Burns

Question 1

Main causes of early death in burns (<48 hours)

Answer 1

Shock and/or inhalation injury

Question 2

Main causes of death in burns (>48 hours)

Answer 2

Multi-organ failure & sepsis

Question 3

According to ABA Severity Grading System, what is a major burn?

Answer 3

2° burn, >20% TBSA (adult) or 10% (age extremes)

3° burn, > 10% TBSA (adult)

All electrical burns

All with inhalation injury (regardless of degree)

Question 4

If patient age + %TBSA is >? = >80% mortality

Answer 4

115
Mortality doubles with added inhalation injury!

According to National Burn Registry*

Question 5

Types of burn injuries

Answer 5

1. Chemical
2. Electrical
   - Damage concentrated at entry & exit wounds
   -Major internal tissue damage not seen
   - Significant electrical burn –> myoglobin –> risk of renal failure
3. Thermal (Heat, Flame, Scald)
4. Inhalational

Question 6

Inhalation injury should be _____ until ruled out

Answer 6

Suspected

Question 7

Inhalation injury classification

Answer 7

Upper airway (a/w), lower a/w or metabolic asphyxiation (carbon monoxide or cyanide).

Question 8

Inhalation injury protective mechanism

Answer 8

Heat in upper airway is dissipated but causes reflex laryngospasm. So, lower airway damage is uncommon.

Question 9

Lower airway damage is rare but if there is some it is related to what?

Answer 9

toxins

Question 10

Inhalation injury warning signs

Answer 10

Hoarseness, sore throat, dysphagia, hemoptysis, tachypnea, respiratory distress, elevated carbon monoxide levels

Question 11

Burn treatment: airway exam gold standard

Answer 11

Direct visualization via laryngoscopy or fiberoptic bronchoscopy (FOB)

Question 12

If upper airway damage is present, _____ intubation is indicated

Answer 12

EARLY (even when asymptomatic)

Question 13

When should you avoid Sch in burns?

Answer 13

> 24 hours post-injury