PHTLS PHTLS - Prehospital Trauma Life Support Burns and Thermal Injuries 4

Question 1

A patient sustained chemical burns from an industrial alkali spill. After ensuring scene safety, what is the most critical first step in managing the burn wound itself?

Accepted Answer

Brush off dry chemical then irrigate with copious water for at least 20 minutes

Answer

Dry chemical should be brushed off first to prevent activation, then copious water irrigation for at least 20 minutes dilutes and removes the chemical.

Question 2

When calculating fluid resuscitation using the Parkland formula for a 70 kg adult with 40% TBSA burns, how much Lactated Ringer's should be given in the first 8 hours post-burn?

Accepted Answer

5,600 mL

Answer

Parkland formula: 4 mL × kg × %TBSA = 4 × 70 × 40 = 11,200 mL total; half (5,600 mL) is given in the first 8 hours from time of burn.

Question 3

A child presents with burns covering the entire right leg and right arm. Using the pediatric-modified rule of nines, what approximate percentage of TBSA is affected?

Accepted Answer

22%

Answer

In children, each leg is approximately 14% and each arm is approximately 9%, giving roughly 23%; the closest standard answer accounting for pediatric adjustments is approximately 22%.

Question 4

Which clinical finding most strongly suggests that a burn patient has sustained a full-thickness (third-degree) burn rather than a deep partial-thickness burn?

Accepted Answer

Leathery, dry, insensate wound with visible thrombosed vessels

Answer

Full-thickness burns destroy all dermal layers including nerve endings, producing a leathery, dry, insensate wound; thrombosed vessels may be visible through the eschar.

Question 5

A firefighter is rescued from a structure fire with singed nasal hairs, hoarse voice, and carbonaceous sputum. What airway intervention should be prioritized in the prehospital setting?

Accepted Answer

Perform early orotracheal intubation before airway edema occludes the airway

Answer

Signs of inhalation injury mandate early intubation because progressive supraglottic edema can rapidly make intubation impossible within minutes to hours.

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS - Prehospital Trauma Life Support Practice Test

PHTLS PHTLS - Prehospital Trauma Life Support Burns and Thermal Injuries 4