ITLS Burns and Environmental Trauma 3

Question 1

What percentage of TBSA does the palm of the patient's hand (including fingers) represent, and when is this method used?

Accepted Answer

1% TBSA; used for estimating small or irregularly shaped burns

Answer

5% TBSA; used for all burn calculations

Answer

0.5% TBSA; used only for pediatric patients

Answer

3% TBSA; used for chemical burns only

Question 2

A chemical plant worker has concentrated hydrofluoric acid on his left hand. What is the unique danger of this chemical burn beyond tissue destruction?

Accepted Answer

Fluoride ions penetrate deep tissues and cause fatal hypocalcemia and cardiac arrest

Answer

It produces toxic fumes that damage the lungs

Answer

It is impossible to decontaminate in the prehospital setting

Answer

It only causes superficial burns that mask deeper injuries

Question 3

When assessing a burn patient, how do you differentiate between a superficial partial-thickness (second-degree) burn and a full-thickness (third-degree) burn?

Accepted Answer

Second-degree burns have blisters and are painful; third-degree burns are waxy, leathery, and painless

Answer

Second-degree burns are painless; third-degree burns are painful

Answer

Second-degree burns are white; third-degree burns are red

Answer

Both have identical appearances and can only be differentiated by biopsy

Question 4

A construction worker has cement powder mixed with water on both arms for 30 minutes. What makes cement burns unique in their management?

Accepted Answer

Cement is alkaline and causes progressive liquefactive necrosis requiring prolonged irrigation

Answer

Cement requires neutralization with vinegar before irrigation

Answer

Cement burns are superficial and require minimal treatment

Answer

Cement only burns when mixed with organic solvents

Question 5

A patient was pulled from cold water after 15 minutes of submersion. He is in cardiac arrest. Should resuscitation efforts be modified due to hypothermia?

Accepted Answer

Yes, attempt defibrillation but limit to three shocks until core temperature exceeds 30°C, and withhold IV medications until rewarmed

Answer

No, standard ACLS protocols apply without modification

Answer

Yes, withhold defibrillation entirely until core temperature exceeds 35°C

Answer

Yes, only perform CPR without any medication or defibrillation

Question 6

What is the primary prehospital concern when treating a patient with radiation burns from an industrial accident?

Accepted Answer

Provider safety through contamination control and limiting exposure time, distance, and shielding

Answer

Radiation burns are immediately more severe than thermal burns

Answer

Radiation cannot cause burns and the patient likely has a chemical injury

Answer

All radiation patients must be decontaminated with bleach