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.
