PHTLS - Prehospital Trauma Life Support Burns and Thermal Injuries Flashcards

Using the Rule of Nines in an adult patient, what percentage of total body surface area (TBSA) does the entire lower extremity represent?

Answer: 18%

Each entire lower extremity accounts for 18% of TBSA in an adult using the Rule of Nines (9% anterior + 9% posterior).

Which burn depth classification is characterized by dry, leathery, insensate skin that does not blanch with pressure?

Answer: Full thickness (third-degree)

Full-thickness burns destroy all layers of the dermis, producing dry, leathery, insensate skin that does not blanch because dermal capillaries are destroyed.

A patient with major burns over 30% TBSA requires IV fluid resuscitation. What is the preferred initial fluid per PHTLS guidelines?

Answer: Lactated Ringer's solution

Lactated Ringer's solution is the preferred isotonic crystalloid for initial burn resuscitation because its electrolyte composition most closely matches plasma.

In prehospital burn care, when should you stop the burning process by cooling a wound with water?

Answer: Immediately, with cool (not cold) water for 10–20 minutes

Cool (15–25°C) water applied within 3 hours of injury for 10–20 minutes reduces burn depth and pain, but ice or cold water should be avoided to prevent hypothermia.

A patient is found unconscious in a burning building. Which inhalation injury concern takes highest priority in management?

Answer: Carbon monoxide poisoning

Carbon monoxide poisoning is the most immediately life-threatening inhalation injury; it binds hemoglobin with 240× the affinity of oxygen and is treated with high-flow 100% oxygen.

Which finding is the most reliable early sign of inhalation injury requiring airway intervention?

Answer: Hoarseness or stridor

Hoarseness or stridor indicates upper airway edema from thermal injury, signaling impending obstruction and the need for early definitive airway management.