ITLS Burns and Environmental Trauma 2

Question 1

A patient rescued from a house fire has singed nasal hairs, hoarseness, and carbonaceous sputum. What should the ITLS provider anticipate?

Accepted Answer

Impending upper airway obstruction from thermal injury

Answer

Carbon monoxide poisoning only

Answer

Third-degree burns to the lungs

Answer

Smoke inhalation without airway compromise

Question 2

Using the Rule of Nines, what is the total body surface area (TBSA) burned for an adult with full-thickness burns to the entire right arm and anterior trunk?

Accepted Answer

27%

Answer

18%

Answer

36%

Answer

45%

Question 3

What is the correct initial fluid resuscitation strategy for a patient with 40% TBSA burns according to the Parkland formula?

Accepted Answer

Lactated Ringer's: 4 mL × body weight (kg) × %TBSA, half in first 8 hours

Answer

Normal saline at a maintenance rate

Answer

Colloid solution bolus of 500 mL

Answer

D5W at 250 mL per hour

Question 4

A patient presents with a circumferential full-thickness burn to the right lower leg. Several hours later, the foot becomes pale, cool, and pulseless. What complication has developed?

Accepted Answer

Compartment syndrome from burn eschar

Answer

Deep vein thrombosis

Answer

Arterial embolism

Answer

Peripheral neuropathy from the burn

Question 5

What is the most dangerous type of electrical burn injury and why?

Accepted Answer

High-voltage AC because it causes internal tissue destruction disproportionate to visible burns

Answer

Low-voltage AC because it causes more skin damage

Answer

High-voltage DC because it produces the most heat externally

Answer

Lightning strike because it always causes cardiac arrest

Question 6

A hiker is found with a core temperature of 30°C (86°F). He is conscious but confused and shivering has stopped. How should the ITLS provider manage this patient?

Accepted Answer

Handle gently, remove wet clothing, insulate, and transport to a hospital for rewarming

Answer

Encourage the patient to exercise to generate heat

Answer

Aggressively warm with hot water bottles placed directly on skin

Answer

Administer warm IV fluids at maximum rate and vigorously rub extremities