Deck 49: Burns Trauma

Question 1

What function of the skin is affected from a burn injury?

A) Thermoregulation
B) Fluid and electrolyte imbalance
C) Protection from bacterial invasion
D) All are correct

Answer 1

All are correct

Question 2

According to Jackson's burn wound model, what zone is where the heat source is at its greatest at the site of injury, and rapid cell death occurs?

A) Zone of coagulative necrosis
B) Zone of stasis
C) Zone of hyperaemia
D) Zone of hypergranulation

Answer 2

Zone of coagulative necrosis

Question 3

Describe the way/s of assisting with minimising oedema and increasing perfusion.

A) Elevate head of the bead at 30o
B) Elevate the limbs
C) Elevate head of the bead at 30o and Elevate the limbs
D) None are correct

Answer 3

Elevate head of the bead at 30o and Elevate the limbs

Question 4

What is the correct immediate approach to put out a fire on a person who is still alert?

A) Instruct the person to stop, drop and roll
B) Instruct the person to lie down and wait until firefighters arrive
C) Leave the person and look for a fire extinguisher
D) Call fire emergency

Question 5

A patient from a fire incident is presented to ED with facial burns, stridor, hoarse voice with a brassy cough and tachypneoa. What should you suspect?

A) Circulatory overload
B) Airway burn
C) Hypovolaemic shock
D) Cellular shock

Question 6

What is the best measure of tissue perfusion in the major burns patient.

A) Check the blood pressure
B) Observe the skin colour
C) Measure the urine output
D) Check the capillary refill

Question 7

In using the 'rule of nines' for measuring the percentage of burn, how much percentage does the whole right arm comprise?

A) 1%
B) 9%
C) 14%
D) 18%

Question 8

These are the characteristics of burn with full thickness tissue damage:

A) Colour is red; no blisters, present capillary refill
B) Colour is dark pink, blisters are present, capillary refill is sluggish
C) Colour is blotchy red, blisters may or may not be present, capillary refill is absent, sensation is absent
D) Colour is white, no blisters, capillary refill is absent, sensation is absent

Question 9

This is a procedure that releases the burn wound surgically by incising the burned skin down to the subcutaneous fat.

A) Escharotomy
B) Debridement
C) Necrotomy
D) Fascification

Question 10

Burns caused by products of combustion will most likely affect:

A) Airway above the larynx
B) Airway below the larynx
C) Systemic intoxiation
D) All are correct

Question 11

You respond to an 18-year-old male who has sustained partial and full thickness flame burns to his entire left arm, entire anterior chest and abdomen and half of the surface area of his right upper arm. He is conscious with a GCS of 15, but is experiencing severe pain. The patient estimates that he weighs 80 kg. Using the Wallace Rule of Nines, the approximate total body surface area burnt is:

A) 40%
B) 35%
C) 30%
D) 25%

Question 12

In relation to question 1 above, using the Parkland formula for fluid replacement therapy the amount of fluid to be administered in the first 8 hours is:

A) 4800 mL
B) 2400 mL
C) 8400 mL
D) 9600 mL

Question 13

The recommended time for irrigating a burn wound with cold water is:

A) For as long as the patient is continuing to experience pain
B) 20 minutes
C) 10 minutes
D) 30 minutes

Question 14

The area of burn characterised by rupture of cell membranes and denaturation of structural proteins is known as the:

A) Zone of coagulation
B) Zone of stasis
C) Zone of hyperaemia
D) Zone of denaturation

Question 15

You are assessing the burn depth on a 15-year-old female who has been scalded with hot water. The burnt area has a dark pink, haemorrhagic appearance with some blistering present and delayed capillary refill. The burnt area is moderately painful. What depth of burn is the patient most likely experiencing?

A) Deep dermal
B) Mid-dermal
C) Full thickness
D) Superficial dermal

Question 16

At 1630 hours you are called to a suburban residence for a 17-year-old male who is experiencing severe pain in his left arm. The patient reports that he was asked to clean up a spill at his workplace where he is a sheet metal worker apprentice. Approximately 5 hrs later he began to develop increasing throbbing pain in his hand and up his arm. He rates the pain at 10/10, appears uncomfortable from the pain. There is some mild redness of the nail beds of his left second, third and fourth fingers. Based on this clinical presentation, the most likely diagnosis is:

A) Electrical burn
B) Cement powder burn
C) Hydrofluoric acid burn
D) Petrol burn

Question 17

In relation to question 6 above, life-threatening consequences from this type of burn are due to:

A) Severe hypocalcaemia leading to lethal cardiac arrhythmias
B) Ventricular fibrillation secondary to electrical current interfering with the normal cardiac conduction system
C) Renal failure secondary to rhabdomyolysis
D) Infection

Question 18

Name the type of necrosis caused by acid burns and alkali burns:

A) Gangrenous; coagulative
B) Liquefactive; coagulative
C) Coagulative; gangrenous
D) Coagulative; liquefactive

Question 19

Using the ANZBA referral criteria for transfer to a burns unit, which of the following burns should be preferentially transported directly to a burns unit?

A) Burns > 10% TSBA
B) Inhalational burns
C) Burns involving the hands
D) All of the above

Question 20

You are dispatched to a house fire where it is reported that the fire service has rescued a 22-year-old female from the house. On your arrival the fire services report that when they rescued the patient from the house she was unconscious, but her level of consciousness has improved and she now has a GCS of 11. Her face, including her tongue, is covered in soot, but there doesn't appear to be any thermal burns and at this stage there is no other evidence of airway involvement. The patient is at high risk for toxicity from which two toxins?

A) Carbon monoxide; sulphur trioxide
B) Cyanide; carbon dioxide
C) Carbon monoxide; cyanide
D) Cyanide; sulphur trioxide