Chapter 29

The palm of your​ patient's hand is approximately what percentage of her total body surface​ area?

1%

When determining the BSA involved in a burn, the EMT should remember that the palm of the patients hand is equal to about what percentage of total body area?

1%

In estimating BSA of a burn, each upper extremity in an adult represents what percentage?

9%

What should you place on a burn that covers more than 10 percent of your​ patient's body?

A burn sheet

You are assessing a​ 36-year-old male who was injured in a house fire. He made it out just before the entire house flashed over. He has burns to his entire right arm and soot marks around his face and nose. What care should you give this​ patient?

Administer​ oxygen, place a dry dressing on the​ arm, and transport him to the burn center.

You are treating a patient with a severe electrical burn on the hand. For what other injury will you NEXT assess on this​ patient?

An exit burn

In accordance with the rule of​ nines, how does the head of an infant compare with the head of an​ adult?

An​ infant's head and neck account for twice the total body surface area of an​ adult's.

A female in her late 20s is lying unconscious in a work area with exposed electrical wiring. The supervisor on scene has turned off and locked out the power source on which the patient was working. As you​ approach, you see burn wounds on both hands. The​ patient's breathing is slow and​ irregular, and her distal pulse is slow and weak. What action should you take​ FIRST?

Assess the​ airway, and assist breathing.

Another way of identifying the seriousness of a burn is by degrees. Which statement is​ TRUE?

A​ full-thickness burn is also known as a​ third-degree burn.

Emergency medical care of a burn patient includes which​ treatment?

Brushing dry chemicals away and then flushing with water

What term is used for a burn that wraps around an entire body​ surface?

Circumferential

You are caring for adult male patient who has a critical burn to the hand after attempting to pick up a piece of hot metal after it was cut with a set of torches. What type of burn mechanism would this​ be?

Contact burn

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?

Cool the burn for 1 to 2 minutes with saline

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, administered​ high-flow oxygen via a nonrebreather​ mask, and cooled the burned area with​ saline, she is still complaining of being in severe pain. After using cool saline to stop the​ burning, which of the additional steps can you take to relieve some of her​ pain?

Cover the burn with a sterile burn sheet.

A patient has​ partial-thickness burns over 18 percent of his​ body, including both feet. Which classification does this patient fall​ under?

Critical

A patient has​ partial-thickness burns over 35 percent of his​ body, including both feet. Which classification does this patient fall​ under?

Critical

Which group of patients are more apt to develop infections secondary to​ burns?

Elderly

What type of burn occurs when the patient comes into contact with fire or​ flames?

Flame burn

What is the resulting injury called when the burn penetrates all the way to the bottom layer of​ skin?

Full thickness

The swelling of the upper airway as a result of inhalation of hot gases would be considered what type of burn​ mechanism?

Gas burn

When an oral burn can cause swelling of the airway​ structures, what is the pulmonary​ result?

Hypoxemia

Age is a major factor in determining the severity of a burn injury. Which statement is​ CORRECT?

Infants have a potential for greater fluid loss in burn injuries than adults.

What is the waste product in the blood from extensive burns that causes renal​ failure?

Myoglobin

After stopping the burning​ process, providing airway and oxygenation​ support, and immobilizing if​ needed, what other aspect of care should you try to provide for the patient with​ burns?

Pain management

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?

Pediatric patients have a high body surface area to body weight ratio.

You are caring for a victim who was rescued from a burning building by the fire department. The patient presents alert and oriented with burns to the​ arms, chest,​ neck, and face. The patient complains that he cannot breathe well. What is this​ patient's MOST critical​ injury?

Possible airway burns

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?

Scald burn

Which body system is generally NOT harmed by extensive​ burns?

Skeletal

What is the MOST ominous finding indicating a​ patient's airway is about to swell shut from an inhalation​ injury?

Stridor

Your​ 22-year-old male patient has sustained thermal burns involving the entire front of both legs. These burns are dry and​ "leather-like." How severe are these​ burns, and how should you care for​ them?

The burns are​ critical, since they are over 10 percent full thickness. Wrap them in a dry dressing.

Regarding the severity of the​ burn, chemical burns are generally limited by which​ process?

The chemical burn generally destroys the tissue with which it is in contact.

If you arrive on scene and find a burned patient with​ hypoperfusion, what does that tell you about the status of the​ patient's circulatory​ system?

The patient has blood loss from elsewhere in the body.

Which consideration could be a concern to your safety when doing a standby at a motor vehicle accident in which a​ tractor-trailer carrying fuel has overturned and the fire department is still extricating the​ driver?

The tanker may​ explode, causing burn injuries.

What is the primary result of the tissue degeneration that results from electrical​ burns?

The tissue releases toxins into the body.

You are called to the scene of a patient who was burned in an electrical mishap. Upon​ arrival, you find the patient lying beside some wiring that he was working on. What should be your first​ consideration?

The wires may still be live

What is the cause of a majority of deaths that are seen prehospitally secondary to a burning​ mechanism?

Toxic inhalation and occluded airway

All of the following are important factors to consider in determining burn severity except:

ambient environment temperature

Your patient suffered a severe electrical burn injury. In your emergency​ care, you should​ always:

assess for an entrance wound and an exit wound.

A burn that encircles a body area such as the chest, an arm, or a leg is called:

circumferential

The FIRST priority on any call in which a person was burned​ is:

completing a scene​ size-up.

The primary care for a liquid chemical burn is​ to:

continually flood the affected area with a large amount of water.

Burns are classified according to:

depth of the injury

The three layers of the skin are the:

epidermis, dermis and subcutaneous

The​ tough, leathery dead soft tissue that forms after a​ full-thickness burn is​ called:

eschar.

This type of burn mechanism is the result of a flammable gas or liquid that ignites​ rapidly, and often the burn damage is to skin surfaces NOT covered by​ clothing:

flash burn.

A​ person's FIRST reaction when startled by a flash fire or explosion is normally​ to:

inhale deeply.

When a person experiences a severe electrical shock caused by directly touching the electrical​ source, the entrance wound is often on the​ hand, and the exit​ wound:

may be difficult to find.

In a child under the age of 5, any partial-thickness burn involving between 10 and 20 percent of BSA should be considered:

moderate

Burns to the face are considered critical​ because:

of the potential for respiratory compromise.

You are assessing a patient and notice red discoloration with blisters on her legs. This type of burn would be classified​ as:

partial thickness.

A​ full-thickness, or​ third-degree, burn:

results from contact with hot​ liquids, flame,​ chemicals, or electricity.

One method that the EMT can use to estimate the body surface area damaged by a burn is:

rule of nines

A standardized way to quickly determine the amount of skin surface that is burned is called​ the:

rule of nines.

The innermost layer of the skin is the:

subcutaneous

An example of a superficial burn would be a(n)

sunburn

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:

the use of local cooling.

Singed nasal hairs in a burned patient are an ominous sign​ because:

they indicate a strong possibility of airway damage.

Your patient was involved in a serious industrial accident in which she sustained a critical electrical burn to both her hands when she accidentally grabbed a live wire. This patient will need to​ be:

transported with ALS as she may experience a cardiac dysrhythmia.

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?

​13.50%

Part of the assessment of a thermal burn is to calculate the percentage of the body surface area that has been burned. Your patient has burns to his anterior torso and the anterior surface of his right arm. What is the estimated percentage of body surface​ burned?

​22.5%

Which burn injury in an adult patient would be considered critical in terms of​ severity?

​Partial-thickness burns of the right hand and arm

The layers of the skin are​ the:

​epidermis, the​ dermis, and the subcutaneous layer.

White and waxy to dark brown or black coloration and charred skin are the signs of​ a:

​full-thickness burn.