Burns, electricity, and TASER emergencies

Question 1

What are the two main factors indicative of burn criticality?

Answer 1

Depth (how many layers involved) and extent (surface area size involved)

Question 2

Which layers are involved in superficial burns?

Answer 2

Epidermis only

Question 3

Does blistering occur in superficial burns?

Answer 3

No

Question 4

Do superficial burns blanch under pressure?

Answer 4

Yes

Question 5

How do superficial burns appear?

Answer 5

Red, painful, tender

Question 6

Which layers are involved in partial thickness burns?

Answer 6

Epidermis and dermis

Question 7

How do partial thickness burns appear?

Answer 7

Dark pink, moist/shiny, very painful

Question 8

Does blistering occur in partial thickness burns?

Answer 8

Yes

Question 9

Which layers are involved in full thickness burns?

Answer 9

Through to underlying structures

Question 10

How to full thickness burns appear?

Answer 10

Thick, dry, leathery, pearly grey or charred black, waxy, may bleed or ooze from vessel damage

Question 11

Are full thickness burns painful at the site?

Answer 11

No

Question 12

Circumferential burns have increased likelihood of ____ ____.

Answer 12

Compartment syndrome

Question 13

Why are airway burns a critical issue?

Answer 13

Swelling may occlude the airway, and IV fluids will increase swelling

Question 14

How long is cool running water applied to a burn injury?

Answer 14

20 minutes

Question 15

How long post-burn is cool water ineffective?

Answer 15

Three hours

Question 16

Cool water should only be applied to minor burn injuries less than ____% in adults and ____% in children.

Answer 16

10% in adults

5% in children

Question 17

True or false: burn injuries can cause a pt to become hypothermic quickly

Answer 17

True - the thermoregulatory system is compromised

Question 18

What are the signs of carbon monoxide inhalation?

Answer 18

• Headache (dull, frontal, continuous)
• Fatigue/ataxic/confusion/convulsions
• Tachycardia
• Hypertension
• N + V
• “Roaring” in ears

Question 19

What are the priority signs of upper airway burns?

Answer 19

• Neck/facial burns
• Singing of nasal hairs/eyebrows
• Tachypnoea/hoarseness/drooling
• Red, dry oral/nasal mucosa

Question 20

What are the priority signs of lower airway burns?

Answer 20

• Loss of consciousness
• Occurred in enclosed space
• Tachypnoea
• Cough
• Wheezes/crackles
• Carbonaceous sputum

Question 21

What occurs when acidic compounds interact with skin?

Answer 21

Protein denaturation and coagulative necrosis produces a scar, which limits the depth the acid can penetrate

Question 22

What occurs when alkalis interact with skin?

Answer 22

Saponification and liquefactive necrosis of body fat. As there is no scar to limit penetration, alkali burns tend to penetrate deeper into tissues than acidic burns

Question 23

Should neutralising agents be used for chemical burns?

Answer 23

No, because the reaction produces heat. Highest recommendation is water.

Question 24

What are the concerns with chemical burns?

Answer 24

• Ongoing damage
• Chemical absorption
• Avoiding personal exposure

Question 25

What are the factors that determine the effect of an electrical current passing through the body?

Answer 25

- Type of current - Voltage - Tissue resistance - Current path - Contact duration

Question 26

Which current is three times more dangerous than the other, AC or DC?

Answer 26

AC

Question 27

AC through the body can produce ____ ____.

Answer 27

Tetanic contraction

Question 28

High voltage is defined as...

Answer 28

Greater than 1000 voltz

Question 29

Voltage is defined as...

Answer 29

The electromotive force in the system, thus the greater the voltage the more extensive the injury - this is dependent on resistance.

Question 30

What human body tissues offer the highest resistance? List them in decreasing order.

Answer 30

Bone, fat, tendon, skin, muscle, blood vessels, nerves.

Question 31

How do clinical manifestations of electrical burns differ from thermal burns?

Answer 31

- Direct effects on heart and nervous system - Electrical injury classically involves deep structures - Small entry and exit wounds do not indicate small extent of damage - Diversity of manifestations seen in electrical injury

Question 32

What is the most common dysrhythmia resulting from electrical injury?

Answer 32

Ventricular fibrillation

Question 33

Currents greater than 5 A cause...

Answer 33

Sustained cardiac asystole

Question 34

AC 30-200 mA will cause...

Answer 34

Ventricular fibrillation

Question 35

The energy from electricity is converted to...

Answer 35

Heat

Question 36

Arc burns are seen in...

Answer 36

External passage of the current from contact to the ground

Question 37

What are arc burns are associated with?

Answer 37

Extensive damage to skin and underlying tissue

Question 38

True or false: electrical burns always have two exit wounds

Answer 38

False - may have single or multiple exit wounds

Question 39

True or false: electrical burns are always full thickness burns

Answer 39

False - can by superficial, partial thickness, or full thickness

Question 40

TASER shocks result in...

Answer 40

Involuntary muscle contraction and overwhelming pain to the subject, causing them to fall to the ground

Question 41

True or false: if a current does not produce VF in 5 seconds, it will not produce VF after 1 minute.

Answer 41

True

Question 42

TASER darts should be removed unless they are embedded in which areas?

Answer 42

- Eyes - Genitals - Face - Neck

Question 43

Under which circumstances may TASERed pts be left in police care?

Answer 43

May be left with police unless: - Probes cannot be removed - Pt requires psychiatric evaluation - Injury assessment (other than probes) is required - Substances other than alcohol are involved - Abnormal 12 lead ECG - Abnormal BGL