Burns

Question 0

Rule of 9’s - Body surface affected

Answer 0

Head and each arm = 9%
Back and chest each = 18%
Each leg = 18%
Perineum = 1%

Surface area of hand = 1% body surface

Question 1

Classification

Answer 1

“Flames Can Cause Excessive Scars”

• Flame burns
• Chemical burns
• Contact burns
• Electric injury
• Scald burns

Question 2

Parkland’s Formula

Answer 2

4ml/kg x % body surface affected = fluid resuscitation
First half in 8hrs, second half in next 16hrs

eg. 100kg pt with 40% burns

4ml x 100kg x 40% = 16 000ml in 24hrs

Question 3

Management

Answer 3

• Weigh pt
• Determine body surface area affected
• Calculate fluid resuscitation
• First 24hrs = crystalloid (ringers lactate)
• Next 24hrs = maintenance fluid + colloid (0.3-0.5ml/kg/%BSA)

Question 4

Signs of inhalation injury

Answer 4

• High index of suspicion
• Hx of flame burns or burns in enclosed spaced
• Deep dermal or full thickness burns to face, neck or upper torso
• Singed nasal hairs
• Carbonaceous sputum or carbon particles in oropharynx

Question 5

Classification of Burn Depth

Answer 5

• Full thickness: extend through all layers into subcutaneous tissue
• Partial thickness: do not extend through all skin layers
  
  • Superficial
  • Superficial dermal
  • Deep dermal

Question 6

Acute management of burn in child under 5

Answer 6

• Secure airway if suspected inhalation burns
• Replace fluid losses –> IV Ringer’s lactate and dextrose infusions
• Irrigate burn with water at 17*C for 20 mins
• Monitor fluid input and output
• Cover with burnshield or Gelonet dressing for first 24hrs
• Analgesia

Question 7

Types of burns and how to differentiate between them

Answer 7

• Superficial: red, no blistering
• Partial thickness: red, hypo-pigmented, blistering
• Full thinkness: thick and leathery
• Complete: burn through to muscle or bone

Question 8

How to assess the size of a burn

Answer 8

• Depth

- Surface area