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.
