Burns

Question 1

What burn category?

red, dry, painful

Blanchable

No blisters

Answer 1

Superficial

Question 2

superficial burns heal w/in ____ days with/without scarring

Answer 2

7 days, without scarring

Question 3

What burn category?

pink, moist blisters
painful
blanchable

Answer 3

superficial partial thickness

Question 4

What burn category?

mottles color/patchy white-red

non-blanching

pain w/ pressure, not inherently painful

blisters

Answer 4

deep partial thickness

Question 5

Partial thickness burns extend to the _______ and have ______ scarring

Answer 5

dermis

minimal to severe scarring

Question 6

Superficial burns extend to the _____ and have _____ scarring

Answer 6

epidermis

no scarring

Question 7

Tx of superficial partial thickness burn:

Answer 7

keep moist w. petroleum + xeroform dressing

debridement

Question 8

common mechanism for superficial partial thickness…

Answer 8

water scald

Question 9

common mechanism for deep partial thickness burn…

Answer 9

oil scalds, flames

Question 10

Tx of deep partial thickness burn

Answer 10

keep moist w. petroleum + xeroform dressing

debridement

PT

+ sulfadiazine if eschar

Question 11

How often to change dressings for partial thickness burns?

Answer 11

QD/BID

Question 12

What type of burn?

dry, non-blanching
hard-leathery
painless

Answer 12

full thickness

Question 13

Initial tx for chemical burn

Answer 13

copious water irrigation

Question 14

In electrical burns, you must monitor for ____ and fluid resus of ______ ccs of urine/kg/hour

Answer 14

cardiac abnormality

1-2 cc urine/kg/hour

Question 15

Circumfrential burns are high risk for…

Answer 15

compartment syndrome

Question 16

2 procedures for circumferential burns…

Answer 16

escharotomy

fasciotomy

Question 17

Pulse ox isn’t reliable for CO poisoning… what is?

Answer 17

carboxyhemoglobin levels

Question 18

MC cause of death related to fire…

Answer 18

smoke inhalation

Question 19

Pt. p/w:

HA/AMS

Cheery Red skin

Hypotension, arrhythmia, CV collapse

Answer 19

cyanide poisoning

Question 20

Tx of CN poisoning…

Answer 20

cyanokit

Question 21

3 upper airway inhalation sxs…

Answer 21

hoarseness
stridor
substernal retractions

Question 22

4 lower airway inhalation sxs

Answer 22

tachypnea
decreased BS
w/r/r
accessory mm

Question 23

4 staples of inhalation tx…

Answer 23

mech. vent

pulmonary toilet

PNA prevention

supp. nutrition

Question 24

The below are indications for what procedure?

•
Closed space smoke exposure
•
Carbonaceous sputum
•
Facial burns
•
COHb >5
•
Hoarse voice
•
Singed facial hair

Answer 24

intubation

Question 25

What is incredibly important to monitor for circulation resus in burns?

Answer 25

I&Os

Question 26

Normal urinary output for adults...

Answer 26

0.5 ml/kg/hr

Question 27

are diuretics indicated in acute setting for burns?

Answer 27

no

Question 28

Burns > ___ require parkland resus

Answer 28

20% BSA

Question 29

Parkland formula...

Answer 29

4mL LR x kg x TBSA = 24 hours post-burn total

Question 30

What is the distribution of parkland formula over 24 hours?

Answer 30

half in 1st 8 hours

Question 31

Is TPN recommended in burns? Why or why not?

Answer 31

no, increased mortality

Question 32

Preferred nutrition therapy

Answer 32

duodenal enteral support

Question 33

What type of diet for burns?

Answer 33

high carb, low fat

Question 34

protein needs for burns...

Answer 34

1.5-2 g/kg

Question 35

vitamin/mineral supplements for burns...

Answer 35

vit. A, E, D, C Selenium Zinc

Question 36

The below indicate what? • Partial-thickness burns of > 10% of TBSA • Third-degree burns in any age group • Burns that involve the face, hands, feet, genitalia, perineum, or major joints • Electrical burns, including lightning injury • Chemical burns • Inhalation injury • Burn injury in patients with preexisting medical disorders that could complicate management, prolong recovery, or affect mortality • Any patients with burns and concomitant trauma… • Children in hospitals without qualified personnel or equipment to care for their burn injuries • Burn injury in patients who will require special social, emotional, or rehabilitative intervention

Answer 36

burn center referral

Question 37

W/in 3-5 days, what type of pathogen causes infx in burn patients?

Answer 37

G+ (staph aureus)

Question 38

Burn pt. p/w: ``` • Decreased urine output • Elevated bladder pressure (>25 mmHg) • Increased Peak Expiratory Pressure • Poor ventilation ```

Answer 38

abd. compartment syndrome

Question 39

3 chronic complications of burns...

Answer 39

chronic ulceration scar contractures hypertrophic scarring

Question 40

Major concern for chronic ulcerations...

Answer 40

marjolin ulcer (CA lesion)