Burns

Question 0

Describe burn classification

Answer 0

Superficial (1st degree) : epidermis damage, skin red & dry, painful
Partial Thickness (2nd degree) : epidermis & dermis, blistered, moist skin, extremely painful
Full Thickness (3rd degree) : damage to all layers, absence of nerve fibres, tough non elastic coagulated collagen of dermis

Question 1

List the causes of burns

Answer 1

Thermal- Dry (fire, stove top) Thermal- Wet (water)
Electrical- power lines
Chemical- caustic soda
Radiation- sunburn

Question 2

How to calculate TBSA of burn?

Answer 2

The rule of nine’s
Body is divided into segments
Each segment is a multiple of 9% of TBSA

Question 3

What is the rule of palms?

Answer 3

Method for estimating irregular shaped burns

Patients palm equal approx 1% of TBSA

Question 4

List 8 time critical burns?

Answer 4

15% of TBSA for adults
10% of TBSA for children
Full thickness burns > 10% TBSA
Disease complications, electrical burns, deep chemical burns
Burns to:,airway, face, hands, feet, genitalia or ears
INfants, elderly or infirm

Question 5

What are signs/symptoms of airway burns?

Answer 5

Burn in, around mouth and nose
Singed/burnt nasal hairs
Painful airway, sooty sputum
Hoarseness, wheeze/stridor, brassy cough

Question 6

What is the Parkland formula?

Answer 6

Fluid= TBSA(%) x Weight (kg) x 2mls

Then divide by 2- half volume given in first 8 hrs, second half in the following 16 hrs.

Question 7

Treatment for burns

Answer 7

Stop burn process, remove jewellery and clothing
Danger- remove patient from burn
Airway- look with torch, always suspect, ask questions
Breathing- high flow O2, salbutamol with wheeze
Circulation- fluid therapy if burn >15% and > 45 min from RPH
Parkland formula
Exposure- cover and cool

Question 8

List burn pain relief

Answer 8

Methoxyflurane- 3ml
Fentanyl- 600mcg in 2ml intra nasal, 100mcg in 2ml IV
Ketamine- 200mg in 2ml (1mg/kg)