PBL 27

Question 1

Describe the characteristics of a 1st degree burn:

1. Layers involved
2. Appearance
3. Texture
4. Sensation
5. Healing time

Answer 1

1. Epidermis
2. Red without blisters
3. Dry
4. Painful
5. 5-10 days

Question 2

Describe the characteristics of a 2nd degree superficial burn:

1. Layers involved
2. Appearance
3. Texture
4. Sensation
5. Healing time

Answer 2

1. Epidermis and papillary dermis
2. Red with clear blister. Blanches with pressure
3. Moist
4. Very painful
5. Less than 2-3 weeks

Question 3

Describe the characteristics of a 2nd degree deep burn:

1. Layers involved
2. Appearance
3. Texture
4. Sensation
5. Healing time

Answer 3

1. Epidermis and reticular dermis
2. Yellow or white
3. Dry
4. Pressure and discomfort. Minimal pain to touch
5. 3-8 weeks

Question 4

Describe the characteristics of a 3rd degree burn:

1. Layers involved
2. Appearance
3. Texture
4. Sensation
5. Healing time

Answer 4

1. Epidermis and entire dermis
2. Stiff and white/brown. No blanching
3. Leathery (eschar forming = leathery dead tissue)
4. Painless
5. Prolonged (months) and incomplete

Question 5

Describe the characteristics of a 4th degree burn:

1. Layers involved
2. Appearance
3. Texture
4. Sensation
5. Healing time

Answer 5

1. Epidermis, dermis and underlying fat, muscle and bone
2. Black, charred with eschar (dead tissue)
3. Dry
4. Painless
5. Required excision

Question 6

Treatment of different degree burns

Answer 6

1st: cream & antibiotic ointment & pain meds
2nd: Antibiotic cream & prescribed ointments

3rd & 4th: More intensive treatments such as IV antibiotics to prevent infection or IV fluids to replace fluids lost when skin was burned. May also need skin grafting or use of synthetic skin

Question 7

Burn calculation equation? What is it used for? How is burn percentage estimated?

Answer 7

Parkland formula AKA Baxter formula
- Used to estimate the amount of replacement fluid required for the first 24hours in a burn patient

• V (mL) = 4 x body weight x burn percentage (body SA affected by burns)
• Burn percentage is estimated by Wallace rule of 9s in adults: 9% for each arm, 18% for each leg, 18% for front torso, 18% for back torso, 9% for head, 1% for perineum
• Burn percentage in children: 9% for each arm, 14% for each leg, 18% front torso, 18% back torso, 18% for head
• First half is given after 8 hours, and the remaining is given over the next 16 hours