Hot Stuff
🚑 Burn or Bust: Transfer Time!
🩹 Dress to Impress
💊 Pain, Pills & Myths
☀️ Sun's Out, Burns Out
100
Symmetric burns to both feet in a child should raise concern for this.
What is nonaccidental trauma (abuse)?
- This was a major concern in Case #3.
- Pattern recognition is critical.
100
Burns to this body part should be referred to a burn center even when TBSA is small.
What is the hand?
- Functional areas matter as much as burn size.
- Even a 1% TBSA burn involving the hand may impact long-term function.
- This was demonstrated in Case #1.
100
This first step should occur before any dressing is applied.
What is irrigation with sterile water or normal saline?
- Wound cleansing removes contaminants and debris.
- Devitalized tissue should be removed when appropriate.
100
This medication is recommended for all burn patients by ABA pain guidelines.
What is acetaminophen?
- ABA guidelines recommend acetaminophen as foundational therapy.
- Often combined with NSAIDs for multimodal pain control.
100
Cooling should ideally begin within this many hours of injury.
What is 3 hours?
- Earlier cooling appears to improve outcomes.
- Delayed cooling provides less benefit.
200
This burn zone represents the area of maximum tissue destruction and is expected to necrose.
What is the Zone of Coagulation
- Jackson described three burn zones:
- Zone of Coagulation = irreversible damage
- Zone of Stasis = potentially salvageable tissue
- Zone of Hyperemia = likely to recover
- Appropriate resuscitation and wound care help preserve the zone of stasis.
200
Facial burns, singed nasal hairs, soot in the mouth, and stridor all raise concern for this injury.
What is inhalation injury?
- Airway edema can worsen rapidly.
- Patients may initially appear stable and then deteriorate during transport.
- Early recognition is critical.
200
This once-popular topical agent is now associated with longer healing times.
What is silver sulfadiazine?
- Once considered the gold standard.
- Multiple studies now demonstrate delayed healing compared with many alternative dressings.
- Evidence supporting routine use is weak.
200
These medications are appropriate unless contraindications exist.
What are NSAIDs?
Avoid in patients with:
- Renal disease
- Coagulopathy
- Significant gastritis
- NSAID allergy
200
Recommended cooling duration is at least this long.
What is 20 minutes?
- Use cool running water.
- Avoid ice or ice water because they may worsen tissue injury.
300
Burns involving this percentage of TBSA trigger a significant systemic inflammatory response and require IV fluid resuscitation.
What is 20% TBSA or greater
- Cytokine release causes capillary leak and widespread edema.
- Complications include:
- Pulmonary edema
- Myocardial depression
- GI ileus
- Multiorgan dysfunction
- These patients require IV fluid resuscitation and burn-center-level care.
300
Patients with suspected inhalation injury should receive this concentration of oxygen during transport.
What is 100% oxygen via non-rebreather mask
- Administer while awaiting EMS transport.
- Carbon monoxide exposure may coexist with inhalation injury.
- Pulse oximetry can be falsely reassuring in carbon monoxide poisoning.
300
Small, intact blisters less than this size can generally be left alone.
What is less than 6 mm?
- Evidence remains limited and controversial.
- Recommendations are largely based on expert consensus rather than high-quality trials.
300
True or False: Prophylactic oral antibiotics are recommended for outpatient burns.
What is False?
- Multiple meta-analyses found insufficient evidence of benefit.
- Antibiotics expose patients to adverse reactions without proven infection prevention.
- Use only if infection develops.
300
Cool running water should ideally be between these temperatures.
What is 12-25°C (54-77°F)?
- Cool—not freezing—is the goal.
- Prevents further tissue damage while avoiding vasoconstriction.
400
This simple UC-friendly method estimates burn size using the patient's hand.
What is the Palmar Surface Method (1% TBSA)?
400
Circumferential burns can threaten circulation and may require this procedure.
What is an escharotomy?
Watch for:
- Decreased pulses
- Pulse ox <95%
- New neurologic deficits
- Increasing pain or swelling
These findings suggest compromised perfusion requiring urgent specialty intervention.
400
Blisters on these thick-skinned areas are often left intact.
What are the palms and soles?
- Thick skin may protect underlying tissue.
- Preserving intact blisters may improve comfort and decrease infection risk.
400
This topical medication may help sunburn pain and erythema based on randomized trial data.
What is topical diclofenac gel?
- One randomized trial of 172 patients demonstrated benefit.
- May be a useful adjunct in moderate sunburn.
400
Name three recommended treatments for uncomplicated sunburn.
What are:
- Cool baths/compresses
- NSAIDs
- Aloe vera/moisturizers
- Sun avoidance
- Most sunburns require supportive care only.
- Education often prevents unnecessary prescriptions.
500
Besides the burn itself, name two additional findings that should heighten concern for abuse.
What are:
- Old injuries
- Unrelated injuries
- Inconsistent history
- Developmentally impossible mechanism
- Always document findings objectively.
- Involve social services when appropriate.
500
Name three body areas considered "high-risk" and warranting burn center referral.
What are the face, hands, feet, major joints, genitalia/perineum?
500
Name two reasons to unroof a burn blister.
What are:
- Large blister
- Thin-walled blister
- Interferes with movement/function
- There is no universal agreement.
- Decision should be individualized.
500
True or False: Steroids are evidence-based treatment for severe sunburn.
What is False?
- No evidence supports topical or systemic steroids.
- Potential risks include infection and pigmentation changes.
- This directly relates to Case #2.
500
This natural remedy has not been shown to improve healing compared with silver sulfadiazine.
What is aloe vera?
- Evidence quality is low.
- Patients may still use it for comfort and moisturizing.