burns management

Question 1

What is the first step in prehospital burn care?

Answer 1

Ensure scene safety.

Question 2

How should thermal burns be cooled?

Answer 2

Cool with tepid/lukewarm water.

Question 3

What type of dressing should be applied?

Answer 3

Wet dressing (dry dressing may stick).

Question 4

What should be done for chemical burns?

Answer 4

Remove particles and contaminated clothing.

Question 5

What should be done for electrical burns?

Answer 5

Remove electrical source.

Question 6

What else should you do?

Answer 6

Call for help; anticipate professional care.

Question 7

Should you apply butter?

Answer 7

No — it is oil-based and worsens burns.

Question 8

Should you douse burns in water?

Answer 8

No.

Question 9

Should you apply ice?

Answer 9

No.

Question 10

Should you apply ointments or sprays?

Answer 10

No antiseptics, pain relievers, first-aid creams.

Question 11

Why avoid oil-based creams?

Answer 11

They worsen burns and must be removed in the ED.

Question 12

What causes fluid shifts in the emergent phase?

Answer 12

Capillary permeability → intravascular to interstitial fluid shift.

Question 13

What type of shock can develop?

Answer 13

Burn shock/hypovolemic shock.

Question 14

What VS and lab changes occur in emergent phase?

Answer 14

Hypotension, tachycardia, tachypnea, elevated Hct.

Question 15

What complications may occur in emergent phase?

Answer 15

AKI, death if fluid resuscitation inadequate.

Question 16

What is the first priority in emergent burn care?

Answer 16

ABCs.

Question 17

Why give 100% O2?

Answer 17

Airway may be compromised or inhalation injury suspected.

Question 18

When is intubation needed?

Answer 18

If airway compromised.

Question 19

What labs should be obtained in emergent phase?

Answer 19

ABG & carboxyhemoglobin.

Question 20

What imaging is necessary?

Answer 20

Chest X-ray.

Question 21

What clothing should be removed?

Answer 21

Only non-adhered clothing.

Question 22

When are two large-bore IVs required?

Answer 22

TBSA >20%.

Question 23

When is a Foley catheter inserted?

Answer 23

TBSA >20%.

Question 24

Why elevate burned limbs?

Answer 24

Reduce edema.

Question 25

What should be monitored for emergent phase?

Answer 25

VS, O2, LOC, heart rhythm.

Question 26

What is the Parkland formula?

Answer 26

4 mL × kg × TBSA % = LR in first 24 hrs.

Question 27

How is the fluid divided?

Answer 27

½ in first 8 hrs, ¼ in second 8 hrs, ¼ in third 8 hrs.

Question 28

What is a major burn requiring aggressive fluids?

Answer 28

>20% TBSA.

Question 29

Example: fluid for 70 kg, 50% TBSA?

Answer 29

14,000 mL in 24 hrs.

Question 30

When does the acute phase begin?

Answer 30

When fluid mobilizes and diuresis begins.

Question 31

When does the acute phase end?

Answer 31

When wounds are almost healed.

Question 32

What improves in acute phase ?

Answer 32

Oxygenation (unless inhalation injury); vitals stabilize.

Question 33

What begins in acute phase?

Answer 33

Wound healing.

Question 34

What causes hyponatremia?

Answer 34

Excess GI suction, diarrhea, excess water intake.

Question 35

What causes hyperkalemia?

Answer 35

Renal failure, adrenocortical insufficiency, deep muscle injury.

Question 36

What causes hypokalemia?

Answer 36

Vomiting, diarrhea, excessive GI suction.

Question 37

When does the rehab phase begin?

Answer 37

When wounds are nearly healed and patient can perform self-care.

Question 38

How long can rehab last?

Answer 38

2 weeks to 8 months.

Question 39

What are rehab goals?

Answer 39

Regain functional role, rehab from function loss, postburn cosmetic surgery.