18 Questions
Which type of burn is characterized by charred, painless and insensitive skin?
Third-degree burn
What is the primary cause of a flash burn?
Exposure to natural gas, alcohol, or combustible liquids
Which type of burn is characterized by a mottled, red, and painful appearance with blisters?
Second-degree burn
Which type of burn involves the underlying tissues, such as muscles and bones?
Fourth-degree burn
What is the typical healing time for a second-degree burn?
14-21 days
Which of the following is considered a mild burn?
Partial thickness burn less than 15% in an adult or less than 10% in a child
What determines the severity of a burn injury?
Percentage of body surface area burned and depth of burn
Which of the following is NOT a potential complication of severe burns?
Hair loss
According to the Wallace Rule of Nine, how much body surface area does the outstretched palm and fingers represent?
9%
Which intervention is crucial in managing burn injuries to prevent contractures?
Provide Nutrition
What does the Wallace Rule of Nine help estimate in burn patients?
Percentage of body surface area burned
Compartment syndrome should be considered during the assessment of burns. What aspect of the patient should be evaluated to monitor compartment syndrome?
Perfusion in extremities
What is the recommended fluid of choice for fluid resuscitation in burn patients?
Ringer lactate
When should blood transfusion be considered in burn patients?
After 48 hours
What should the rate of colloids be used after the first 24 hours in burn patients?
0.35-0.5 ml/kg/% of burns
What is the minimum recommended urine output per hour in burn patients during fluid resuscitation?
30-50 ml/hr
When can Albumin 5% be used in burn patients?
To maintain serum albumin levels
What is the purpose of using antibiotic cream and gauze dressing in burn management?
To kill bacteria and protect the wound
Study Notes
Causes of Burns
- Thermal injury: scald, flame, flash burns, and contact with hot metals/objects/materials
- Electrical injury
- Chemical burns: acid/alkali
- Cold injury: frostbite
- Ionizing radiation
Classification of Burns
-
First-degree burn: • Involves epidermis only • Red and painful • No blisters • Heals rapidly in 5-7 days • By epithelialization without scarring
-
Second-degree burn: • Involves epidermis and dermis • Mottled, red, and painful • With blisters • Heals in 14-21 days • Superficial burn heals, causing pigmentation • Deep burn heals, causing scarring and pigmentation
-
Third-degree burn: • Involves full thickness of skin • Charred, painless, and insensitive • Thrombosis of superficial vessels • Requires grafting • Eschar is charred, denatured, and insensitive • Heals by re-epithelialization from wound edge
-
Fourth-degree burn: • Involves underlying tissues: muscles, bones
Classification of Burns by Percentage
-
Mild: • Partial thickness burn < 15% in adult or < 10% in children • Full thickness burn < 2% in adult or < 10% in children
-
Moderate: • Second-degree burn 15-25% in adult or 10-20% in children • Third-degree burn 2-10% in adult or > 10% in children
-
Major: • Second-degree burn > 25% in adult or > 20% in children • Third-degree burn > 10% in adult or > 10% in children • Burns involving eyes, ears, feet, hand, or perineum • All inhalational and electrical burns
Signs and Symptoms
- Blisters
- Pain
- Swelling
- White or charred skin
- Peeling skin
Complications
- Arrhythmia
- Dehydration
- Disfiguring scars and contractures
- Edema
- Organ failure
- Hypotension leading to shock
Assessment of Burns
- Burned surface area
- Depth of burn
- Wallace Rule of Nine: method to estimate burned surface area in adults and children
Management of Burns
- Stop the burning process
- ABCDE assessment
- Determine percentage area of burn (Rule of 9's)
- Good IV access and early fluid replacement
- Cool the area with tap water
- Clean and dress the wound
- Sedation and analgesia
- Assessment of percentage, degree, and type of burn for fluid management
- Chemoprophylaxis: tetanus toxoid, antibiotics, and local antiseptics
Fluid Resuscitation
- Ringer lactate is the fluid of choice
- Blood transfusion after 48 hours
- First 24 hours: crystalloids only
- After 24 hours: colloids like plasma, gelatin, and dextran
- Urine output: 30-50 ml/hr
- Albumin 5% to maintain serum albumin levels at 2 g/dl
- Sodium supplementation may be needed for burns > 20% BSA
Local Management
- Open Method: application of silver sulphadiazine without dressings
- Closed Method: with dressings to soothe and protect the wound
Learn about the causes and classification of burn injuries, including thermal, electrical, chemical, and cold burns. Understand the different categories based on the thickness of skin involved.
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