A 70 kg man comes in with 40% TBSA burns, how 4 x 70 x 40 =11,200 (11.2 L) over 24 hrs
much fluid do u give him? - 5.6 L in first 8 hrs and 5.6 L over next 16 hrs
Are there routine labs for a simple retinal No unless other comorbidities are present
detachment or CRVO?
For wounds for soft tissue trauma, when should AFTER neurovascular and tendon function is checked
anesthesia be given?
,How are burns classified? 1st degree: epidermis involved, looks like sunburn
- features: red, dry, painful, blanches w pressure, NO BL
- healing: 3-6 days and no scar
2nd degree: epidermis + some dermis
- superficial partial thickness: blisters form, moist, weepi
blanches; heals in 2-3 weeks
- deep partial thickness: pale or mottled, some blisterin
blanching, less painful; may need graft to heal and high
scarring
3rd degree: epidermis and dermis destroyed
- features: leathery, dry, charred, not painful, no blanchi
- healing: needs graft
4th degree: all the way through skin to muscle, fat, bone
- features: eschar, painless, loss of muscle or bone
- healing: needs surgery or amputation
,How are FB and bites managed in the ED? FB:
- remove if safe
- X-RAY for glass/metal, US for wood/plastic
Bites:
Dog = crush/tear → get X-RAY
Cat = puncture → high infx risk
Human = high infx risk
Prophylaxis:
- rabies & tetanus
- amoxicillin clavulanate
, How can Neuroleptic Malignant Syndrome be Onset:
differentiated from Seratonin Syndrome? - SS = acute
- NMS = more gradual
Neuro signs:
- SS = hyperreflexia, clonus, tremor
- NMS = hyperreflexia, lead pipe rigidity
Pupils:
- SS = dilated
- NMS = normal
GI:
- SS = diarrhea
- NMS = normal
How does TBSA for burns translate to < 10% = outpatient
management? > 10% = burn center
much fluid do u give him? - 5.6 L in first 8 hrs and 5.6 L over next 16 hrs
Are there routine labs for a simple retinal No unless other comorbidities are present
detachment or CRVO?
For wounds for soft tissue trauma, when should AFTER neurovascular and tendon function is checked
anesthesia be given?
,How are burns classified? 1st degree: epidermis involved, looks like sunburn
- features: red, dry, painful, blanches w pressure, NO BL
- healing: 3-6 days and no scar
2nd degree: epidermis + some dermis
- superficial partial thickness: blisters form, moist, weepi
blanches; heals in 2-3 weeks
- deep partial thickness: pale or mottled, some blisterin
blanching, less painful; may need graft to heal and high
scarring
3rd degree: epidermis and dermis destroyed
- features: leathery, dry, charred, not painful, no blanchi
- healing: needs graft
4th degree: all the way through skin to muscle, fat, bone
- features: eschar, painless, loss of muscle or bone
- healing: needs surgery or amputation
,How are FB and bites managed in the ED? FB:
- remove if safe
- X-RAY for glass/metal, US for wood/plastic
Bites:
Dog = crush/tear → get X-RAY
Cat = puncture → high infx risk
Human = high infx risk
Prophylaxis:
- rabies & tetanus
- amoxicillin clavulanate
, How can Neuroleptic Malignant Syndrome be Onset:
differentiated from Seratonin Syndrome? - SS = acute
- NMS = more gradual
Neuro signs:
- SS = hyperreflexia, clonus, tremor
- NMS = hyperreflexia, lead pipe rigidity
Pupils:
- SS = dilated
- NMS = normal
GI:
- SS = diarrhea
- NMS = normal
How does TBSA for burns translate to < 10% = outpatient
management? > 10% = burn center
