CBM Special Populations in Burn Care 1 — Questions and Answers
Question 1: Why is the Lund and Browder chart preferred over the Rule of Nines for estimating TBSA in pediatric burn patients?
- It is faster to complete in emergency settings
- It accounts for age-related differences in body proportions (Correct answer)
- It is required by JCAHO standards for pediatric care
- It uses fewer anatomical landmarks
Correct answer: It accounts for age-related differences in body proportions
Children have proportionally larger heads and smaller legs than adults, and the Lund and Browder chart adjusts body segment percentages by age to reflect these differences accurately.
Question 2: What is the most common burn mechanism in children under age 5?
- Flame burns from house fires
- Electrical contact injuries
- Scald burns from hot liquids (Correct answer)
- Chemical exposure burns
Correct answer: Scald burns from hot liquids
Scald burns from hot liquids such as hot water, beverages, and cooking liquids are the leading cause of burns in toddlers, frequently occurring in kitchens and bathrooms.
Question 3: Pediatric fluid resuscitation formulas for burns differ from adult formulas primarily by including:
- Higher albumin concentrations
- Electrolyte bolus supplementation
- Maintenance fluid requirements (Correct answer)
- Fresh frozen plasma volumes
Correct answer: Maintenance fluid requirements
Pediatric burn resuscitation must add maintenance fluids to the resuscitation volume because children require ongoing baseline hydration support that adult formulas do not address.
Question 4: A child presents with burn injuries that are inconsistent with the caregiver's explanation. The burn care team's first priority is to:
- Perform additional diagnostic imaging
- Report suspected non-accidental trauma to child protective services (Correct answer)
- Consult psychiatry for caregiver assessment
- Repeat the history interview with the child alone
Correct answer: Report suspected non-accidental trauma to child protective services
Healthcare providers are mandatory reporters; injury patterns inconsistent with stated history require immediate reporting to child protective services while continuing burn care.
Question 5: Children are more susceptible to hypothermia during burn resuscitation than adults primarily because:
- They have a higher resting metabolic rate
- Their pain response triggers systemic vasodilation
- They have a higher surface area-to-body mass ratio (Correct answer)
- They produce less endogenous heat through shivering
Correct answer: They have a higher surface area-to-body mass ratio
The larger surface area-to-body mass ratio in children causes proportionally greater heat loss through the skin, making hypothermia a significant risk during resuscitation and wound care.
Question 6: Per American Burn Association guidelines, partial-thickness burns in children under 10 years warrant burn center referral at what minimum TBSA threshold?
- 5% TBSA
- 10% TBSA (Correct answer)
- 15% TBSA
- 20% TBSA
Correct answer: 10% TBSA
The American Burn Association recommends burn center referral for children under 10 years with partial-thickness burns exceeding 10% TBSA due to their unique physiological and psychosocial care needs.
Question 7: The Galveston formula for pediatric burn nutrition calculates caloric needs based on:
- Ideal body weight and percent TBSA burned
- Body surface area and percent TBSA burned (Correct answer)
- Actual body weight and age in months
- Resting energy expenditure adjusted for fever
Correct answer: Body surface area and percent TBSA burned
The Galveston formula calculates 1800 kcal/m² BSA/day plus 2200 kcal/m² burned/day, using body surface area to account for the wide variation in pediatric body size.
CBM Special Populations in Burn Care 1
Why is the Lund and Browder chart preferred over the Rule of Nines for estimating TBSA in pediatric burn patients?