dry, white, and leathery regardless of skin color.
(c) Thick leathery damaged skin referred to as eschar.
(d)Common, misconception that these burns are pain free because nerve endings are destroyed. These patients have varying degrees of pain

Answer 8

Full thickness

Question 9

Point of Injury Care for burns

Answer 9

(1) Stop the burning process.
(2) Provide resuscitative care. Hemorrhage control. Airway maintenance.
(3) Remove all constricting articles.
(4) Cover the patient.
(5) Protect against hypothermia.
(6) Establish IV access.
(7) Begin resuscitation.

Question 10

Estimate hourly fluid rate
Initial hourly rate =

Answer 10

%TBSA Burn x 10 ml/hr
-Adjust rate by 25% as needed.

Question 11

These are criteria for what?
(a) Partial-thickness burns greater than 10% of TBSA
(b) Burns that involve the face, hands, feet, genitalia, perineum, or major joints
(c) Third-degree burns in any age group
(d) Electrical burns, including lightning injury
(e) Chemical burns
(f) Inhalation injury
(g) Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality
(h) Burned children in hospitals without qualified personnel or equipment for the care of children
(i) Burn injury in patients who will require special social, emotional, or rehabilitative intervention

Answer 11

Burn center referral

Question 12

What is the target UOP for burn patients?

Answer 12

.5 ml/kg/hr

Question 13

What are ideal for monitoring a burn patient depending on capabilities

Answer 13

TWO IV’s, Foley, ECG monitoring, pulse Ox, a core temp, and NG tube

Question 14

If available NG decompression for prolonged care in patients with over 20% TBSA due to ______.

Answer 14

gastric ileus

Question 15

If UOP is less than target for 1-2 increase rate by __%. If response is greater than target decrease rate by __%.

Answer 15

25%

Question 16

Wound and extremity care

Answer 16

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