Burn Injury Medical Quiz
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Questions and Answers

How should the options in a multiple-choice question be structured?

  • All options should be similar in length
  • Options must be mutually exclusive (correct)
  • Options should reflect a single idea
  • At least one option should be obviously correct

What is a common mistake when creating distractors for a question?

  • Using definitive terminology (correct)
  • Using plausible alternatives
  • Including incorrect but similar ideas
  • Making distractors homogeneous in content

When should a stem be negatively stated?

  • When significant learning outcomes necessitate it (correct)
  • When the question is straightforward
  • When it reduces complexity
  • When it clearly enhances understanding

Which of the following guidelines should be followed regarding the correct answer?

<p>The correct answer must be mentioned in prior content (B)</p> Signup and view all the answers

What percentage of burn injuries occurs in the home?

<p>65% (A)</p> Signup and view all the answers

Which group represents the highest percentage of burn victims?

<p>Men (D)</p> Signup and view all the answers

Which type of burn injury is considered most preventable in children under 5?

<p>Scald injuries (D)</p> Signup and view all the answers

What is the mortality rate for elderly patients with burns greater than 40% TBSA?

<p>90% (B)</p> Signup and view all the answers

What percentage of burn cases is represented by individuals over 60 years of age?

<p>13% (C)</p> Signup and view all the answers

Which of the following factors increases the risk of burns in older adults?

<p>Chronic illnesses (B)</p> Signup and view all the answers

How many people with burn injuries receive medical treatment each year?

<p>500,000 (D)</p> Signup and view all the answers

Which burn injury is associated with the highest mortality rate?

<p>Inhalation injuries (C)</p> Signup and view all the answers

What is the characteristic healing time for a superficial burn?

<p>7 days (C)</p> Signup and view all the answers

Which type of burn destroys the entire dermis and may affect underlying muscle and bone?

<p>Full-thickness burn (C)</p> Signup and view all the answers

What is a common characteristic of a superficial partial-thickness burn?

<p>It has blisters with exposed red and moist dermis (B)</p> Signup and view all the answers

Which factor does NOT determine the depth of a burn?

<p>Level of pain experienced (D)</p> Signup and view all the answers

What distinguishes a deep partial-thickness burn from other types?

<p>It affects the reticular layer of the dermis and may result in permanent scarring. (A)</p> Signup and view all the answers

How does a full-thickness burn typically present in appearance?

<p>Charred or leathery with color variation (B)</p> Signup and view all the answers

What does the term 'spontaneous healing' refer to in terms of burn management?

<p>Healing that occurs only in superficial burns (C)</p> Signup and view all the answers

What crucial factor should nurses recognize about burn injuries?

<p>Damage may still occur even after exposure to the burn source ends (C)</p> Signup and view all the answers

What defines a minor burn injury for adults?

<p>Second-degree burn of less than 15% TBSA (C)</p> Signup and view all the answers

Which of the following constitutes a major burn injury?

<p>All third-degree burns 10% TBSA or more (C)</p> Signup and view all the answers

In which zone of burn injury is tissue completely destroyed?

<p>Zone of coagulation (B)</p> Signup and view all the answers

What percentage of TBSA defines a moderate, uncomplicated burn injury in adults?

<p>15-25% (C)</p> Signup and view all the answers

Which of the following is NOT considered an at-risk patient for burn injuries?

<p>Healthy adults (A)</p> Signup and view all the answers

What physiological response occurs when burns exceed 20% TBSA?

<p>Decreased myocardial contractility (A)</p> Signup and view all the answers

What is a common systemic response associated with burn shock?

<p>Loss of circulating plasma volume (B)</p> Signup and view all the answers

What is the primary systemic event in burn shock?

<p>Hemodynamic instability (C)</p> Signup and view all the answers

What is the main characteristic of the zone of coagulation in a burn injury?

<p>Area of cellular death (C)</p> Signup and view all the answers

Which of the following best describes the zone of stasis?

<p>Compromised blood supply and injury (C)</p> Signup and view all the answers

What complication is associated with delayed fluid resuscitation in patients with large burn wounds?

<p>Abdominal compartment syndrome (D)</p> Signup and view all the answers

What is the primary electrolyte solution used for fluid resuscitation in burn patients?

<p>Lactated Ringer's solution (A)</p> Signup and view all the answers

In burn shock, what physiological change leads to circulatory collapse if inadequately treated?

<p>Increased peripheral vascular resistance (A)</p> Signup and view all the answers

During the first 24-36 hours after a burn, what type of fluid shift primarily occurs?

<p>Fluid loss from the intravascular compartment (D)</p> Signup and view all the answers

What is the recommended range for intra-abdominal pressure (IAP) in patients with burn injuries?

<p>5-7 mm Hg (D)</p> Signup and view all the answers

What method is used to monitor intra-bladder pressure (IBP)?

<p>Bladder catheter and saline instillation (A)</p> Signup and view all the answers

What is the primary purpose of using a Foley catheter in burn patients?

<p>To drain urine from the bladder (B)</p> Signup and view all the answers

Which of the following conditions is associated with burn shock?

<p>Hypovolemic and distributive shock (B)</p> Signup and view all the answers

Which instrument is used to convert a physical quantity into a usable signal in burn management?

<p>Transducer (A)</p> Signup and view all the answers

What complication may arise from fluid resuscitation in burn patients?

<p>Compartment syndrome (C)</p> Signup and view all the answers

Why is the measurement of fluid input and output critical in burn patients?

<p>It ensures accurate fluid management (B)</p> Signup and view all the answers

What is a significant risk factor associated with severe lactic acidosis in burn patients?

<p>Decreased pH levels (A)</p> Signup and view all the answers

Which solution is used to provide lactate that can be metabolized into bicarbonate in burn patients?

<p>Ringer's lactate (B)</p> Signup and view all the answers

Which of the following describes a primary nursing alert when managing burn patients?

<p>Ensure accurate I&amp;O measurement (D)</p> Signup and view all the answers

What is the primary reason for monitoring carbon monoxide levels in patients with inhalation injuries?

<p>It assesses the competition between carbon monoxide and oxygen for hemoglobin binding. (D)</p> Signup and view all the answers

Which of the following symptoms indicates a higher level of carboxyhemoglobin, specifically in the range of 20-40%?

<p>Disorientation and visual impairment (C)</p> Signup and view all the answers

What is one limitation of pulse oximetry in carbon monoxide poisoning?

<p>It cannot distinguish between oxygenated hemoglobin and carbon monoxide-poisoned hemoglobin. (C)</p> Signup and view all the answers

Which factor is NOT typically assessed when diagnosing inhalation injuries?

<p>Urinary output volume (D)</p> Signup and view all the answers

Why is observation for at least 24 hours important in patients with suspected inhalation injuries?

<p>To detect potential pulmonary complications. (A)</p> Signup and view all the answers

What clinical intervention is essential to facilitate the removal of carbon monoxide from the body?

<p>Administration of 100% oxygen (C)</p> Signup and view all the answers

What symptom is associated with carboxyhemoglobin levels exceeding 60%?

<p>Death (C)</p> Signup and view all the answers

Which statement regarding the treatment of carbon monoxide poisoning is FALSE?

<p>Pulse oximetry is the definitive measure for assessing oxygen levels. (C)</p> Signup and view all the answers

What is the primary cause of acute tubular necrosis in burn patients?

<p>Hemoglobin and myoglobin occlusion in renal tubules (B)</p> Signup and view all the answers

Which of the following is a sign of renal dysfunction in burn patients?

<p>Pigmented urine (C)</p> Signup and view all the answers

What complication is associated with impaired thermoregulation in burn patients?

<p>Low body temperature initially (D)</p> Signup and view all the answers

During which phase of burn care is prevention of infection a priority?

<p>Acute/Intermediate phase (B), Emergent/Resuscitative phase (D)</p> Signup and view all the answers

A common gastrointestinal complication after a burn injury is:

<p>Paralytic ileus (C)</p> Signup and view all the answers

What is the typical urine output goal during fluid resuscitation in burn patients?

<p>2 mL/kg/hr (D)</p> Signup and view all the answers

What is a significant immunologic alteration after a burn injury?

<p>Impaired granulocyte and macrophage production (A)</p> Signup and view all the answers

Which nutrient support is essential during the acute phase of burn management?

<p>Protein (A)</p> Signup and view all the answers

Which phase of burn care focuses on psychosocial adjustment and vocational rehabilitation?

<p>Rehabilitation phase (C)</p> Signup and view all the answers

Which factor can contribute to increased mortality in burn patients with severe injuries?

<p>Combined inhalation injury with TBSA &gt; 60% (C)</p> Signup and view all the answers

What is the preferred method to extinguish flames on clothing?

<p>Drop to the ground and roll. (B)</p> Signup and view all the answers

Which of the following actions is NOT advised after extinguishing a burn?

<p>Apply ice or cold compresses directly to the wound. (C)</p> Signup and view all the answers

What should you do with any jewelry on a burn victim?

<p>Remove it immediately to prevent constriction. (A)</p> Signup and view all the answers

What is the initial step to take when caring for a chemical burn?

<p>Irrigate the burn with cool, clean water. (C)</p> Signup and view all the answers

What is the primary reason for covering a burn wound quickly?

<p>To minimize bacterial contamination and pain. (A)</p> Signup and view all the answers

Which symptom may indicate worsening conditions after a burn?

<p>Reducing urine output. (D)</p> Signup and view all the answers

What immediate action should be taken in the case of high-voltage electrical injuries?

<p>Immobilize the cervical spine. (D)</p> Signup and view all the answers

How should breathing be managed during initial burn care?

<p>Administer 100% humidified oxygen. (A)</p> Signup and view all the answers

What is a common physiological response observed after a burn?

<p>Tachycardia and slight hypotension. (A)</p> Signup and view all the answers

What should be done if a burn victim exhibits signs of cerebral hypoxia?

<p>Assess their neurological status and monitor closely. (A)</p> Signup and view all the answers

What is the minimum urinary output goal for adult patients during fluid resuscitation after a burn injury?

<p>0.5 to 1 mL/kg/hr (C)</p> Signup and view all the answers

Which method is used to determine the adequacy of fluid resuscitation in burn patients?

<p>Assessing vital signs and urine output (B)</p> Signup and view all the answers

Which of the following assessments is crucial for a patient with burn injuries?

<p>Determining the depth and extent of the burn (A)</p> Signup and view all the answers

What initial action should be taken once circulatory and respiratory functions are stable in a burn patient?

<p>Gather comprehensive patient history (D)</p> Signup and view all the answers

In what situation should a nasogastric tube be inserted for a burn patient?

<p>Patient is intubated or burn exceeds 20% TBSA (C)</p> Signup and view all the answers

What is the consequence of excessive fluid resuscitation in burn patients within the first 24 hours after injury?

<p>Potentially deleterious effects (A)</p> Signup and view all the answers

Which of the following electrolytes is likely to show excess levels in patients with burn injuries?

<p>Potassium (K+) (D)</p> Signup and view all the answers

What critical assessment must be included in the care of burn injuries regarding immunization?

<p>Tetanus prophylaxis status (A)</p> Signup and view all the answers

What immediate priority should be addressed following respiratory difficulties in burn management?

<p>Preventing irreversible shock (A)</p> Signup and view all the answers

Flashcards

Superficial Burn

Damages only the epidermis (outer skin layer).

Superficial Partial-Thickness Burn

Damages the epidermis and part of the dermis.

Deep Partial-Thickness Burn

Damages the deeper layers of the dermis; second-degree.

Full-Thickness Burn

Damages all skin layers, subcutaneous fat, and potentially underlying tissues.

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Burn Depth

Measured by how much of the dermis is affected.

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Burn Classification

Categorization based on burn depth and affected area.

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Causative Agent

The substance or event that caused the burn injury e.g. flame, scald, chemical, hot tar

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Duration of Contact (Burn Injury)

The length of time skin was subjected to a heat source, such as in scalding.

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Common burn etiologies

The most frequent causes of burns are flame and scald injuries.

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Common burn location

The majority of burn injuries happen at home, particularly in children under 5.

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Burn incidence rate

Approximately 500,000 people receive medical treatment for burn injuries each year, and about 3,000 deaths occur.

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Burn victim demographics

Males are more commonly affected by burns, and children under 5 and individuals over 60 constitute significant portions of the cases.

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Gerontologic burn risk

Older adults are more vulnerable to burns due to factors like reduced mobility, vision changes, and decreased sensation.

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Elderly burn complications

Elderly individuals have greater morbidity and mortality risk due to thinner, less elastic skin.

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Severe burn TBSA

Burns exceeding 40% of total body surface area (TBSA) in individuals over 60 have a high mortality rate.

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Common burn causes

Flame and scald injuries are the most frequent causes of burns.

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What are the most common burn causes?

Flame and scald injuries account for the majority of burn cases.

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Who is more vulnerable to burn injuries?

Children under 5 and adults over 60 are statistically more likely to sustain burn injuries.

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Zone of Coagulation

Area of cellular death caused by a burn injury. This zone represents the most severe damage.

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Zone of Stasis

Area of compromised blood supply and inflammation following a burn injury. Cells are in danger of dying.

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Zone of Hyperemia

The least damaged outer zone of a burn injury. This area has increased blood flow and redness.

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Abdominal Compartment Syndrome

Increased pressure within the abdomen that can compress organs and reduce blood flow. This is a serious complication of large burns.

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Intra-bladder Pressure (IBP)

Pressure inside the bladder, measured to assess abdominal compartment syndrome. High IBP can indicate the condition.

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Lactated Ringer's (LR) Solution

A type of intravenous fluid used for burn fluid resuscitation. It is a close substitute for blood plasma.

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Burn Shock

A severe complication of burns characterized by fluid loss, low blood volume, and decreased heart function.

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Burn Severity Classification

Divides burn injuries into minor, moderate, and major categories based on the extent and type of burn, and any additional complexities.

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TBSA Burn Percentage

Total body surface area (TBSA) burned, expressed as a percentage, is crucial for determining the severity of a burn injury.

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Special Care Areas in Burns

Areas like eyes, ears, hands, feet, perineum, and joints are considered 'special' due to their crucial functions and increased risk of complications.

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Burn Zones: Coagulation

The innermost zone of a burn, where tissue is completely destroyed and irreversible damage has occurred.

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Burn Zones: Stasis

The zone surrounding the zone of coagulation, where tissue is potentially salvageable if treated promptly.

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Burn Zones: Hyperemia

The outermost zone of a burn, where blood flow is increased due to an inflammatory response.

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Burn Shock: Hemodynamic Alterations

Burn shock is a life-threatening condition caused by fluid shifts and cardiovascular changes due to extensive burn injury.

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Burn Shock: Systemic Response

The systemic response to severe burns includes hemodynamic changes, fluid loss, and organ dysfunctions.

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What is needed for accurate I&O recording?

The amount of fluid instilled from the patient's urinary output is vital for accurate I&O (input and output) record.

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Compartment Syndrome

This occurs when pressure builds up within a muscle compartment, restricting blood flow and causing damage to the tissue. This can happen in burn patients due to swelling (edema) after fluid resuscitation.

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What's the main goal of Burn Shock treatment?

To reverse hypoperfusion (inadequate blood flow) by restoring fluid balance and addressing electrolyte imbalances.

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What is Lactic Acidosis?

A buildup of lactic acid in the blood due to lack of sufficient oxygen. Common in burn shock because of hypovolemia and hypoperfusion.

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What are you most concerned about with Lactic Acidosis?

Severe lactic acidosis (pH less than 7.2) is highly associated with a high mortality rate.

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How does the Lactate in Ringer's Lactate solution help?

Lactate in Ringer's lactate IV solution is metabolized into bicarbonate, which helps balance acidity.

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Why is patient liver function important in regards to Lactate?

The nurse must assess the patient's liver function to ensure efficient lactate metabolism into bicarbonate.

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Pulse Oximeter Limitation

Pulse oximeters measure oxygen saturation (SpOâ‚‚) but can't differentiate between oxygenated hemoglobin and carbon monoxide-bound hemoglobin. This can lead to inaccurate readings in carbon monoxide poisoning.

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Carboxyhemoglobin (COHb)

Carbon monoxide binds to hemoglobin, preventing oxygen from attaching. It has a much higher affinity for hemoglobin than oxygen, making it a serious threat.

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Inhalation Injury

Damage to respiratory tissues caused by inhaling hot gases, smoke, or steam. This causes inflammation, edema, and can lead to respiratory distress.

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Inhalation Injury Treatment

100% oxygen is crucial to remove carbon monoxide from the system. Pulse oximetry is used to monitor oxygen saturation, but readings may be inaccurate due to CO binding.

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Early Signs of Inhalation Injury

Indicators include a history of enclosed space burns, singed nasal hairs, hoarseness, or bloody sputum. Prompt observation and assessment are vital.

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Delayed Pulmonary Complications

Inhalation injury complications may not be immediately apparent. Careful observation for at least 24 hours is required to manage respiratory complications.

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Importance of Carbon Monoxide Monitoring

Pulse oximetry alone is insufficient in carbon monoxide poisoning. Carboxyhemoglobin levels need to be measured for accurate oxygen saturation assessment.

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Fiberoptic Bronchoscopy in Inhalation Injury

This procedure is used to directly visualize the airway and lungs, assess for damage, and collect samples for testing.

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ARDS and Burns

Acute Respiratory Distress Syndrome (ARDS) is a serious lung complication common in burn victims, especially with large burns and inhalation injury. It can dramatically increase mortality rate.

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Burn-Related Kidney Issues

Burns can cause kidney problems due to decreased blood volume and muscle damage releasing myoglobin and hemoglobin, which the kidneys try to filter. This can lead to acute tubular necrosis and kidney failure.

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Burn and Immune System

Burn injury weakens the immune system by impairing skin integrity, inflammatory responses, and production of immune cells, leading to increased susceptibility to infections.

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Temperature Regulation After Burns

Burn patients often experience temperature fluctuations, with initial low body temperature followed by hyperthermia, even without infection.

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Paralytic Ileus After Burns

A common gastrointestinal complication after burns where intestinal muscles stop moving, causing decreased peristalsis and potential bowel issues.

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Curling Ulcer

A stress ulcer in the stomach or duodenum caused by burn injury, leading to bleeding. It's a major gastrointestinal complication.

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Phases of Burn Care

Burn care is divided into three stages: emergent/resuscitative, acute/intermediate, and rehabilitation. Each phase has distinct priorities and overlaps with the others.

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Emergent/Resuscitative Phase

This initial phase of burn care focuses on stabilizing the patient, preventing shock, addressing airway issues, assessing the burn, and beginning infection control.

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Acute/Intermediate Phase

This stage focuses on wound healing, preventing infections, and addressing complications, while promoting nutrition and preventing scarring.

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Rehabilitation Phase

This final stage focuses on restoring function, minimizing scarring, and helping the patient return to their optimal physical and psychosocial well-being.

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Stop, Drop, and Roll

The immediate action to take if your clothes catch fire. This involves falling to the ground, covering your face, and rolling to extinguish the flames.

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Cool the Burn

After extinguishing the fire, immediately soak the burned area with cool water to reduce tissue damage and pain.

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Remove Restrictive Items

Remove clothing and jewelry from the burned area, except adherent clothing which should be left until cooled.

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Monitor Circulation After a Burn

Check the heart rate and blood pressure frequently after a burn. Look for signs of tachycardia and hypotension.

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Establish an IV Line

Administer fluids through an IV line inserted into a non-burned body part.

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Cover the Wound

Cover the burn with a sterile dressing, if available, or a clean cloth to prevent infection.

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Irrigate Chemical Burns

Immediately wash the burned area with copious amounts of cool, clean water to neutralize the chemical.

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Breathing Assessment

Assess breathing immediately and provide 100% humidified oxygen if needed.

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Immobilize the Cervical Spine

In high-voltage electrical injuries, immobilize the cervical spine to prevent further injury.

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Assess Neurological Status

Monitor the victim for signs of confusion, restlessness, or decreasing alertness, which could indicate brain injury.

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CABD

The initial priority in the emergency department for burn victims, referring to airway, breathing, circulation, and disability.

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TBSA

Total Body Surface Area, a measurement used to estimate the extent of a burn injury.

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Why is IV analgesia preferred for burn patients?

IV analgesia, typically morphine, is used due to poor tissue perfusion accompanying burns, ensuring effective pain management.

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Nasogastric (NG) tube in burns

An NG tube is inserted for burn patients with >20% TBSA or those intubated to prevent vomiting and decompress the abdomen.

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What are the key parameters for monitoring fluid resuscitation?

Vital signs (heart rate, blood pressure) and urine output are primary indicators of fluid resuscitation effectiveness.

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Urine output goals for fluid resuscitation

Urine output goals are 0.5-1 mL/kg/hr for adults and 1 mL/kg/hr for children to ensure adequate renal perfusion.

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What are the signs of dehydration in burn patients?

Generalized dehydration, reduced blood volume, decreased urinary output, potassium excess, sodium deficit, metabolic acidosis, and hemoconcentration are signs of fluid loss.

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When might IV fluid administration be decreased?

If urine output exceeds 50 mL/hr within the first 24 hours, IV fluid administration may be decreased to prevent complications.

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Why is a burn center referral sometimes needed?

The severity of the burn (depth and extent) determines if transfer to a burn center is necessary for specialized care.

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What is the most urgent need after managing respiratory difficulties in a burn patient?

Preventing irreversible shock by replacing lost fluids and electrolytes is the most urgent need after airway and breathing are addressed.

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