ATLS Module 9 - Thermal Injuries
QUESTIONS AND ANSWERS
1. American burn affiliation diagnosis necessities for inhalation harm - ANSWER-publicity
to flamable agent and signs and symptoms of publicity to smoke in lower airway,
beneath vocal cords, seen on bronchoscopy
2. are burns considered clean? - ANSWER-fresh burns are easy regions that ought to
be protected from contaminations
*if it burns the skin, it burns the micro organism
purple textual content
3. are prophylactic antibiotics important in early postburn length? - ANSWER-now not
except required for different accidents
*reserve use of antibiotics for tx of contamination
4. direct thermal injury to decrease airway is uncommon... When does is basically occur? -
ANSWER-simplest after exposure to superheated steam or ignition of inhaled
flammable gases
crimson textual content
5. electric burns often are extra severe than they appear on the frame surface... How do
the currents travel? - ANSWER-contemporary travels inner blood vessels and
nerves and may reason nearby thrombosis and nerve injury
*intense injuries generally reason extremity contracture
*extremities, in particular digits, are especially at risk
6. warm tar or asphalt burns are feasible in industrial settings... Tar adheres to pores and
skin and infiltrates clothing, ensuing in persisted switch of warmth... How is this handled?
- ANSWER-fast cooling of tar and care to avoid further trauma at the same time as
doing away with it
*mineral oil is used to dissolve tar
7. how can burn accidents impact the airway? - ANSWER-airway can turn out to be
obstructed from direct damage (inhalation damage) and the massive edema as a
consequence of burn injury
red textual content
8. how will you lower the ache of wounds? - ANSWER-cowl wounds
9. how will you lessen neck and chest wall edema following inhalation harm? -
ANSWER-after spinal harm has been excluded... Increase head and chest to 30
ranges
10.how do you adjust the quantity of fluids given to the sufferers? - ANSWER-adjust based
totally on urine output
, *goal of zero.5mL/kg/hr in adults; 1 mL/kg/hr in youngsters
*if preliminary resuscitation charge fails to produce target urine output, boom fluid
rate until urine output is met
11.how do you manage resuscitation of fluids in pediatric burn sufferers? -
ANSWER-pediatric pts with second or 3rd degree burns
3mL ringers x weight (kg) x % TBSA
<30kg - add maintenance fluids of 5% dextrose in water
12.how do you prevent patients developing deep-tissue injury from constricting burn
eschar? - ANSWER-recognize that burned skin is not elastic
13.*circumferential burns may require escharotomies
14.how do you prevent severe pain with dressing change? - ANSWER--provide adequate
analgesia before manipulating burns
-use non-adherent dressings or burn sheets to protect burn from contamination
before transfer
15.how do you stop the burn if contaminated with chemicals? - ANSWER-be careful when
removing any clothing contaminated by chemicals... Brush any dry chemical
powders from the wounds... Then irrigate the burn areas with copious amounts of
warm saline irrigation or rinsing in warm shower
16.how do you stop the burning process? - ANSWER-completely remove the clothing...
But don't peel off adherent clothing
*but prevent overexposure and hypothermia
*recognize that "stop drop & roll" is appropriate but can lead to contamination of
burn with debris/contaminated water
17.how does frost bite create damage? - ANSWER-due to freezing of tissue, ice crystal
formation causing cell membrane injury, microvascular occlusion, subsequent
tissue anoxia
*some damage can occur from reperfusion injury from rewarming
18.how does the resuscitation of burn patients differ from other types of trauma in which
fluid deficit is typically due to hemorrhage? - ANSWER-burn resuscitation is required
to replace ONGOING losses from capillary leak due to inflammation
red text
19.How is burn resuscitation affected when the patient also has an injury causing
hemorrhage? - ANSWER-control bleeding and resuscitate per standard ATLS
protocol for hemorrhagic shock before starting burn resuscitation
20.how much does the palmar surface (including fingers) of a patient's hand represent in
comparison to body surface? - ANSWER-1%
red
21.how should frozen toes be thawed? - ANSWER-use moist rewarming
*recognize this can be very painful & lead to systemic effects, such as a drop in
core temp as the frozen limb becomes perfused
*remember, pt can develop reperfusion syndrome
QUESTIONS AND ANSWERS
1. American burn affiliation diagnosis necessities for inhalation harm - ANSWER-publicity
to flamable agent and signs and symptoms of publicity to smoke in lower airway,
beneath vocal cords, seen on bronchoscopy
2. are burns considered clean? - ANSWER-fresh burns are easy regions that ought to
be protected from contaminations
*if it burns the skin, it burns the micro organism
purple textual content
3. are prophylactic antibiotics important in early postburn length? - ANSWER-now not
except required for different accidents
*reserve use of antibiotics for tx of contamination
4. direct thermal injury to decrease airway is uncommon... When does is basically occur? -
ANSWER-simplest after exposure to superheated steam or ignition of inhaled
flammable gases
crimson textual content
5. electric burns often are extra severe than they appear on the frame surface... How do
the currents travel? - ANSWER-contemporary travels inner blood vessels and
nerves and may reason nearby thrombosis and nerve injury
*intense injuries generally reason extremity contracture
*extremities, in particular digits, are especially at risk
6. warm tar or asphalt burns are feasible in industrial settings... Tar adheres to pores and
skin and infiltrates clothing, ensuing in persisted switch of warmth... How is this handled?
- ANSWER-fast cooling of tar and care to avoid further trauma at the same time as
doing away with it
*mineral oil is used to dissolve tar
7. how can burn accidents impact the airway? - ANSWER-airway can turn out to be
obstructed from direct damage (inhalation damage) and the massive edema as a
consequence of burn injury
red textual content
8. how will you lower the ache of wounds? - ANSWER-cowl wounds
9. how will you lessen neck and chest wall edema following inhalation harm? -
ANSWER-after spinal harm has been excluded... Increase head and chest to 30
ranges
10.how do you adjust the quantity of fluids given to the sufferers? - ANSWER-adjust based
totally on urine output
, *goal of zero.5mL/kg/hr in adults; 1 mL/kg/hr in youngsters
*if preliminary resuscitation charge fails to produce target urine output, boom fluid
rate until urine output is met
11.how do you manage resuscitation of fluids in pediatric burn sufferers? -
ANSWER-pediatric pts with second or 3rd degree burns
3mL ringers x weight (kg) x % TBSA
<30kg - add maintenance fluids of 5% dextrose in water
12.how do you prevent patients developing deep-tissue injury from constricting burn
eschar? - ANSWER-recognize that burned skin is not elastic
13.*circumferential burns may require escharotomies
14.how do you prevent severe pain with dressing change? - ANSWER--provide adequate
analgesia before manipulating burns
-use non-adherent dressings or burn sheets to protect burn from contamination
before transfer
15.how do you stop the burn if contaminated with chemicals? - ANSWER-be careful when
removing any clothing contaminated by chemicals... Brush any dry chemical
powders from the wounds... Then irrigate the burn areas with copious amounts of
warm saline irrigation or rinsing in warm shower
16.how do you stop the burning process? - ANSWER-completely remove the clothing...
But don't peel off adherent clothing
*but prevent overexposure and hypothermia
*recognize that "stop drop & roll" is appropriate but can lead to contamination of
burn with debris/contaminated water
17.how does frost bite create damage? - ANSWER-due to freezing of tissue, ice crystal
formation causing cell membrane injury, microvascular occlusion, subsequent
tissue anoxia
*some damage can occur from reperfusion injury from rewarming
18.how does the resuscitation of burn patients differ from other types of trauma in which
fluid deficit is typically due to hemorrhage? - ANSWER-burn resuscitation is required
to replace ONGOING losses from capillary leak due to inflammation
red text
19.How is burn resuscitation affected when the patient also has an injury causing
hemorrhage? - ANSWER-control bleeding and resuscitate per standard ATLS
protocol for hemorrhagic shock before starting burn resuscitation
20.how much does the palmar surface (including fingers) of a patient's hand represent in
comparison to body surface? - ANSWER-1%
red
21.how should frozen toes be thawed? - ANSWER-use moist rewarming
*recognize this can be very painful & lead to systemic effects, such as a drop in
core temp as the frozen limb becomes perfused
*remember, pt can develop reperfusion syndrome
