Physical and Environmental Emergencies
Exam Questions With Detailed Answers
what history should you get for burns? - ANSWER>>AMPLE
- allergies
- medications
- PMHx
- last meal
- events regarding the injury
what should you look at in the primary survey for burns? - ANSWER>>-
ABCs
- look at face and neck for upper airway and laryngeal edema
- oxygen by nasal cannula or face mask
- monitor pulse ox (readings may be falsely elevated with increased
carboxyhemoglobin levels)
a circumferential full thickness chest wall burns may need? -
ANSWER>>emergency escharotomy
what should patients with full upper airway and laryngeal edema, chest
wall burns, stridor, hoarseness, or hypoxia in burns need? -
ANSWER>>early endotracheal intubation
which burns can deteriorate rapidly and need endotracheal intubation? -
ANSWER>>burns > 60% BSA
,what should you do if endotracheal intubation is unsuccessful? -
ANSWER>>cricothyrotomy or tracheostomy
what is the treatment for smoke inhalation? - ANSWER>>100% O2 by tight
fitting face mask or ET tube
what do you need to document prior to treatment of burns? - ANSWER>>-
diagram charts available (many EMR's will have this)
- location, extent, depth
- do not dress or wrap burns until secondary survey is complete
what tests should be gotten in burns? - ANSWER>>- CBC
- electrolytes
- ABGs (determine respiratory involvement, assist in patient management
- carboxyhemoglobin
- urine for myoglobin
how do you determine the total BSA burned? - ANSWER>>rule of 9s
- each arm (front and back): 9%
- each leg (front and back): 18%
- head: 9%
- back: 18%
- chest and abdomen: 18%
- perineum: 1%
capillary refill is not seen in starting at which degree burns? -
ANSWER>>possibly starting at deep partial thickness
, what degree burns are blisters seen? - ANSWER>>superficial partial
thickness
what burns are white, black, or brown? - ANSWER>>full thickness
what is the criteria for burn center referral? - ANSWER>>- second degree
burn or deeper, >10% BSA or on hands, face, eyes, ears
- circumferential burns
- inhalation
- electrical/lightning
- chemical burns
- associated injuries/trauma
- underlying medical condition
- age: <5; > 55 y/o
- patients that will require special social, emotional, rehab intervention
what % BSA needs fluid resuscitation? - ANSWER>>>15% BSA
fluid loss in burns is maximal when? - ANSWER>>begins immediately,
maximal during first 6-8 hours
what formula is used for calculating fluid resuscitation? -
ANSWER>>parkland formula
4 mL x TBSA% x weight in kg = mL to be given in first 24 hours, half over 1st
8 hours, half over next 16 hours
ex:
Exam Questions With Detailed Answers
what history should you get for burns? - ANSWER>>AMPLE
- allergies
- medications
- PMHx
- last meal
- events regarding the injury
what should you look at in the primary survey for burns? - ANSWER>>-
ABCs
- look at face and neck for upper airway and laryngeal edema
- oxygen by nasal cannula or face mask
- monitor pulse ox (readings may be falsely elevated with increased
carboxyhemoglobin levels)
a circumferential full thickness chest wall burns may need? -
ANSWER>>emergency escharotomy
what should patients with full upper airway and laryngeal edema, chest
wall burns, stridor, hoarseness, or hypoxia in burns need? -
ANSWER>>early endotracheal intubation
which burns can deteriorate rapidly and need endotracheal intubation? -
ANSWER>>burns > 60% BSA
,what should you do if endotracheal intubation is unsuccessful? -
ANSWER>>cricothyrotomy or tracheostomy
what is the treatment for smoke inhalation? - ANSWER>>100% O2 by tight
fitting face mask or ET tube
what do you need to document prior to treatment of burns? - ANSWER>>-
diagram charts available (many EMR's will have this)
- location, extent, depth
- do not dress or wrap burns until secondary survey is complete
what tests should be gotten in burns? - ANSWER>>- CBC
- electrolytes
- ABGs (determine respiratory involvement, assist in patient management
- carboxyhemoglobin
- urine for myoglobin
how do you determine the total BSA burned? - ANSWER>>rule of 9s
- each arm (front and back): 9%
- each leg (front and back): 18%
- head: 9%
- back: 18%
- chest and abdomen: 18%
- perineum: 1%
capillary refill is not seen in starting at which degree burns? -
ANSWER>>possibly starting at deep partial thickness
, what degree burns are blisters seen? - ANSWER>>superficial partial
thickness
what burns are white, black, or brown? - ANSWER>>full thickness
what is the criteria for burn center referral? - ANSWER>>- second degree
burn or deeper, >10% BSA or on hands, face, eyes, ears
- circumferential burns
- inhalation
- electrical/lightning
- chemical burns
- associated injuries/trauma
- underlying medical condition
- age: <5; > 55 y/o
- patients that will require special social, emotional, rehab intervention
what % BSA needs fluid resuscitation? - ANSWER>>>15% BSA
fluid loss in burns is maximal when? - ANSWER>>begins immediately,
maximal during first 6-8 hours
what formula is used for calculating fluid resuscitation? -
ANSWER>>parkland formula
4 mL x TBSA% x weight in kg = mL to be given in first 24 hours, half over 1st
8 hours, half over next 16 hours
ex:
