29: Burns HW Study Guide

According to the rule of​ nines, what would the involved surface area be for an adult victim who has received burns to her right arm and right anterior​ chest? A. ​9.50% B. ​13.50% C. ​18% D. ​16%

13.5% 817-818 The arm would account for 9​ percent, and one side of the anterior chest would account for another 4.5​ percent, for a total of 13.5 percent.

Chemical burns to the eye should be flushed with water for at​ LEAST: A. 5 minutes. B. 10 minutes. C. 20 minutes. D. 15 minutes.

20 minutes The current recommendation for flushing the eyes of a patient who received a chemical burn to the eye is to do so for at least 20 minutes. Remember that is the​ minimum, which means that if time​ allows, the EMT can do so for longer.

What should you place on a burn that covers more than 10 percent of your​ patient's body? A. A burn sheet B. Sterile water C. Moistened gauze D. A petroleum dressing

A burn sheet Cover the burned area with a dry sterile dressing or a​ sterile, particle-free disposable burn sheet or an approved commercial burn dressing. A clean white sheet is acceptable if no burn sheet is available. Continual use of a wet or moist dressing may cause hypothermia because of the loss of heat regulation in the burned area.​ However, some EMS systems may use a moist dressing on a 10 percent BSA or less​ partial-thickness burn. Check with local medical direction about the use of wet or moist dressings.

Which statement about electrical burns is​ TRUE? A. Use a wooden broom handle to move a patient away from the electrical source. B. Patients in cardiac arrest from exposure to electricity are rarely​ resuscitated, because even shockable heart rhythms will not respond to defibrillation. C. All tissue between the entrance and exit wounds may be injured. D. Scene safety is crucial. Even if disconnected from the electrical​ source, the patient can still transmit stored electricity to you.

All tissue between the entrance and exit wounds may be injured 823-824 Scene safety is crucial in electrical burn injuries because of the extremely hazardous nature of the electrical source. Always assume that the electrical source is still charged unless you have received reliable information that the power source has been completely shut down. As the energy enters the​ body, it will seek the path of least resistance to exit the body. All tissues between the entrance and exit of the current will potentially be​ injured, owing to the extreme heat created by the resistance of body structures to the electricity. Since the​ body, especially the​ heart, produces its own electrical energy from chemical​ reactions, electrical injuries can disturb or destroy these​ functions, causing irregular heartbeat or even cardiac arrest.

In accordance with the rule of​ nines, how does the head of an infant compare with the head of an​ adult? A. An​ infant's head and neck account for half the total body surface area of an​ adult's. B. An​ infant's head and neck account for twice the total body surface area of an​ adult's. C. The rule of nines does not apply to infants. D. An​ infant's head and neck account for the same total body surface area as an​ adult's.

An​ infant's head and neck account for twice the total body surface area of an​ adult's. pg 817-818 (DOUBLES) For an​ adult, the head and neck account for a total of 9 percent of the body area. For​ infants, divide the head and neck area into the anterior and posterior​ surface, and award nine percent for each. This doubles the amount of applied surface area for infants.

Another way of identifying the seriousness of a burn is by degrees. Which statement is​ TRUE? A. A superficial burn is also called a​ second-degree burn. B. A​ first-degree burn is the most serious and the deepest. C. A​ second-degree burn is characterized by​ red, dry skin. D. A​ full-thickness burn is also known as a​ third-degree burn.

A​ full-thickness burn is also known as a​ third-degree burn. 815 Formerly known as a​ third-degree burn, a​ full-thickness burn involves all the layers of the skin. This type of burn results from contact with extreme heat sources such as hot liquids or​ solids, flame,​ chemicals, or electricity. The skin will become​ dry, hard,​ tough, and leathery and may appear white and waxy to dark brown or black and charred.

Your patient has sustained a chemical burn to his hands from a dry chemical. How is this treated in the​ field? A. Brush off the powder before using water to flush. B. Flush the patient immediately with water. C. Use baby oil to flush the injury. D. Use only sterile water to flush the patient.

Brush off the powder before using water to flush. 823 If a patient has a dry chemical on his​ skin, first identify the​ substance, brush it​ off, and then flush if that is acceptable to do for that specific chemical.

Emergency medical care of a burn patient includes which​ treatment? A. Application of a burn ointment to the affected area B. Continual immersion of the burned area in cool water throughout transport C. Brushing dry chemicals away and then flushing with water D. If the burn source is a​ semisolid, such as tar or​ grease, cooling the burn and attempting to remove the substance to limit tissue damage

Brushing dry chemicals away and then flushing with water 821 Dry chemicals should be brushed off before being flushed with water. Most chemical burns can be flushed with copious amounts of water. Always ensure that the chemical is one that may be diluted with water. Consult a hazardous materials guidebook because some chemicals may produce combustion when they come into contact with water. If the burn source is a​ semi-solid or​ liquid, such as​ tar, grease, or​ oil, cool the burn with water or saline to stop the burning​ process, but do not attempt to remove the​ substance, since this could cause further tissue damage. Once the patient has been removed from the source of the​ burn, you can stop the burn process by using water or​ saline, but do not keep the burned area immersed. Apply no ointment.

What is the FIRST step in removing dry chemicals from the​ body? A. Neutralizing the chemical with vinegar B. Pouring water on the body C. Vacuuming the excess material D. Brushing off the excess material

Brushing off the excess material 823 The first step with chemicals on the body​ (especially dry​ chemicals), is to brush off any excess. Then use a copious amount of water to flush the exposed areas.

The condition that occurs after a burn when fluid and proteins move out of the vasculature and into surrounding tissue is​ called: A. hypovolemic shock. B. burn shock. C. cardiogenic shock. D. leaky capillary beds.

Burn shock pg 813 (circulatory system) A condition that can occur with moderate to major burns that cover sufficient body surface area​ (BSA) is called burn shock. Burn​ shock, which develops only after the first few​ hours, results from extensive vascular bed damage that allows both fluid and protein molecules in the plasma to leak into surrounding tissues. The fluid loss just described can lead to shock​ (hypoperfusion).

What term is used for a burn that wraps around an entire body​ surface? A. Partial thickness B. Complete C. Circumferential D. Eschar

Circumferential Circumferential​ burns, which encircle a body area such as an​ arm, a​ leg, or the​ chest, and especially burns that encircle joint​ areas, are critical because of the circulatory compromise and nerve damage that result from constriction or from swelling tissues. Burns that encircle the chest may impede respiratory function by limiting expansion of the chest. A​ partial-thickness burn involves not only the epidermis but also portions of the dermis. The tough and leathery dead soft tissue that is formed in the​ full-thickness burn injury is called an eschar.

Which patient care modality can reduce the pain associated with your​ patient's moderate to severe​ partial-thickness burns? A. Cool the burn sites with cold water immersion. B. Initiate​ high-flow oxygen therapy. C. Cover the burns with a sterile burn sheet. D. None of the above will assist in pain control.

Cover the burns with a sterile burn sheet Dressings keep air movement past the sensitive​ partial-thickness burn to a minimum and thereby reduce pain. Use local cooling only for​ partial-thickness burns that involve less than 15 percent of the BSA or very small​ full-thickness burns that involve less than 2 percent of the​ BSA, but never immerse a burn. Cover the burned area with a dry sterile dressing or a​ sterile, particle-free disposable burn sheet or an approved commercial burn dressing. A clean white sheet is acceptable if no burn sheet is available. Oxygen therapy may be indicated but will not reduce pain.

A patient has​ partial-thickness burns over 35 percent of his​ body, including both feet. Which classification does this patient fall​ under? A. Superficial B. Critical C. Minor D. Moderate

Critical 814-821 ​Partial-thickness burns involving over 25 percent of the body in adults would be considered critical. Burns to areas of the body that can result in a significant loss of function are also considered​ critical, independent of the total BSA involved.

What type of burn mechanism may NOT have significant superficial tissue​ injuries, but the burns may be located deeper in the​ tissue? A. Electrical burn B. Chemical burn C. Flame burn D. Flash burn

Electrical Burn 818-819 Because​ bones, muscles, and other tissues offer resistance to the electrical energy passing through​ them, the​ by-product is​ heat, which results in internal burns.​ Often, the internal burns are more significant than the cutaneous burns.

What type of burn occurs when the patient comes into contact with fire or​ flames? A. Flame burn B. Flash burn C. Gas burn D. Contact burn

Flame Burn 818-819 A flame burn occurs when the patient comes into contact with an open flame. The clothing may​ ignite, causing further burn injury. Natural clothing fibers typically will​ burn, whereas synthetic fibers will usually​ melt, which causes a contact burn in addition to the flame burn. Hot gases may cause upper airway​ burns; however, it is not likely that the hot gas will cause distal airway burns. A contact burn occurs from contact with a hot object. A flash burn is a type of flame burn but is the result of a flammable gas or liquid that ignites quickly

Which type of burn destroys nerve​ cells? A. ​Full-thickness B. ​Second-degree C. ​Partial-thickness D. Superficial

Full-thickness pg 815 ​Full-thickness burns are not very painful because nerve endings have been destroyed.​ However, in most such​ injuries, there will be surrounding areas of​ partial-thickness and/or superficial burns that may cause intense pain. In superficial and​ partial-thickness burns, the nerve endings are still​ intact, so the patient will experience pain from the entire burned area.

The swelling of the upper airway as a result of inhalation of hot gases would be considered what type of burn​ mechanism? A. Flame burn B. Gas burn C. Contact burn D. Flash burn

Gas Burn pg 818-819 Hot gases may cause upper airway​ burns; however, it is not likely that the hot gas will cause distal airway burns. Distal airway injury may occur from the​ by-products of combustion rather than from the hot gas. In a flame​ burn, the patient comes into contact with an open flame. A contact burn occurs from contact with a hot object. A flash burn is a type of flame burn but is the result of a flammable gas or liquid that ignites quickly.

Infants who suffer burn injuries are at higher risk than adults for​ shock, airway​ difficulties, and: A. cardiac arrest. B. epidermal infections. C. ​full-depth wounds. D. hypothermia.

Hyporthermia 817 With the damage to any​ patient's skin, there will be a diminishment in the thermoregulation capabilities of the body. Since infants have a higher proportion of surface​ area, infants who suffer burn injuries would be especially prone to hypothermia if it is not prevented.

What should be done for all geriatric and pediatric patients who suffer from burn​ injuries? A. Withhold pain medication. B. Load fluids less aggressively. C. Increase the burn severity by one level. D. Immediately wrap and cool burns with water.

Increase the burn severity by one level. Burn severity should be increased by one level with pediatric and geriatric patients and patients who are suffering from other trauma or acute medical problems.

Age is a major factor in determining the severity of a burn injury. Which statement is​ CORRECT? A. Adults over 45 years of age have less tolerance for burn injuries. B. Children under 10 years of age have less tolerance for burn injuries. C. Any burn that is classified as minor in an adult younger than 55 years of age is classified as critical in an adult older than 55 years of age. D. Infants have a potential for greater fluid loss in burn injuries than adults.

Infants have a potential for greater fluid loss in burn injuries than adults. pg 817 Because of​ children's relatively larger skin surface in relation to body​ mass, children have the potential for greater fluid loss in burn injuries than adults do.

If the patient sustains burns to the​ hands, the EMT should​ remove: A. jewelry. B. dressings that are separating the digits. C. peeling skin. D. acrylic fingernails.

Jewelry pg 822 As you work to stop the​ burning, attempt to remove any smoldering clothing and​ jewelry, which will still be producing heat and may constrict swollen extremities. If any clothing still adheres to the​ patient, cut around the area. Do not attempt to remove the adhered​ portion, since this may cause further damage to the soft tissues. Separate all digits with​ dry, sterile dressing material to prevent adhering of burned areas.

What occurs in the gastrointestinal system when burns start to exceed 10 percent of the body surface​ area? A. Constipation B. Nausea and vomiting C. Abdominal pain D. Diarrhea

Nausea and Vomiting 29.3.2 pg 813 Nausea or vomiting are common in burns of greater than 10 percent of the BSA and can further upset normal chemical​ balances; long-term stress may cause ulcers. To promote healing and survival of burn​ patients, the gastrointestinal system must be kept functioning properly to ensure adequate nutritional support for healing.

Upon your arrival for a burn​ patient, the scene​ size-up reveals that the patient is a child. Why do pediatric patients have more difficulty dealing with burns than​ adults? A. Pediatric patients have a low tolerance for the associated pain. B. Pediatric patients have an underdeveloped integumentary system. C. Pediatric patients have a high body surface area to body weight ratio. D. Pediatric patients deal with burns better than adults do.

Pediatric patients have a high body surface area to body weight ratio. The pediatric patient has a high body surface area to body weight​ ratio, which means that the fluid reserves needed for dealing with the burn effects are lower than those of their older counterparts.

If a child pulled a boiling pot of water off the stove and was burned by​ it, what type of burn mechanism would this​ be? A. Flash burn B. Immediate burn C. Electrical burn D. Scald burn

Scold BURN 818-819 Contact with hot liquid causes a scald burn. The more viscous the​ liquid, the more severe the burn because of a longer contact time. Intentional​ scalds, often seen in child​ abuse, typically involve the entire extremity being immersed and held in the hot water. A flash burn is a type of flame burn but is the result of a flammable gas or liquid that ignites quickly. An electrical burn is the result of passing electric current through the body

Which body system is generally NOT harmed by extensive​ burns? A. Gastrointestinal B. Circulatory C. Skeletal D. Nervous

Skeletal With severe​ burns, the​ circulatory, nervous,​ gastrointestinal, respiratory, and muscular systems can be involved even though they were not part of the initial burn. The skeletal​ system, unless specifically involved in the​ burn, generally is not affected.

What part of the body often receives the highest heat generated from electrical​ burns? A. Nerve tissue B. Skin C. Underlying musculature D. Mucous membranes

Skin Electrical energy will always seek to flow to ground. As the energy enters the​ body, it will seek the path of least resistance to exit the body. The highest heat occurs at the points of greatest​ resistance, often at the skin. Because of its nonconductive​ nature, skin is highly resistant to electrical flow.

Which burns would be considered minor in an adult patient in terms of burn​ severity? A. ​Partial-thickness burns of the right hand and arm B. ​Partial-thickness burns over both legs C. Superficial burns over the front and back of both arms D. ​Full-thickness burns of one leg

Superficial burns over the front and back of both arms pg 814-815 Superficial burns that involve less than 50 percent of the body are considered minor. Given the extent of injuries described in this​ patient, superficial burns that involve roughly 18 percent of the body would be minor. Just as the depth of the burn injury and its body surface area are​ important, so too is the location of the burn. Injuries to certain body areas are more critical than injuries to other areas. Burns of the face are considered critical because of the potential for respiratory compromise and​ long-term cosmetic​ concerns, as are burns to the eyes or ears. Hands and feet are also given special consideration because of the potential for loss of function. Circumferential​ burns, which encircle a body area such as an​ arm, a​ leg, or the​ chest, and especially burns that encircle joint​ areas, are critical because of the circulatory compromise and nerve damage that result from constriction or from swelling tissues.

What is the primary result of the tissue degeneration that results from electrical​ burns? A. Nerve exposure results in severe pain. B. The tissue releases toxins into the body. C. The skin can no longer maintain homeostasis. D. Tissue degeneration results in clothing or other combustibles catching fire.

The tissue releases toxins into the body A severe burn injury will cause many​ wastes, such as myoglobin from muscle​ destruction, to form in the blood. This is particularly true with electrical burns. Since the kidneys are responsible for filtering the contaminated​ blood, a blockage in the kidneys may result. In the​ end, this may cause all or parts of the kidneys to stop functioning.

What is the cause of a majority of deaths that are seen prehospitally secondary to a burning​ mechanism? A. ​Dehydration, toxic​ inhalation, and hypothermia B. Subcutaneous​ depression, hypertension, and toxic inhalation C. Toxic shock​ syndrome, superheated air​ inhalation, and cellular degeneration D. Toxic inhalation and occluded airway

Toxic inhalation and occluded airway 820 Remember that critical burns themselves are not immediately life threatening. Immediate causes of death are airway swelling and inhalation​ injury, so the EMT should remain alert for these problems.

How is the circulatory system affected by severe​ burns? A. Slowing of the heart rate and increased systemic vascular resistance B. Increased blood volume from burn shock C. Blood vessel blockage D. Vascular damage with fluid shifting

Vascular damage with fluid shifting A condition that can occur with moderate to major burns that cover sufficient body surface area​ (BSA) is called burn shock. Burn​ shock, which develops only after the first few​ hours, results from extensive vascular bed damage that allows both fluid and protein molecules in the plasma to leak into surrounding tissues. The result is a large fluid shift out of the vessels and into the spaces surrounding the cells to a point at which the total vascular volume is insufficient to meet the​ body's needs.

The FIRST priority on any call in which a person was burned​ is: A. stopping the burning process. B. contacting aeromedical support. C. completing a scene​ size-up. D. determining the transport mode.

completing a scene​ size-up. 819 Your first priority is to determine whether the scene is safe to enter. Do not enter scenes for which you are not trained. If the patient is in an unsafe​ environment, such as a​ fire-engulfed building, and you do not have the proper equipment or training to​ enter, you must wait until properly equipped and trained personnel can safely remove the patient. Once the scene is safe to​ enter, you must take appropriate Standard Precautions and then begin assessing the mechanism of injury and number of patients.

You are treating a​ 57-year-old female victim of​ partial-thickness thermal burns of the​ hands, arms,​ feet, legs,​ genitalia, and anterior torso. After you have brought her airway under control and administered​ high-flow oxygen via a nonrebreather​ mask, she is complaining of being in severe pain. Which step should you take next to relieve some of her​ pain? A. Cover the burns with silver sulfadiazine. B. Pain management is not necessary for​ full-thickness burns. C. Cool the burn for 1 to 2 minutes with saline. D. Cover the burn with a sterile burn sheet.

cool the burn for 1 to 2 minutes with saline 819 Dressings keep air movement past the sensitive​ partial-thickness burn to a minimum and thereby reduce pain. Use local cooling for only 1 to 2 minutes but never immerse a burn. After​ cooling, cover the burned area with a dry sterile dressing or a​ sterile, particle-free disposable burn sheet or an approved commercial burn dressing. A clean white sheet is acceptable if no burn sheet is available. Oxygen therapy may be indicated but will not reduce pain.

The layers of the skin are​ the: A. superior​ layer, the medial​ layer, and the inferior layer. B. primary​ dermis, the secondary​ dermis, and the adjunct dermis. C. ​epidermis, the​ dermis, and the subcutaneous layer. D. superficial​ layer, the​ partial-thickness layer, and the​ full-thickness layer.

epidermis, the​ dermis, and the subcutaneous layer. pg 812 The skin has a structure of three layers. The outermost layer is the​ epidermis, which provides a watertight and resilient barrier from the external​ environment; the second layer is the​ dermis, which contains small capillary beds as well as the sensory structures of the​ skin; and the innermost layer is the hypodermis​ (also called the subcutaneous​ layer), which is composed of fatty connective tissue and contains larger blood vessels.

The​ tough, leathery dead soft tissue that forms after a​ full-thickness burn is​ called: A. deep injury. B. keratosis. C. scar tissue. D. eschar.

eschar pg 815 The tough and leathery dead soft tissue that is formed in the​ full-thickness burn injury is called an eschar. Keratosis pilaris is a common skin condition that causes rough patches and​ small, acne-like​ bumps, usually on the​ arms, thighs, cheeks and buttocks.

You are treating a patient with a severe electrical burn on the hand. For what other injury will you NEXT assess on this​ patient? A. An exit burn B. Deteriorated cartilage C. A myocardial infarction D. Psychogenic shock

exit burn 824 Usually, where the electricity enters the​ body, there is a cutaneous injury known as an entry or contact injury. When the electricity leaves the​ body, there is also a cutaneous injury that is larger and is known as an exit or ground injury. Always assess for entrance and exit burn injuries. All tissue in between is suspect for injury even if not readily visible. Emergency medical care for entrance and exit injuries is the same as that for other thermal burns.

Continual use of a wet dressing in a burn patient may​ cause: A. epidermal edema. B. hypothermia. C. saline saturation. D. infection.

hypothermia Because of the loss of thermoregulation of the skin with larger​ burns, the use of a wet dressing may cause the patient to become hypothermic and should be avoided. Cool for 60 to 120 seconds only.

A​ person's FIRST reaction when startled by a flash fire or explosion is normally​ to: A. lose consciousness. B. inhale deeply. C. protect the eyes. D. run.

inhale deeply 820 Most burns do not bleed and are not a cause of early shock. If signs and symptoms of shock are​ present, look for other sources of blood loss or possible spinal injury. As in all traumatic​ emergencies, a burn injury patient is a priority for transport if he is unresponsive with no gag reflex or is responsive but not following​ commands, if he has airway compromise or difficulty​ breathing, if he shows signs of shock or uncontrolled​ bleeding, or if he presents with severe pain. Critical burns themselves are not immediately life threatening. Immediate causes of death are airway swelling and inhalation​ injury, so the EMT should remain alert for these problems.

If clothing that is burned adheres to a​ patient, you​ should: A. dampen the burned clothing with water. B. cut it away only if it constricts the skin. C. leave it and cover it with a​ dry, sterile dressing. D. remove it.

leave it and cover it with a​ dry, sterile dressing. If any clothing still adheres to the​ patient, cut around the area. Do not attempt to remove the adhered​ portion, since this may cause further damage to the soft tissues.

A group of teenagers were lighting​ fireworks, and one teen suffered multiple injuries as a result. His injuries include burns to the​ face, eyes,​ neck, hands, and arms. Three fingers are missing from his left hand. He is crying out and states that he cannot see and that he is in a lot of pain. He denies difficulty breathing. The NEXT action you should take is​ to: A. administer​ high-flow oxygen. B. cool the burns with water. C. listen to his lung sounds with a stethoscope. D. cover both his eyes with a bandage.

listen to lung sounds with a stethoscope Do not skip any steps of the primary assessment. Evaluate the​ patient's airway,​ breathing, oxygenation, and circulation. Look for any indications that the airway may be injured or compromised. Parts of the body that are especially vulnerable to blast injuries are the​ lungs, ears,​ abdomen, and brain. Injuries to the lungs are the most common cause of death in burn patients.

Guidelines for the treatment of chemical burns​ include: A. minimizing further wound contamination when flushing with water by making sure the fluid runs away from the injury and not toward uninjured areas. B. continuing to flush the burned area with water for at least 5 minutes. C. flushing a chemical out of the eye from the corner of the eye to the bridge of the nose. D. immediately flushing dry chemicals off the skin with copious amounts of water to minimize the severity of the burn.

minimizing further wound contamination when flushing with water by making sure the fluid runs away from the injury and not toward uninjured areas. 823 Minimize further wound contamination by making sure fluid runs away from the injury but not toward any uninjured areas. Dry chemicals should be brushed off before being flushed with water. Most chemical burns can be flushed with copious amounts of water. Always ensure that the chemical is one that may be diluted with water. Consult a hazardous materials guidebook because some chemicals may produce combustion when they come into contact with water.

The general rule to remember with respect to the initial care of chemical burns is​ that: A. the burn should be wrapped in an occlusive dressing. B. if you choose to rinse the​ chemical, you must use sterile saline. C. most chemical burns can be flushed with copious amounts of water after the dry excess is brushed off. D. water should not be used on a chemical burn.

most chemical burns can be flushed with copious amounts of water after the dry excess is brushed off. 823 Dry chemicals should be brushed off before the burn is flushed with water. Most chemical burns can be flushed with copious amounts of water. Always ensure that the chemical is one that may be diluted with water. Consult a hazardous materials guidebook because some chemicals may produce combustion when they come into contact with water. Most locations where there are chemical accidents​ (e.g., laboratories, industrial​ sites) have portable showers to flush the chemical​ burn, since this is the first approach to treatment.

Burns to the face are considered critical​ because: A. of an elevated risk of infection. B. the skin is thinner on the face. C. the​ patient's speech may be affected. D. of the potential for respiratory compromise.

of the potential for respiratory compromise. Burns of the face are considered critical because of the potential for respiratory compromise and​ long-term cosmetic​ concerns, as are burns to the eyes or ears.

You are assessing a patient and notice red discoloration with blisters on her legs. This type of burn would be classified​ as: A. superficial. B. partial thickness. C. subcutaneous. D. full thickness

partial thickness 820 Formerly known as a​ second-degree burn, a​ partial-thickness burn involves not only the epidermis but also portions of the dermis.​ Partial-thickness burns occur from contact with fire​ (flame or​ flash), hot liquids or​ objects, chemical​ substances, or the sun. In​ addition, damage to the small blood vessels causes plasma and tissue fluid to collect between the layers of skin and form blisters. Since pain receptors are still​ intact, the patient will complain of pain from the burn. A superficial burn involves only the​ epidermis; the skin will appear pink to red and will be dry. A​ full-thickness burn involves all the layers of the​ skin; the skin will become​ dry, hard,​ tough, and leathery and may appear white and waxy to dark brown or black and charred.

Treatment of the superficial burn may​ include: A. providing intravenous fluids. B. scouring the injury site. C. applying ice. D. pouring cool saline over the injury.

pouring cool saline over the injury. pg 821 Removing the patient from the burn source does not completely stop the burning process. Burn injuries need to be cooled down within approximately the first 10 minutes of injury. Stop the burning process initially by using water or saline. Do not keep the burn​ immersed, as this may cause​ hypothermia; cool for 60 to 120 seconds only. Do not apply ice or scour the injury site.

A​ full-thickness, or​ third-degree, burn: A. will cause the skin to appear​ red, moist, and mottled. B. results from contact with hot​ liquids, flame,​ chemicals, or electricity. C. will cause the epidermis to peel and will take several days to heal. D. can cause intense pain from nerve ending damage.

results from contact with hot​ liquids, flame,​ chemicals, or electricity. 815 Formerly known as a​ third-degree burn, a​ full-thickness burn involves all the layers of the skin. This type of burn results from contact with extreme heat sources such as hot liquids or​ solids, flame,​ chemicals, or electricity. The skin will become​ dry, hard,​ tough, and leathery and may appear white and waxy to dark brown or black and charred. The tough and leathery dead soft tissue that is formed in the​ full-thickness burn injury is called an eschar. Most​ full-thickness burns are not very painful because nerve endings have been destroyed.​ However, in most such​ injuries, there will be surrounding areas of​ partial-thickness and/or superficial burns that may cause intense pain.

In applying burn dressings to the​ hands, feet or​ eyes, the guidelines​ include: A. separating all digits with​ dry, sterile dressing material. B. forcing the eyelids open if they are burned and irrigating the eyes with saline. C. applying a dressing only to the injured eye so that the patient can still see with the unaffected eye. D. leaving rings and other jewelry in place to reduce swelling.

separating all digits with​ dry, sterile dressing material. In dressing a​ burn, avoid using any material that shreds or leaves​ particles, since this may further contaminate the burn. Remove all rings and​ jewelry, which may constrict with swelling after the burn injury. Separate all digits with​ dry, sterile dressing material to prevent adhering of burned areas. Do not force eyelids open if they are​ burned; when dressing the​ eye, cover the unaffected eye also.

Burned toes should be separated​ with: A. a tongue depressor. B. cotton. C. sterile gauze pads. D. an occlusive dressing.

sterile gauze pads 822 In dressing a​ burn, avoid using any material that shreds or leaves​ particles, since this may further contaminate the burn. Remove all rings and​ jewelry, which may constrict with swelling after the burn injury. Separate all digits with​ dry, sterile dressing material to prevent adhering of burned areas.

Burns can result in what effect on the integumentary​ system? A. Swelling B. Body temperature fluctuations C. Stratification D. Capillary retention

swelling 813 As the fluids shift from the vascular beds as the result of​ buns, the total vascular volume is insufficient to meet the​ body's needs. This also explains the extensive swelling that is seen in the burn patient. In the first 24 hours after a burn​ injury, as a result of the fluid loss from the vessels into the​ tissues, the edema may cause the body to swell to double its normal size.

You are treating a​ 20-year-old male patient with a​ partial-thickness burn of his right arm. He is conscious and well oriented with stable vitals and SpO2 of 100 percent on room air. You have removed clothing and jewelry that was in contact with the affected area and have placed a clean sheet over the burns. The NEXT step in your treatment plan should​ include: A. the use of local cooling. B. initiating​ high-flow oxygen via nonrebreather mask. C. initiating aggressive fluid therapy. D. immediately transporting the patient to the nearest burn center.

the use of local cooling Use local cooling to treat minor​ soft-tissue burns involving only a​ partial-thickness injury and a small proportion of the body surface area. Provide this care only for​ partial-thickness burns that involve less than 15 percent of the BSA or very small​ full-thickness burns of less than 2 percent of the BSA.

Singed nasal hairs in a burned patient are an ominous sign​ because: A. they are very painful. B. the smell can be overpowering. C. they indicate a strong possibility of airway damage. D. they make it difficult to administer oxygen.

they indicate a strong possibility of airway damage. 820 Singed nasal hairs indicate that the patient has inhaled superheated air or even flame from a flash exposure. In either​ instance, airway swelling could be occurring and the​ patient's airway is in jeopardy. Signs and symptoms of inhalation injury include stridor or crowing from the upper​ airway; obvious burns to the body and​ clothing; burns to the neck and​ face; singed​ hair, particularly nasal​ hair, eyebrows, and other facial​ hair; and carbonaceous​ (black) sputum.

Your patient has suffered a severe electrical burn. When caring for electrical burn​ injuries, you should​ NEVER: A. take time to assess for an entrance or exit wound. B. assess the patient for muscular tenderness. C. touch a patient who is still in contact with the electrical source. D. administer oxygen by nonrebreather mask.

touch a patient who is still in contact with the electrical source. To care for an electrical burn​ injury, the EMT should​ (1) never attempt to remove a patient from an electrical source unless trained and equipped to do​ so, (2) never touch a patient who is still in contact with the electrical​ source, (3) administer oxygen by nonrebreather mask at 15​ lpm, (4) monitor the patient for cardiac​ arrest, (5) assess the patient for muscle tenderness with or without twitching and any seizure​ activity, (6) always assess for entrance and exit burn​ injuries, and​ (7) transport the patient as soon as possible.

You are dispatched to the scene of a propane tank fire. On your​ arrival, you are directed to a​ 30-year-old male patient with​ partial-thickness burns over the anterior side of​ legs, genital​ area, thorax, and face. As you approach the​ patient, you establish that he is conscious and well​ oriented, his respirations are​ 22, his radial pulse is​ 96, and the pulse oximeter shows 92 percent on room air. You immediately place him on​ high-flow oxygen via nonrebreather mask. To what oxygen saturation should you titrate your oxygen​ therapy? A. ​>94% B. ​>92% C. ​>90% D. ​100%

​>94% If inhalation of toxic gases is​ suspected, maintain an open​ airway, and administer oxygen by nonrebreather mask at 15 lpm. If toxic inhalation is not​ suspected, administer oxygen if the SpO2 is less than 94​ percent; if the patient complains of​ dyspnea; or if the patient exhibits signs or symptoms of respiratory​ distress, hypoxia,​ hypoxemia, poor​ perfusion, or heart failure.

You arrive at a chemical explosion in a factory and are completing your scene​ size-up. What types of burn mechanisms might have​ occurred? A. ​Gas, contact,​ flame, and flash B. ​Electrical, water, and corrosive C. ​Contact, corrosive, and flash D. ​Water, electrical,​ flame, and flash

​Gas, contact,​ flame, and flash 823 In case of an explosion in a chemical​ factory, the EMT should anticipate potential burns from​ gas, contact,​ flame, and flash mechanisms. Hot gases may cause upper airway​ burns; however, it is not likely that the hot gas will cause distal airway burns. Distal airway injury may occur from the​ by-products of combustion rather than from the hot gas. A contact burn occurs from contact with a hot object. The burn is normally localized to the area of contact. Flame burn occurs when the patient comes into contact with an open flame. The clothing may​ ignite, causing further burn injury. A flash burn is a type of flame burn but is the result of a flammable gas or liquid that ignites quickly. Areas of the body that are covered by clothing normally are not burned by the flash.

Which statement is TRUE about a​ partial-thickness burn? A. ​Partial-thickness burns are not very painful due to the nerve ending damage. B. A​ partial-thickness burn involves only the​ epidermis; causes​ red, dry​ skin; and can be very painful. C. ​Partial-thickness burns cause damage to the blood vessels and cause plasma and tissue fluid to collect and form blisters. D. The damaged skin of a​ partial-thickness burn is called eschar.

​Partial-thickness burns cause damage to the blood vessels and cause plasma and tissue fluid to collect and form blisters. 814-815 A​ partial-thickness burn involves not only the epidermis but also portions of the dermis.​ Partial-thickness burns occur from contact with​ fire, hot liquids or​ objects, chemical​ substances, or the sun. In​ addition, damage to the small blood vessels causes plasma and tissue fluid to collect between the layers of skin and form blisters. Since pain receptors are still​ intact, the patient will complain of pain from the burn. Eschar is the tough and leathery dead soft tissue that is formed in the​ full-thickness burn injury.

White and waxy to dark brown or black coloration and charred skin are the signs of​ a: A. ​full-thickness burn. B. ​partial-thickness burn. C. ​second-degree burn. D. superficial burn.

​full-thickness burn. 815 A​ full-thickness burn involves all the layers of the skin. This type of burn results from contact with extreme heat sources such as hot liquids or​ solids, flame,​ chemicals, or electricity. The skin will become​ dry, hard,​ tough, and leathery and may appear white and waxy to dark brown or black and charred. A superficial burn involves only the​ epidermis; the skin will appear pink to red and will be dry. Formerly known as a​ second-degree burn, a​ partial-thickness burn involves not only the epidermis but also portions of the dermis. Damage to the small blood vessels causes plasma and tissue fluid to collect between the layers of skin and form blisters.