Chapter 29 Burns

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You are assessing a patient who complains of a burn. The skin is dry and pink in color. There are no blisters. This burn is most likely A. superficial. B. deep​ partial-thickness. C. superficial​ partial-thickness. D. ​full-thickness.

A. superficial.

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

B. Cover the burns with a sterile burn sheet.

What is the MOST ominous finding indicating a​ patient's airway is about to swell shut from an inhalation​ injury? A. ​Partial-thickness burns to the face B. Stridor C. Burns in the mouth D. Singed nasal hairs

B. Stridor

The palm of your​ patient's hand is approximately what percentage of her total body surface​ area? A. 9 percent B. 0.5 percent C. 1 percent D. 2 percent

C. 1 percent ***An alternative way to determine the BSA estimate is to compare it to the surface area of the​ patient's palm, which equals approximately 1 percent of BSA. This is known as the rule of​ ones, also called the rule of palms.

Which of the following is the second layer of the​ skin? A. Epidermis B. Hyperdermis C. Dermis D. Hypodermis

C. Dermis ***The dermis is the second layer of skin and contains the small capillary beds and the sensory structures.

Which of the following is the​ body's largest​ organ? A. Brain B. Liver C. Skin D. Stomach

C. Skin ***The skin is the largest organ of the body and serves as a barrier against outside insult and injury.

A​ 3-year-old male patient pulled a pan of hot grease from an electric stove onto himself. He has burns to both arms and his chest. How would this burn be​ classified? A. Chemical B. Radiation C. Thermal D. Electrical

C. Thermal ***Thermal burns are associated with heat applied to the body.

Which degree of burn is commonly associated with electrical​ injuries? A. Third B. Second C. First D. Fourth

D. Fourth

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? A. The patient will have airway burns. B. The patient will probably be in ventricular fibrillation. C. The patient should be flown to the closest burn center. D. The wires may still be live.

D. The wires may still be live.

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. Scene safety is crucial. Even if disconnected from the electrical​ source, the patient can still transmit stored electricity to you. D. All tissue between the entrance and exit wounds may be injured.

D. All tissue between the entrance and exit wounds may be injured. ***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.

The EMT is called to an area business due to an alkaline substance​ leaking, causing burns to the skin. Which type of burn would this be classified​ as? A. Inhalation B. Radiation C. Electrical D. Chemical

D. Chemical

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

D. Inhale deeply.

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

D. burn shock. ***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 type of burn mechanism may NOT have significant superficial tissue​ injuries, but the burns may be located deeper in the​ tissue?

Electrical burns ***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?

Flame burn ***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.

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

Gas burn ***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

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

The EMT is determining total body surface area involved due to severe​ full-thickness burns to a large portion of the body in an adolescent. Which method should the EMT​ use? A. Rule of threes B. Rule of ones C. Rule of fives D. Rule of nines

A. Rule of threes ***The rule of nines is used to calculate total body surface area in a person with​ partial-thickness or​ full-thickness burns. The rule of ones refers to using the size of the palm of the hand and is used for​ smaller, more patchy burns. There are no rules of threes or fives.

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: A. may be difficult to find. B. will be obvious. C. is always the body part closest to the ground. D. will be opposite the body part with the entrance wound.

A. may be difficult to find.

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

A. 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.​

A female patient 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? A. Assess the airway and assist breathing. B. Immobilize the patient to a long backboard. C. Attach an​ AED, as the patient is about to go into cardiac arrest. D. Complete a secondary assessment.

A. Assess the airway and assist breathing. ***Establish and maintain a patent airway and adequate breathing. If the tidal volume or respiratory rate is​ inadequate, initiate positive pressure ventilation at a rate of 10 to 12 per minute.

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

A. Brushing off the excess material ***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.

A patient has​ partial-thickness burns over 18 percent of his​ body, including both feet. Which classification does this patient fall​ under? A. Critical B. Minor C. Moderate D. Superficial

A. Critical ***Hands and feet are given special consideration because of the potential for loss of function. Burn injuries to the genital or groin region are of concern because of the potential for loss of genitourinary function and increased chances for infection.

What is the resulting injury called when the burn penetrates all the way to the bottom layer of​ skin? A. Full thickness B. Partial thickness C. Superficial D. Superficial partial thickness

A. Full thickness ***Formerly known as a​ third-degree burn, a​ full-thickness burn involves all the layers of the skin. A​ partial-thickness burn involves not only the epidermis but also portions of the dermis. A superficial burn involves only the epidermis.

A​ 42-year-old male patient was rescued from a house fire. His legs appear black and charred. He does not complain of any pain. What is the proper classification of this​ burn? A. ​Full-thickness. B. Superficial​ partial-thickness C. Superficial D. Deep​ partial-thickness

A. Full-thickness. ***​Full-thickness burns do not usually present with pain due to nerve damage. The skin may present black and charred or hard and leathery.

Which of the following is an accurate statement regarding the​ dermis? A. It contains the sensory structures of the skin. B. It provides a watertight barrier. C. It is composed of fatty connective tissue. D. It contains the larger blood vessels.

A. It contains the sensory structures of the skin. ***The dermis contains small capillary beds and the sensory structures of the skin.

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

A. 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.

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

A. Superficial burns over the front and back of both arms ***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.

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? A. The patient has blood loss from elsewhere in the body. B. The​ patient's heart is failing. C. The​ patient's blood vessels are starting to dilate. D. The patient is suffering from burn shock.

A. The patient has blood loss from elsewhere in the body. ***The fluid loss from burn shock is usually not significant in the early hours of a burn. An EMT who finds a newly burned patient in a state of hypoperfusion should first consider direct blood loss from an associated external or internal hemorrhage.

A patient sustains burns from boiling water that spilled from a pot. Which type of burn should the paramedic document in the​ record? A. Thermal burn B. Flash burn C. Flame burn D. Contact burn

A. Thermal burn ***A thermal burn is caused by contact with hot​ water, heat, or steam. A flash burn is a flame burn that happens from a flammable gas or liquid that quickly ignites. A flame burn occurs from an individual coming in contact with an open flame. A contact burn occurs from contact with a hot object such as a curling iron or hot exhaust pipe.

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

A. full-thickness 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 innermost layer of skin is known as the A. hypodermis. B. hyperdermis. C. dermis. D. epidermis.

A. hypodermis. ***The hypodermis​ (also called the subcutaneous​ layer) is the innermost layer of skin.

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

B. Critical

You are assessing a​ 36-year-old male patient 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? A. Take​ vitals, and then transport him to the local hospital. B. Administer​ oxygen, place a dry dressing on the​ arm, and transport him to the burn center. C. Wrap the arm in a wet​ dressing, and transport him to the local emergency department for further assessment. D. Flush the burn injury right away.

B. Administer​ oxygen, place a dry dressing on the​ arm, and transport him to the burn center. ***Pay particular attention to evidence of inhalation injury to the​ patient's upper airway. Maintain an open​ airway, and administer oxygen by nonrebreather mask at 15​ lpm, since inhalation of toxic gases is suspected. Give the patient a full​ assessment, apply a dry​ dressing, and prepare to transport him to the burn center.

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.

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

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? A. Place an ice pack over the burn. B. Cover the burn with a sterile burn sheet. C. Pain management is not necessary for​ partial-thickness burns. D. Cover the burns with silver sulfadiazine.

B. Cover the burn with a sterile burn sheet. ***Use water or saline to help stop the burning and reduce pain. When you have finished doing​ this, cover the patient with a sterile burn​ sheet, as even the movement of air currents over a burn can be painful. Do not use ice packs.

Age is a major factor in determining the severity of a burn injury. Which statement is​ CORRECT? A. 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. B. Infants have a potential for greater fluid loss in burn injuries than adults. C. Children under 10 years of age have less tolerance for burn injuries. D. Adults over 45 years of age have less tolerance for burn injuries.

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

The paramedic arrives on the scene of a train derailment. There are people around the area who are having difficulty breathing. Which type of injury should the paramedic expect to​ find? A. Electrical B. Inhalation C. Radiation D. Thermal

B. Inhalation ***Inhalation injuries occur from airway damage from toxic gases or steam. They would cause airflow restriction.

Which burn injury in an adult patient would be considered critical in terms of​ severity? A. Superficial burns over the front and back of both arms B. ​Partial-thickness burns of the right hand and arm C. ​Partial-thickness burns to the upper thorax posteriorly D. ​Partial-thickness burns involving the anterior thigh and shin

B. Partial-thickness burns of the right hand and arm ***Although the involved percentage is only 9​ percent, involvement of a hand shifts this patient from minor to​ critical, as hand injuries are considered to be more significant because of potential loss of function. 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. Burn injuries to the genital or groin region are of concern because of the potential for loss of genitourinary function and increased chances for infection.​ Finally, burns that occur to regions of the body where there is major joint function may be considered critical because of loss of joint function if the injury does not receive appropriate burn care early in the course of recovery.

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 deal with burns better than adults do. B. Pediatric patients have a high body surface area to body weight ratio. C. Pediatric patients have a low tolerance for the associated pain. D. Pediatric patients have an underdeveloped integumentary system.

B. 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.

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

B. 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.

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

B. 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.

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

B. separating all digits with​ dry, sterile dressing material. ***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.

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

B. ​Partial-thickness burns cause damage to the blood vessels and cause plasma and tissue fluid to collect and form blisters ***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.

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. 9.5 percent B. 18 percent C. 13.5 percent D. 16 percent

C. 13.5 percent ***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.

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 the​ 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. 90 percent or greater B. 92 percent or greater C. 94 percent or greater D. 100 percent

C. 94 percent or greater ***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.

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

C. 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.

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. ​Water, electrical,​ flame, and flash B. ​Contact, corrosive, and flash C. ​Gas, contact,​ flame, and flash D. ​Electrical, water, and corrosive

C. Gas, contact,​ flame, and flash ***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.

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.

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

An EMT working a local sporting event responds to a call for a burn. The EMT notes it is a​ first-degree burn from contact to spilled hot chocolate. The skin is pink without blistering. Which type of burn should the EMT​ document? A. ​Partial-thickness B. ​Full-thickness C. Superficial D. Deep​ partial-thickness

C. Superficial ***A superficial burn is a​ first-degree burn that presents with pink to red dry skin without blistering. A​ full-thickness burn involves all layers of the skin causing a​ charred, dark brown or​ white, leathery appearance.​ Partial-thickness burns are further classified as superficial​ partial-thickness and deep​ partial-thickness burns. These burns have blisters with white to red skin that is moist and mottled.

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 inhalation and occluded airway D. Toxic shock​ syndrome, superheated air​ inhalation, and cellular degeneration

C. Toxic inhalation and occluded airway

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

C. completing a scene​ size-up. ***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.

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

C. eschar ***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.

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

C. 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.

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

C. hypothermia. ***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.

If clothing that is burned adheres to a​ patient, you​ should:

C. leave it and cover it with a​ dry, sterile dressing. ***If clothing that is burned adheres to a​ patient, you​ should:

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

C. minimizing further wound contamination when flushing with water by making sure the fluid runs away from the injury and not toward uninjured areas. ***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.

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. subcutaneous. C. partial thickness. D. full thickness.

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

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

The EMT is caring for a patient who presents with burns to the hand from touching a stove top burner. Which type of burn would this be​ considered? A. Radiation B. Scald C. Chemical D. Contact

D. Contact ***Contact burns occur from contact with a hot object such as a stove top burner. Contact with hot liquid causes a scald burn. A chemical burn is caused by​ acids, alkalis, or other chemicals. Radiation burns are from contact with radiation.

Which group of patients are more apt to develop infections secondary to​ burns? A. Adult males B. Teenagers C. Adult females D. Elderly

D. Elderly ***Geriatric patients are less able to combat infection and are more apt to have underlying diseases that complicate the initial injury as well as compensatory and recovery mechanisms.​ Pre-existing cardiovascular,​ pulmonary, endocrine, or neurological disease may turn a minor or moderate burn into a critical condition in an elderly patient because of the older​ body's inability to adequately respond to the stress of the burn.

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

D. Full-thickness ***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

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

D. 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 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? A. One of the rescuers may be injured if they are using power tools. B. The patient may arrest before extrication. C. Police on scene have closed down the​ freeway, causing you to be trapped. D. The tanker may​ explode, causing burn injuries.

D. The tanker may​ explode, causing burn injuries.

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

D. They indicate a strong possibility of airway damage. ***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

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. cool the burns with water. B. administer​ high-flow oxygen. C. cover both his eyes with a bandage. D. listen to his lung sounds with a stethoscope.

D. listen to his 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.

A standardized way to quickly determine the amount of skin surface that is burned is called​ the: A. rule of eighteens. B. Parkinson formula. C. Parkland formula. D. rule of nines.

D. rule of nines ***The rule of nines is a standardized way to quickly determine the amount of skin​ surface, or the body surface area​ (BSA) percentage, of a burn. Only to​ partial-thickness or​ full-thickness burns, not applied to superficial burns.


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