That's Classified
The degree that involves entire dermis to subcutaneous tissue and may involve muscle and bone
Third or fourth degree
The method that is the most precise to calculate TBSA
Lund-Browder Method
Which phase of burn care should you establish an airway?
Emergent
True or False
The priority of care for burns on admission to the ER/Burn Unit is ABC (airway, breathing, circulation).
False
CABD, circulation is priority due to imminent shock with large burns
Calculate TBSA using Rule of Nines:
Right arm, anterior left arm, anterior chest and face.
36%
Depth that recuperates in less than 3 days
Superficial
True or False
Does the rule of nines need to be adjusted for pediatric patients? Why?
True
Children have proportionally larger heads and smaller limbs
In which phase would you monitor for hyperglycemia?
Acute Phase
When calculating fluid resuscitation using the Parkland Formula, what SPECIFIC measurement are you evaluating for?
0.5mL/kg/hr urine output adults
1mL/kg/hr urine output children
Calculate the total volume to be given for 24hrs using the Parkland Formula:
Adult patient is 160lbs with 53% TBSA
15418mL
Degree that has symptoms of tingling, supersensitivity and pain relieved by cooling
First Degree
Calculate TBSA:
head, anterior chest and anterior left arm are burned
9 + 18 + 4.5 = 31.5%
This phase primary concern is to prevent scars and contractures.
Rehabilitation Phase
Who is the greatest priority:
Patient with 41% burn at 48 hours with oliguria, increased LFTs and firm abdomen.
Patient with 60% burn at 24hours, BP 125/67, HR 110, Pain 9/10, anxious, increased PVCs on monitor.
First patient: signs of abdominal compartment syndrome
Your adult patient is 65kg, the TBSA is 40%. Calculate the total mL/hr of fluid to be given in the first 8 hours using the Parkland formula.
5200mL over 8hrs = 650mL/hr
Depth/degree that involves dry, pale, white, leathery or charred wound.
Deep, partial thickness or second degree
Calculate TBSA:
Right leg, entire thorax, right arm, anterior left leg
18 + 37 + 9 + 9 = 73%
In the emergent phase, distributive shock occurs due to what pathologic process?
Capillary leak syndrome
The loss of fluid, electrolytes, albumin from blood to interstitium (Third spacing)
What early intervention is needed to prevent infection/sepsis and reduce mortality?
Removal of burn eschar and wound closures
Easy one: What is the percentage marked for the groin in the Rule of Nines?
1 percent
Degree that sweat glands and hair follicles are destroyed
Third or Fourth degree
Calculate TBSA:
Posterior head, back, buttocks, posterior bilateral arms, right leg
4.5 + 18 + 9 + 18 = 49.5%
What is the major complication that causes a mortality rate of 75% due to capillary leak syndrome and fluid resuscitation in the emergent phase?
Abdominal Compartment Syndrome
Which patient is the priority:
Patient with extensive burns to face, neck and hands, SpO2 93% on 100% O2, agitated and confused.
Patient with 2nd degree burns to chest and abdomen, Temp 99.8, BP 94/57, HR 112, Na 131 and K+ 3.2.
First patient
Signs of cerebral hypoxia, SpO2 may be falsely high. Pulse oximeters cannot distinguish between HbO2 and HbCO.
Patient with bilateral legs, abdomen burned, 236lbs.
107.27kg 54% TBSA
23171 mL total
first 8 hours: 11586 ml/8 = 1448mL/hr