2005 EMT-Intermediate Bridge Course

Burns

Terms and Key Points

Terms and Concepts

Integumentary system

Circumferential burn

Eschar

Burn depth classifications and assessment findings

-Superficial

-Partial-thickness

-Full-thickness

Rule of Nines

Rule of Palms

Factors in determining burn severity

Mechanisms of specific burn injuries

-Thermal

-Electrical

-Inhalation

-Chemical

Potentially critical findings for an inhalation burn

Burn treatment strategies

-IV fluids and use of the Parkland Formula

-Pain medications

Morphine sulfate
Ketorolac
Nalbuphine

- Transport considerations

Burns Application

List the structures found in each of the layers of skin outlined below.

Epidermis:

Dermis:

Subcutaneous layer:

Discuss the factors that determine the severity of a burn injury.

Define the following:

Voltage:

Amperage:

Resistance:

The human body is ______resistant to the flow of electricity.

Describe the diffferent paths of thermal and electrical injuries when an electrical current enters and exits a patient.

Matching: more than one answer may be appropriate

_____BlistersA.Superficial Burn

B.Partial-Thickness Burn

_____Destruction of nerve endsC.Full-Thickness Burn

_____Epidermal layer, mainly

_____Reddening and pain

_____High potential for infection

_____“Partial thickness”

_____No pain

Burn Assessment

Discuss how the following will impact a severely burned patient:

Major Trauma:

Temperature

Regulation:

Advanced Age of

the Patient:

Fill in the blank areas for the “Rule of Nines” assessment:

AdultLocationChild

Head

Anterior Leg

Upper Half of

Torso

Anterior Arm

Calculate the burn % and relative severity of the burns for the following patient scenarios:

A 22 year-old male was burned on his face and shoulders when the propane tank on his camping stove blew while he was attempting to light the burner. You notice that his face is red and weeping and his right shoulder is developing blisters.

A 64 year-old female was asleep in her bedroom when the living room caught fire. She was trapped in the house for approximately 20 minutes before she escaped. She has soot in her nose and is coughing but she has no singed hair or soot in her mouth. You notice burns to the palms of her hands and to her upper back. Both injury sites appear to be reddened only. She has a past medical history of angina and hypertension.

A 4 year-old child is screaming and crying from burns sustained to her torso and arms after she pulled a pot off of the stove. You notice her entire front torso and arms are red and blistered.

A 39 year-old male was injured when he fell onto a live wire during a house remodel. You notice a dry white and black area near his elbow with a reddened area surrounding it on one side of his upper forearm. You notice that his fingers are contracted. He is unable to straighten his fingers.

Burn Management

Describe a patient presentation that will require early, aggressive airway management in a burn scenario.

Match the descriptions and doses with the most appropriate medication. More than one description may apply to one or more of the medications.

____ 100% binding to opiate receptorsA. Morphine

____ 10mg doseB. Nubain

____ Moderate potential for sedationC. Toradol

____ Use caution in patients with history of GI bleeds

____ High potential for hypotension

____ 2-10mg dose

____ Limited-to-no sedative properties

____ Use caution in patients in the elderly and patients with renal failure

____ Agonist/antagonist drug with opiate receptors

____ Inhibits the production of prostaglandins

____ 30-60mg dose

____ Nausea as a side effect

____ Non-synthetic narcotic

____ NSAID (non-steroidal anti-inflammatory)

Outline the recommended treatment plan for the following types of burns. Assume that the burns are not located in critical areas of the body.

Full-thickness burn, 10% BSA

Superfiical burn, 20% BSA with a partial-thickness burn at 10% BSA

Partial-thickness burn, 50% BSA

Superficial burn, 10% BSA