Burns

Question 1

what is the immediate first aid response to burns caused by heat?

Answer 1

1. remove the person from the source
2. within 20mins of the injury irrigate the burn with cool water for between 10-30 minutes
3. cover the burn using cling film, layered, rather than wrapped around a limb

Question 2

what is the immediate first aid response to burns caused by electical source?

Answer 2

1. switch off power supply
2. remove the person from the source

Question 3

what is the immediate first aid response to burns caused by chemical source?

Answer 3

1. brush any powder off
2. irrigate with water

Question 4

assessing the extent of the burn

Wallace’s Rule of Nine

Answer 4

• head + neck = 9%
• each arm = 9%
• each anterior part of the leg = 9%
• each posterior part of the leg = 9%
• anterior chest = 9%
• posterior chest = 9%
• anterior abdomen = 9%
• posterior abdomen = 9%

Question 5

assessing the extent of the burn

lund and browder chart

Answer 5

most accurate method

Question 6

assessing the extent of the burn

palmar surface

Answer 6

palmar surface = 1% of total body surface area (TBSA)

not accurate for burns >15% TBSA

Question 7

what is the appearance of a superficial epidermal burn?

first-degree

Answer 7

red and painful

Question 8

what is the appearance of a partial thickness (superficial dermal) burn?

second-degree

Answer 8

pale pink, painful, blistered

Question 9

what is the appearance of a partial thickness (deep dermal) burn?

second-degree

Answer 9

• typically white but may have patches of non-blanching erythema
• reduced sensation

Question 10

what is the appearance of a full thickness burn?

third-degree

Answer 10

• white/brown/black in colour
• no blisters
• no pain

Question 11

what burns should be referred to seconday care?

Answer 11

• all deep dermal and full thickness
• superficial dermal burns >3% TBSA in adults and >2% TBSA in children
• superficial dermal burns on face, hands, feet, perineum, genitalia, flexure, torso, neck
• any inhalation injury
• any electrical or chemical injury
• suspicion of non-accidental injury

Question 12

what is the inital management of a superficial epidermal burn?

Answer 12

symptomatic relief - analgesia, emollients

Question 13

what is the initial management of superficial dermal burn?

Answer 13

• cleanse wound
• leave blister intact
• non-adherent dressing
• avoid topical creams
• review in 24 hours

Question 14

what is the pathophyiology of severe burns?

Answer 14

• local response with progressive tissue loss and release of inflammatory cytokines
• cardiovascular effects from fluid loss
• catabolic response
• immunosuppresion
• bacterial translocation from the gut lumen
• sepsis

Question 15

what airway emergency can occur followig smoke inhalation?

Answer 15

airway oedema

Question 16

when are IV fluids given in burns?

Answer 16

• children with >10% TBSA
• adults with >15% TBSA

Question 17

what is an escharotomy and when is it performed?

Answer 17

• careful divison of the encasing band of burnt tissue to improve ventilation or relieve compartment syndrome and oedema
• performed in circumferential full thickness burns to the torso or limbs