Trauma Management Flashcards

Burns are classified by depth; a full-thickness (third-degree) burn is characterised by:

Answer: Destruction of all skin layers, white/brown/black leathery appearance, painless due to nerve destruction

Full-thickness burns destroy the epidermis, dermis, and subcutaneous structures, appearing as dry, leathery, white/brown/black, and painless as the nerve endings are destroyed.

The Parkland formula for burn fluid resuscitation is:

Answer: 4ml × weight (kg) × %TBSA burned, of Lactated Ringer's, with half given in first 8 hours

The Parkland formula calculates the 24-hour fluid requirement for major burns; half is given in the first 8 hours (timed from the injury, not hospital arrival) and half over the subsequent 16 hours.

The 'Rule of Nines' estimates total body surface area (TBSA) burned; the head and neck account for:

Answer: 9% in adults

In adults, the Rule of Nines allocates: head and neck = 9%, each arm = 9%, each leg = 18%, anterior trunk = 18%, posterior trunk = 18%, and perineum = 1%. Children have proportionally larger heads.

Inhalation injury is suspected in a burn patient when:

Answer: There are facial burns, singed eyebrows/nasal hair, carbonaceous (sooty) sputum, and hoarse voice

Clinical indicators of inhalation injury include facial burns, singed nasal/facial hair (indicating exposure to flame), carbonaceous sputum (soot in the airway), and hoarseness (glottic oedema) — the last indicating imminent airway compromise.

Traumatic asphyxia presents with:

Answer: Petechial haemorrhages to face and neck, cyanosis, conjunctival haemorrhages after severe chest compression

Traumatic asphyxia results from a sudden massive increase in intrathoracic pressure (e.g., crush injury) forcing blood retrograde through the valveless veins of the head and neck, causing petechiae, cyanosis, and subconjunctival haemorrhages.

Near-drowning (submersion injury) pre-hospital management priorities are:

Answer: Removal from water, airway opening, ventilation, CPR if pulseless, warm core temperature

Near-drowning management: safely rescue from water, establish airway and provide rescue breathing, begin CPR if in cardiac arrest, prevent/treat hypothermia, and transport to hospital — all standard ALS priorities.