Burn and Thermal Trauma Flashcards

How does burn shock differ from simple hypovolemic shock from hemorrhage?

Answer: Burn shock involves both intravascular volume loss and massive capillary leak from systemic inflammatory mediator release

Burn shock involves massive capillary permeability from inflammatory mediator release combined with third-spacing, making it more complex than hemorrhage-only hypovolemia.

Why is tetanus prophylaxis a standard component of burn wound management?

Answer: Burn wounds create a necrotic, anaerobic environment ideal for Clostridium tetani proliferation

Devitalized burn tissue creates an anaerobic, protein-rich environment that is ideal for Clostridium tetani growth, making tetanus prophylaxis essential.

In a patient rescued from a fire involving burning synthetic materials who remains hemodynamically unstable despite 100% oxygen therapy, the trauma nurse should suspect:

Answer: Concurrent cyanide poisoning in addition to carbon monoxide toxicity

Combustion of synthetic materials and plastics releases hydrogen cyanide; persistent instability unresponsive to oxygen therapy suggests combined CO and cyanide poisoning.

A patient with high-voltage electrical burns develops dark, cola-colored urine. What is the correct initial management?

Answer: Increase urine output to 1–2 mL/kg/hour and consider urinary alkalinization with sodium bicarbonate

Myoglobin released from electrically destroyed muscle is nephrotoxic; increasing urine flow flushes tubules and alkalinizing the urine with bicarbonate prevents myoglobin precipitation in renal tubules.

When decontaminating a patient with tar or asphalt burns, the recommended technique is:

Answer: Application of a lipophilic agent such as petroleum jelly to dissolve and gently remove the tar

Tar and asphalt are lipophilic and adhere firmly to tissue; applying petroleum-based products dissolves the material for safe removal without causing additional mechanical trauma.

In a patient with combined blast injury and thermal burns, what assessment takes priority after the airway is secured?

Answer: Assessing for blast lung injury (pulmonary barotrauma) as a life-threatening cause of hypoxia

Blast lung injury causes pulmonary barotrauma with pneumothorax or parenchymal hemorrhage and is immediately life-threatening, taking priority over burn surface area assessment.

Which clinical finding is most characteristic of a full-thickness (third-degree) burn wound?

Answer: Dry, leathery, insensate wound with white, brown, or charred appearance

Full-thickness burns destroy all dermal layers including nerve endings, producing a dry, leathery, insensate wound that is painless due to complete nerve destruction.