what is the most significant difference between burns and other injuries? -ANSWER - consequences of burn injury are directly linked to the extent of inflammatory response to the injury
red text
what are the lifesaving measures for patients with burn injuries? -ANSWER - stopping the burning pr...
ATLS Module 9 - Thermal Injuries
Questions with Correct Answers 100%
Pass
what is the most significant difference between burns and other injuries? -ANSWER -
consequences of burn injury are directly linked to the extent of inflammatory response to
the injury
red text
what are the lifesaving measures for patients with burn injuries? -ANSWER - stopping
the burning process, ensuring that airway and ventilation are adequate, managing
circulation by gaining IV access
how do you stop the burning process? -ANSWER - completely remove the clothing...
but don't peel off adherent clothing
*but prevent overexposure and hypothermia
*recognize that "stop drop & roll" is appropriate but can lead to contamination of burn
with debris/contaminated water
how do you stop the burn if contaminated with chemicals? -ANSWER - be careful when
removing any clothing contaminated by chemicals... brush any dry chemical powders
from the wounds... then irrigate the burn areas with copious amounts of warm saline
irrigation or rinsing in warm shower
how can burn injuries effect the airway? -ANSWER - airway can become obstructed
from direct injury (inhalation injury) and the massive edema resulting from burn injury
red text
what factors increase the risk of upper airway obstruction? -ANSWER - increasing burn
size/depth, burns to head/face, inhalation injury, associated trauma, burns inside mouth
who are at greater risk for airway problems between adults and children? -ANSWER -
children because their airways are smaller
what are the indications for early intubation? -ANSWER - -Signs of respiratory distress
(stridor, hoarseness, accesorry muscle use, sternal retraction
-extent of burn >40% total body surface area
-extensive & deep facial burns
-burns inside mouth
-significant edema or risk for edema
, -difficulty swallowing
-signs of respiratory compromise (unable to clear secretions, respiratory fatigue, poor
oxygenation)
-decreased level of consciousness
-anticipated transfer of large burn
what carboxyhemoglobin level in a patient who was involved in a fire suggests
inhalation injury? -ANSWER - >10%
pt with inhalation injuries should be transferred to burn centers. what do you do if
transport time is prolonged? -ANSWER - intubate before transport
direct thermal injury to lower airway is rare... when does is essentially occur? -ANSWER
- only after exposure to superheated steam or ignition of inhaled flammable gases
red text
what are the 3 causes that breathing concerns arise from? -ANSWER - hypoxia, carbon
monoxide poisoning, smoke inhalation injury
what symptoms are seen in patients with higher carbon monoxide levels? -ANSWER -
headache, confusion, coma, death
why should all patients with CO exposure receive high flow 100% oxygen via non
rebreathing mask? -ANSWER - CO dissociates very slowly (4 hours) on room air... but
the half life can be reduced to 40 minutes when on 100% oxygen
why cant you reliably use pulse oximetry to rule out carbon monoxide poisoning? -
ANSWER - most cannot distinguish oxyhemoglobin from carboxyhemoglobin
what is a sign of potential cyanide toxicity?
*which can occur from products of combustion when burns occur within a confined
space -ANSWER - persistent profound unexplained metabolic acidosis
what is the sequence of events that may occur in the distal bronchioles following an
inhalation injury? -ANSWER - -smoke particles settle into bronchioles
-leads to damage and death of mucosal cells
-leads to increased inflammatory response
-which leads to capillary leakage
-results in increased fluid requirements and oxygen diffusion defect
-then, necrotic cells slough off & obstruct airways... diminishing clearance & increasing
risk of pneumonia
how can you reduce neck and chest wall edema following inhalation injury? -ANSWER -
after spinal injury has been excluded... elevate head and chest to 30 degrees
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