8-Burns

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Questions and Answers

What is the significance of the Zone of Hyperemia in burn assessment?

It indicates healthy tissue regeneration.

It represents areas with superficial blood flow.

It refers to the inflamed edges of the wound. (correct)

It shows the effectiveness of burn resuscitation.

In managing burn victims, what factors determine the continuation of fluid volume administration?

Time since injury, urine output, and mean arterial pressure. (correct)

Patient age and burn percentage of body surface area.

Skin temperature and wound depth.

Severity of pain and patient hydration status.

What condition may develop during the post-burn phase after 48-72 hours?

Hypovolemic shock.

Acute renal failure.

Septic shock.

Pulmonary edema. (correct)

What should be prioritized after 48-72 hours of burn treatment?

Shift to colloid administration. Signup and view all the answers

Why do children under 20 kg require special consideration in burn management?

They lack sufficient glycogen stores to maintain adequate glucose levels. Signup and view all the answers

What is a potential consequence of inadequate fluid resuscitation in burn patients?

Respiratory failure. Signup and view all the answers

What does the capillary leak phenomenon imply in burn patients?

Fluid has excessive leaked into the interstitium. Signup and view all the answers

What is a key endpoint for fluid resuscitation in burned patients?

Achieving urine output above 0.5 mL/kg/hour. Signup and view all the answers

What is the main purpose of assessing the Total Burn Surface Area (TBSA) in burn patients?

To calculate fluid resuscitation needs Signup and view all the answers

What differentiates 'breathing' from 'circulation' in the context of emergency assessment?

Breathing relates to the entry of air, while circulation relates to blood flow Signup and view all the answers

Which type of burn is most commonly associated with hospital admissions?

Flame burns Signup and view all the answers

Which of the following statements regarding burn classifications is correct?

Partial-thickness burns include blisters Signup and view all the answers

What fundamental principle applies regarding exposure time and burn severity?

Higher temperatures result in faster tissue destruction regardless of exposure time Signup and view all the answers

Which type of burn is characterized by leathery texture and non-blanching properties?

Full Thickness (Third degree) Signup and view all the answers

What is the hallmark characteristic of a fourth-degree burn?

Dry, brittle, desiccated bone Signup and view all the answers

In the event of an electrical injury, what is the recommended baseline assessment?

Baseline ECG Signup and view all the answers

What is the gold standard treatment for carbon monoxide poisoning?

100% normobaric oxygen Signup and view all the answers

What percentage of adults are reported to have a normal ECG in the case of low-voltage injury?

25% Signup and view all the answers

What factor increases the mortality risk in burn patients with smoke inhalation?

Total Body Surface Area (TBSA) burns greater than 20% Signup and view all the answers

Which type of burn is defined as having pale and tense skin?

Deep Partial Thickness Signup and view all the answers

Which presentation is consistent with cyanide toxicity?

Persistent lactic acidosis Signup and view all the answers

Which statement about hydrogen cyanide toxicity diagnosis is correct?

ST elevation on ECG is a potential indicator. Signup and view all the answers

What condition is NOT associated with electrical injuries?

Respiratory distress Signup and view all the answers

What is the primary mechanism by which cyanide exerts its toxic effects?

Inhibition of Cytochrome Oxidase Signup and view all the answers

For which type of burn is referral to a burn center recommended when it exceeds 10% TBSA?

Partial-thickness Signup and view all the answers

Which statement about burns and exposure time is true?

Increased temperature decreases the time required for tissue destruction. Signup and view all the answers

What is the expected outcome of administering Hydroxocobalamin in cyanide poisoning?

Formation of non-toxic thiocyanate Signup and view all the answers

What is the main concern with necrotic tissue in burn patients?

It can lead to further infection and septic processes Signup and view all the answers

How does smoke inhalation complicate treatment outcomes for burn patients?

It is correlated with a higher chance of pneumonia. Signup and view all the answers

What is the effect of carbon monoxide on its half-life when treated with normobaric oxygen?

It reduces to 60 minutes. Signup and view all the answers

What percentage of fluid should be administered in the first eight hours after a burn?

33% Signup and view all the answers

What is the affinity of carbon monoxide for hemoglobin compared to oxygen?

It is 200-250 times greater than oxygen Signup and view all the answers

What type of symptoms should raise suspicion for inhalation injury in burn patients?

Unexpected neurologic or cardiac symptoms Signup and view all the answers

Why can pulse oximetry be falsely elevated in cases of carbon monoxide poisoning?

It cannot detect levels of carboxyhemoglobin Signup and view all the answers

What role does carbon monoxide (CO) poisoning play in burn patients?

It contributes to increased mortality Signup and view all the answers

Which condition is NOT associated with increased mortality in burned patients?

Skin grafting Signup and view all the answers

At what point should the calculation for fluid administration begin after a burn injury?

At the time of injury Signup and view all the answers

What is considered an absolute indication for intubation in burn victims?

Burned vocal cords Signup and view all the answers

Why is fluid resuscitation particularly important in burn patients?

To prevent renal failure due to hemoglobin and myoglobin deposits Signup and view all the answers

What should the target urine output be maintained at for adults after a burn injury?

75-100cc/hr Signup and view all the answers

Which of the following is a common complication associated with inhalation burns?

Immediate death from anoxia Signup and view all the answers

What is the role of silver sulfadiazine in burn treatment?

Primarily as a prophylaxis against burn wound infections Signup and view all the answers

How does overfeeding in burn patients affect their recovery?

It promotes fat storage instead of muscle anabolism. Signup and view all the answers

What condition could occur as a result of circumferential chest burns?

Escharotomy may be required Signup and view all the answers

What is a common ECG change that may happen after a burn injury?

Delayed rhythm abnormalities Signup and view all the answers

Study Notes

Burn Patient Initial Evaluation

Initial evaluation of a burned patient follows the same priorities as any trauma patient, starting with ABCDE: Airway, Breathing, Circulation, Disability, Exposure.
In children under 3, the head has a proportionally larger surface area and needs to be considered when evaluating burn size.
The Lund and Browder chart is more accurate than the "rule of nines" for assessing burn size, especially in children and odd-shaped burns.
The "rule of the palm" is a useful quick guide; the surface area of the patient's palm, including fingers, is approximately 1% of total body surface area (TBSA).

Burn Classification

Most burns are thermal, with causes like flames, contact, or scalds. Flame burns are commonly associated with hospital admission for burns and have a higher mortality rate.
Electrical burns can cause cardiac arrhythmias and renal problems, and compartment syndrome and rhabdomyolysis are common.
Chemical burns necessitate immediate removal of the chemical, followed by copious water irrigation. Formic acid causes hemolysis and hemoglobinuria; hydrofluoric acid requires calcium-based therapies.

Burn Depth

Superficial (first-degree): painful, no blistering, redness, and usually heals on its own. Sunburns are an example.
Partial-thickness (second-degree): reddening, blisters, and pain. Superficial partial-thickness burns are redder in color, while deep partial-thickness burns are pale, tense, and moist.
Full-thickness (third-degree): non-blanchable, leathery, and painless; requires skin grafting.
Fourth-degree: penetrates through muscle to bone; causes charring. Fifth- and sixth-degree burns are less common.

Burn Fluid Resuscitation

Parkland or Baxter formulas are commonly used, calculating initial fluid resuscitation needs based on total body surface area (TBSA) burned and patient weight.
The initial 50% is administered within the first 8 hours, followed by the remaining 50% over the next 16 hours.
Fluid resuscitation is adjusted using factors like urine output and MAP.
Children under 20kg have additional fluid requirements for glucose maintenance.

Inhalation Injury and CO Poisoning

Inhalation injuries are a significant concern in burn patients, often leading to elevated mortality.
CO poisoning frequently accompanies inhalation injuries, as CO has a high affinity for hemoglobin, displacing oxygen.
Treatment involves administering 100% normobaric oxygen, which reduces CO's half-life.

Complications

Compartment syndrome may follow severe burns, requiring fasciotomies.
Pulmonary complications, like edema, pneumonia, and acute respiratory distress syndrome (ARDS), are possible.
Deep vein thrombosis (DVT) and pulmonary embolism are potential complications, necessitating prophylactic heparin therapy.
Hypocalcemia can occur, requiring careful monitoring.

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Description

This quiz focuses on the initial evaluation and classification of burn patients. It covers important assessment priorities, burn types, and evaluation methods such as the Lund and Browder chart. Get ready to test your knowledge on managing burn injuries effectively.