burns

Question 1

how can you assess the extent of the burn

Answer 1

Wallace’s rule of nines
head+neck = 9%
each arm = 9%
each anterior leg = 9%
each posterior leg = 9%
anterior chest = 9%
posterior chest = 9%
abdomen = 9%
posterior abdo = 9%

TBSA = total body surface area

Question 2

superficial epidermal burn

Answer 2

(1st degree)

red + painful
dry, no blisters

(like sunburn)

Question 3

partial thickness (superficial dermal) burn

Answer 3

(2nd degree)

pale pink, painful, blistered

slow cap refill

(blisters, moist, painful)

Question 4

partial thickness (deep dermal) burn

Answer 4

2nd degree

• typically white but may have patches of non-blanching erythema
• reduced sensation, painful to deep pressure (Less painful)

(dry, pale, less painful)

Question 5

full thickness burn

Answer 5

(3rd degree)

White (“waxy”)/brown (“leathery”) / black in colour

no blisters, no pain

Question 6

when to refer to secondary care

Answer 6

• all deep dermal + full thickness
• superficial dermal burns of more than 3% TBSA in adults or 2% TBSA in kids

– or if invovling, face, hands, feet, perineum, flexure/circumferential burns

Question 7

when is IV fluids used in the management of burns

Answer 7

kids = burns >10% of TBSA

adults = 15% of TBSA

Question 8

how is the volume of fluids used in management of burns calculated

Answer 8

Parkland formula !

volume = TBSA of burn % X weight X 4

• half of the fluid is given in first 8hrs