The Candid Test On Burn Module

1. Third degree burns typically require surgical repair.

True

False

Third degree burns usually require surgical repair due to the depth and extent of the injury.

Explanation

Third degree burns usually require surgical repair due to the depth and extent of the injury.

2. Burn injuries typically produce massive bleeding.

True

False

Burn injuries rarely result in any bleeding.

Explanation

Burn injuries rarely result in any bleeding.

3. The most common cause of poisoning deaths in the United States is attributed to:

Carbon Dioxide

Carbon Monoxide

Cyanide

Dioxin

Carbon Monoxide (CO) is a clear, odorless, and tasteless by-product of incomplete combustion. This gas binds with the body’s hemoglobin more than 200 times faster than does oxygen, resulting in immediate and prolonged hypoxia. The patient should receive high flow 02 during transport, as the half-life of CO can be 2-3 hours post exposure

Explanation

Carbon Monoxide (CO) is a clear, odorless, and tasteless by-product of incomplete combustion. This gas binds with the body’s hemoglobin more than 200 times faster than does oxygen, resulting in immediate and prolonged hypoxia. The patient should receive high flow 02 during transport, as the half-life of CO can be 2-3 hours post exposure

4. The largest organ of the body is the:

Liver

Stomach

Skin

Kidneys

The skin is considered the largest organ in the body. It is responsible for temperature regulation, acts as a mechanical and protective barrier, and acts as a sensory receptor.

Explanation

The skin is considered the largest organ in the body. It is responsible for temperature regulation, acts as a mechanical and protective barrier, and acts as a sensory receptor.

5. The leading cause of all fire deaths is:

Inhalation Injuries

Chemical Injuries

Thermal Injuries

None of the above

Inhalation injuries are the leading cause of all fire deaths because when a fire occurs, the smoke and toxic gases produced can be extremely harmful to the respiratory system. Inhaling these substances can cause severe damage to the lungs and other organs, leading to respiratory distress and even death. Therefore, it is crucial to prioritize the prevention and treatment of inhalation injuries in order to reduce the number of fire-related fatalities.

Explanation

Inhalation injuries are the leading cause of all fire deaths because when a fire occurs, the smoke and toxic gases produced can be extremely harmful to the respiratory system. Inhaling these substances can cause severe damage to the lungs and other organs, leading to respiratory distress and even death. Therefore, it is crucial to prioritize the prevention and treatment of inhalation injuries in order to reduce the number of fire-related fatalities.

6. You are called to a rural medical facility to transport a 80kg, 50 year old male who has suffered second and third degree burns to the entire anterior thorax, anterior right arm, and the anterior of the left upper leg. Using the Parkland Formula for fluid resuscitation, the patient should receive _______ fluids in the first 24 hours post injury.

8,640cc fluids

10,000cc fluids

11,520cc fluids

14,400cc fluids

The Parkland Formula is four times weight in kilograms times the percentage area of burn. This patient would get 4cc x 80kg = 320, x 27% area of burn = 8,640cc, to be administered in the first 24 hours following the burn injury. Half of these fluids should be given within the first eight hours, with the remaining fluids administered in the following sixteen hours. Note that if treatment were started 2 hours after the burn time, half would be given in the first SIX hours.

Explanation

The Parkland Formula is four times weight in kilograms times the percentage area of burn. This patient would get 4cc x 80kg = 320, x 27% area of burn = 8,640cc, to be administered in the first 24 hours following the burn injury. Half of these fluids should be given within the first eight hours, with the remaining fluids administered in the following sixteen hours. Note that if treatment were started 2 hours after the burn time, half would be given in the first SIX hours.

7. You call for the medical report and learn you will be transporting a 55-year-old male who was admitted an hour ago to the ER after being found unresponsive in a house fire. The nursing personnel report the patient has stridor, singed nasal hairs, chest tightness, and a productive cough. He appears confused and is not aware of his surroundings. The patient is on high flow oxygen and is receiving normal saline at 100cc per hour. The sending facility cannot provide any additional information. Based on this limited information, the flight team should consider which of the following:

Notify the Medical Director once you arrive at the patient’s bedside

Consider elective intubation prior to transport

Refuse the flight, as the patient is too critical for transport

Administer fluids during transport based on the Parkland Formula

The patient demonstrating stridor following a closed-space inhalation should have their airway secured immediately. The best means for securing the airway is endotracheal intubation.

Explanation

The patient demonstrating stridor following a closed-space inhalation should have their airway secured immediately. The best means for securing the airway is endotracheal intubation.

8. Fluid resuscitation for an adult should be aimed at maintaining a urine output of __________.

10-20cc per hour

20-30cc per hour

30-50cc per hour

40-60cc per hour

The Medical Flight Team should aim their fluid resuscitation efforts at maintaining a urine output of 30-50cc per hour in an adult (more generally, at least 0.5-1 cc/kg/hour).

Explanation

The Medical Flight Team should aim their fluid resuscitation efforts at maintaining a urine output of 30-50cc per hour in an adult (more generally, at least 0.5-1 cc/kg/hour).

9. In severe burns involving the face or airway, it is best to use nasotracheal intubation.

True

False

Generally it is best to use the largest ET possible for intubating a burn patient with a compromised airway, because there will be swelling of tissues which may tend to reduce ET tube diameter. Larger tubes can be placed by the oral route than by the nasal.

Explanation

Generally it is best to use the largest ET possible for intubating a burn patient with a compromised airway, because there will be swelling of tissues which may tend to reduce ET tube diameter. Larger tubes can be placed by the oral route than by the nasal.

10. You are called to a rural medical facility to transport a 50 year old male who has suffered second and third degree burns to the entire anterior thorax, anterior right arm, and the anterior of the left upper leg. Using the Rules of Nine, you determine the total body surface burns to be:

9%

18%

27%

36%

The anterior thorax accounts for 18%; the entire arm is 9%, and entire leg is 18%. The anterior aspect of the leg is 9%. Adding the upper anterior leg (4.5%) to the anterior arm (4.5%) totals 9%. This, added to the 18% from the anterior thorax injury, equals a 27% total body surface (TBS) injury.

Explanation

The anterior thorax accounts for 18%; the entire arm is 9%, and entire leg is 18%. The anterior aspect of the leg is 9%. Adding the upper anterior leg (4.5%) to the anterior arm (4.5%) totals 9%. This, added to the 18% from the anterior thorax injury, equals a 27% total body surface (TBS) injury.