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Burns, including electrical injury

6 important questions on Burns, including electrical injury

How much increases the fluid requirements when inhalation burns are present

The presence of inhalational burns increases fluid requirements by at least 25%.

Which two classification systems are used to assess burn area and which is prefered in children

- Rule of 9 (mostly for adults) (left on the image)
- Lund-Browder diagram (right on the image)
NB. Small or irregular areas of burn can be estimated using the palm of the patient's hand as a guide. The area of the palm, including the digits is approximately 1% of TBSA (0.5% of TBSA, if the digits are excluded).

Name the classification of burn depth and what their clinical characteristics are:

First degree: red, dry, painful
Second degree: red, blistering, wet and very painful
Third degree: hard, leathery, dry, non-blanching, relatively painless
Fourht degree: involving the subcutaneous tissues, tendons or bone

What are the main goals of fluid rescucitation in a burn patient?

Warm peripheries
Heart rate and blood pressure appropriate for age and for the patient
Urine output 1.0 ml/kg/hr
Absence of metabolic acidosis
Normal level of consciousness

What is the best means of monitoring a burn patient?

This is partly depending on co-existing injury's, multi-organ failure, and/or cardiac disease but if not present monitoring of the hemodynamic status using physhiological variables including central venous pressure should be sufficient.

When a burn patient does need ongoing fluid requirements of remains hypotensive despite adequate fluid suppletion which things should come to mind?

- unrecognised associated injuries,
- missed inhalational burn,
- associated poisoning,
- other complications such as myocardial infarction or sepsis.

The question on the page originate from the summary of the following study material:

Environmental Hazards

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