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

The patient's palm with fingers represents approximately 1% of their total body surface area and is used to estimate burns that are small, scattered, or irregularly shaped where the Rule of Nines is impractical.

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

Hydrofluoric acid is uniquely dangerous because fluoride ions penetrate deeply, binding calcium and magnesium, causing systemic hypocalcemia that can trigger fatal cardiac dysrhythmias.

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

Superficial partial-thickness burns preserve nerve endings, causing pain and blistering, while full-thickness burns destroy all skin layers including nerve endings, resulting in a painless, leathery or waxy appearance.

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 (calcium hydroxide) is a strong alkali. Unlike acid burns that coagulate tissue (creating a barrier), alkali burns cause liquefactive necrosis that allows the chemical to penetrate progressively deeper, requiring extended irrigation.

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

In hypothermic cardiac arrest, the cold heart is resistant to defibrillation and medications. Current guidelines recommend limiting to three defibrillation attempts and withholding IV medications until core temperature exceeds 30°C.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS Burns and Environmental Trauma 3