Burns pt1 Exam 1

Question 1

List the types of burns (5)

Answer 1

• Heat
• Electrical
• Friction
• Chemical
• Radiation

Question 2

Depth of thermal injury related to? (3)

Answer 2

• Contact temperature
• Duration of contact
• Thickness of skin

Question 3

Heat burns usually involve which layers of tissue?

Answer 3

epidermis and dermis

Question 4

Name the 4 most common examples of heat burn

Answer 4

• Flame
• Hot liquid
• Hot solid
• Steam

Question 5

Electrical energy transformed to heat when current passes through body tissue is classified as what type of burn?

Answer 5

Electrical Burn

Question 6

Electrical Burns disrupts?

Answer 6

Cell membrane potential

Question 7

The magnitude of electrical burn damage depends on? (3)

Answer 7

• Pathway of current
• Resistance to current flow
• Strength and duration of current flow

Question 8

What is the major difference between electrical and thermal burns

Answer 8

Electrical burns often involve cardiac injury

Question 9

What are friction burns?

Answer 9

Combo of mechanical disruption and heat generated by friction

Question 10

What are the caustic reactions of chemical burns? (3)

Answer 10

• PH alteration
• Disruption of cell membranes
• Direct toxic effect on metabolic process

Question 11

The magnitude of chemical burns are related to?

Answer 11

• Duration of exposure
• Nature of agent

Question 12

Acid causes tissue necrosis via ______.
Alkali causes tissue necrosis via ______

Answer 12

• Coagulation
• Liquefaction

Question 13

Radiation burns cause what type of damage?

Answer 13

Ionization

Question 14

Radiation magntiude depends on?

Answer 14

• Dose and time of exposure
• Types of particles

Question 15

Most common examples of radiation burns? (4)

Answer 15

• Sunburns
• Therapeutic radiation
• Diagnostic procedures
• Nuclear industry workers

Question 16

Burns take about ____ hours to fully declare themselves

Answer 16

24-48

Question 17

What age group have deeper burns from less exposure and less intensity due to the thin skin?

Answer 17

• Adults >55
• Kids <5

Question 18

Describes what degree of burn:

• Involving only the epidermis
• red in color
• dry, no blisters
• hypersensitive

Answer 18

1st degree superficial burn

Question 19

Superficial 1st Degree Burns heal in approximately how many days?

Answer 19

3-6 days

Question 20

What are the characteristics of a Superficial Partial Thickness (2nd Degree) Burn?

Answer 20

• Involves the epidermis and part of dermis
• Mottled red color
• Blisters or weeping
• Very painful / nerve endings exposed
• Small burns usually heal in 10 – 14 days
• Minimal scarring

Question 21

What burn category is not counted in the TBSA (Total Burn Surface Area) ?

Answer 21

1st degree (superficial) burns

Question 22

What are the characteristics of a Deep Partial Thickness (2nd Degree) Burn?

Answer 22

• Extends more deeply into the dermis
• Decreased moisture
• Destroyed sweat glands + Impaired tissue integrity
• Difficulty regulating body temperature
• Pale in color – Usually a white/pinkish color
• Absent or prolong blanching – No cap refill, stays blanched for quite a while
• Healing in 21-28 days

Question 23

At what point is skin grafting typically required?

Answer 23

Deep partial thickness burns

Question 24

What are the characteristics of a Full Thickness (3rd Degree) Burn?

Answer 24

• Dermis and epidermis are destroyed
• Translucent, dry, painless, charred
• Non-blanching
• Requires grafting or amputation

Differences in deep partial and full thickness is subtle and often hard to tell the exact transition areas in early hours.

Question 25

Compare and Contrast the various degrees of burn injuries.

Answer 25

Question 26

What is the most painful burn?

Answer 26

Superficial Partial Thickness (2nd Degree Burn)

Question 27

What is the Rule of nines in adults?

Answer 27

* Head 9% (full head) * Each arm 9% (4.5% front/back) * Each leg 18% (9% front/back) * Ant/Post trunk each 18% (9% upper/lower) * Perineum 1%

Question 28

The rule of nines is approximately ________ accurate. Why?

Answer 28

60-70% D/t varying depths

Question 29

What is the pediatric version of the rule of nines?

Answer 29

* Head 21% * Arms 10% * Back 13% * Chest 13% * Legs 13.5% * Butt 5% * Perineum 1%

Question 30

What is the Palmer method?

Answer 30

TBSA used for **patient's palm** with fingers together = 1%

Question 31

Larger burn surface areas are often overestimated. T/F?

Answer 31

False. They are underestimated

Question 32

Women with large breasts have a _____

Answer 32

larger surface area than what was accounted for and may be disproportionate

Question 33

Fluid losses secondary to burns are a function of ____ and ____.

Answer 33

* Burn size * Patient weight

Question 34

Patients with ____ TBSA will develop burn shock and need IV resuscitation in an ICU.

Answer 34

>20%

Question 35

An under fluid resuscitated patient is at risk for what?

Answer 35

↓ perfusion, burn shock, end organ failure

Question 36

An overly fluid resuscitated patient is at risk for what?

Answer 36

- Abdominal compartment syndrome - Pulmonary edema/ARDS

Question 37

List the 5 effects of auto-cannibalism.

Answer 37

* Loss of fat (Lipolysis) * Loss of lean body mass (proteolysis) * Gluconeogenesis * Hypermetabolism * Insulin resistance .

Question 38

The Intensity and duration of auto-cannibalism depends on which two factors?

Answer 38

* Magnitude of injury * Degree of pain (leads to tachycardia and HTN, thus ↑ metabolism)

Question 39

What happens to the metabolic rate in a >40% BSA burn?

Answer 39

Metabolic rate **doubles**.

Question 40

The effects of auto-cannibalism may last how long?

Answer 40

Months ## Footnote Immunodepression, recurrent infections, poor wound healing will also be seen