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

Singed nasal hairs, hoarseness, and carbonaceous sputum are classic signs of thermal inhalation injury, which causes progressive upper airway edema that can lead to complete obstruction within hours.

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

The entire right arm is 9% and the anterior trunk is 18%, totaling 27% TBSA. This exceeds the threshold for major burn center referral.

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

The Parkland formula calculates total crystalloid needs as 4 mL × kg × %TBSA burned, with half the calculated volume infused in the first 8 hours from the time of burn and the remainder over the following 16 hours.

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

Circumferential full-thickness burns create a rigid, non-elastic eschar that acts like a tourniquet as underlying tissue swells, causing compartment syndrome with vascular compromise.

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

High-voltage AC causes the most dangerous electrical burns because current travels through the body along blood vessels and nerves, destroying deep tissues while skin burns may appear minimal.

ITLS - International Trauma Life Support Practice Test

ITLS - International Trauma Life Support Practice Test

ITLS Burns and Environmental Trauma 2