Burns ☺️

Question 1

Immediate first aid

• heat burns
• electrical burns
• chemical burns

Answer 1

A-E assessment
Heat
-remove person from source
-irrigate with cool water for 10-30mins
-cover with layers of clingfilm

Electrical

• switch off power supply
• remove person from source

Chemical
-brush powder off, irrigate with water

Question 2

Assessing the extent of burn

-rule of 9s

Answer 2

H+N = 9
Front of both arms = 9
Back of both arms = 9
Front of both legs = 18
Back of both legs = 18
Front of chest = 9
Back of chest = 9
Front of abdo = 9
Back of abdo = 9

Question 3

Assessing the depth of burn

• 1st degree/superficial epidermal
• 2nd degree/partial thickness (sup dermal)
• 2nd degree/partial thickness (deep dermal)
• 3rd degree/full thickness

Answer 3

Superficial epidermal/1st deg
-red, painful

Partial thickness/sup dermal/2nd degree
-pale pink, painful, blistered

Partial thickness/deep dermal/2nd degree

• cherry red
• dull sensation

Full thickness/3rd degree

• white
• no blisters, no pain

Question 4

Primary care management of burns

-when to refer to secondary care

Answer 4

Immediate management

1. counteract temp
2. cover with layers of clingfilm to protect from contamination from outside and reduce nerve exposure to air

Epidermal - analgesia

Superficial dermal U3% TBSA - clean burn, leave blister alone, non adherent dressing, avoid creams

Refer

• SD burns of face, hands, feet, perineum, genitalia, flexures, circumferential burns of limbs, torso, neck
• inhalation injury
• electrical or chemical burns
• non accidental injury
• DD, FT, SD 3%+

Question 5

Pathophysiology of severe burns

Answer 5

Inflammatory response => fluid loss + fluid mv into third space => severe hypovolemia

Immunosuppression from burn => sepsis

Question 6

Secondary care management of severe burns

Answer 6

A-E

10%+ TBSA/complex/hand, perineum, face burns => burns unit

15%+ TBSA => IV fluids + urinary catheter + analgesia
Parkland formula = 4(TBSA x kg)
-1/2 volume in 8hrs

Circumferential FT affecting limb/torso impeding breathing => escharotomy
-divide encasing band of tissue to relieve compartment syndrome/edema/breathing

Conservative
Excision and skin grafting