Burns.

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What is the generally accepted time you should run cool water over a burn?

20 minutes.

5 minutes.

30 minutes.

1 hour.

It should be cool running water. Do this as soon as possible after the burn but benefits have been shown for up to 3 hours after the burn.

Do not use ice or butter.

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Which describes the "Modified Parkland Formula" for IV fluid replacement?

2mls/kg/% burn. Give 1/2 in the first 8hrs from the burn, rest in next 16hrs.

4mls/kg/% burn. Give 1/2 in the first 8hrs from the burn, rest in next 16hrs.

2mls/kg/% burn. Give 1/2 in the first 12hrs from the burn, rest in next 12hrs.

4mls/kg/% burn. Give in the first 12hrs from the burn.

It is a guide only and you should regularly reassess the fluid requirements of the patient depending on the urine output and their cardiovascular status.

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Which of the following burns should make you suspect child abuse?

Symmetrical well delinated burns.

Buttock sparing burns.

Burns with a specific shape.

All of the above.

Symmetrical well delineated burns and those with relative buttock sparing often occur with immersion in hot water. If the burn has a specific shape (eg round) it may be from a cigarette. Always be suspicious especially if the presentation is delayed and the injury does not fit with the developmental age of the child.

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What dressing does the RCH guidelines give for partial thickness burns (those affecting the epidermis and down to deep dermal layer)?

SSD cream and cling film.

Acticoat moisened with sterile water, cover with cling film and bandage.

A non stick dressing like Mepitel secured with Hyperfix if required.

Moist combines covered with cling film and secured with Hyperfix.

Acticoat needs to be changed after 3 days. There is Acticoat 7 which can stay for 7 days. Place it on blue side down. Moisten with sterile water not normal saline as this inactivates the silver which is anti microbial.

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What is a "Chinese burn"?

When you drop a hot Dim Sum on your naked arm.

When someone twists the skin of your forearm between their hands.

It is Australian slang for sunburn in a tourist.

When you accidentally put "Zheng Gu Shui" on broken skin.

A Chinese burn is a particularly nasty painful manouevre occasionally seen in the school playground or performed by a vindictive sibling.

Zheng Gu Shui is a popular traditional Chinese linament.

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What is the rule of 9s when assessing burns?

It is the 9 essential steps to treat a significant burn.

It is a rapid way to roughly assess the extent of the body that is burnt.

It determines in the United Kingdom when you should call 999.

It tells you the 9 specific roles that need to be allocated in a major burn resuscitation.

9% for head and neck. 9% for each arm. 18% for each leg. 18% for anterior trunk. 18% for posterior trunk. 1% Perineum.

Used for adults.

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Which of the following is WRONG about escharotomies?

They can be performed on the limbs or the chest.

It involves a cutting down to the subcutaneous tissue.

It is a very bloody procedure.

It is used to release the constrictive pressure of the "eschar".

Surprisingly an escharotomy is not particularly bloody as you are cutting through the skin and tissue that has suffered coagulative necrosis from the burn.

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This patient has a Hydroflouric acid burn. What of the following is NOT a possible treatment?

Subcutaneous Calcium gluconate injections.

Apply 5% Calcium gluconate gel to the area.

Biers block with 10mls of 10% Calcium gluconate +5000IU Heparin in 40mls 5% Dextrose.

Immerse in copper sulphate solution.

The lower the % of Hydrofluric acid soultion that the patient has been exposed to the later they present. Speak to toxicology early on 131126 for guidance.

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When, generally, should you refer a patient to a burns unit?

> 10% Total body surface area in an adult, >5% in a child.

> 5% Total body surface area in an adult, >2.5% in a child.

> 20% Total body surface area in an adult, >10% in a child.

> 30% Total body surface area in an adult, >10% in a child.

Also > 5% BSA total thickness burn. Burns to hands, feet, perineum, genitalia, major joints. Circumferential burns. Burns in very young or old. Burns in pregnancy.

Essentially look to transfer for any significant burn.

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What advertisement was Michael Jackson doing in 1994 when he suffered burns from his hair catching fire?

Coca Cola.

7-Up.

Moove chocolate milk.

Pepsi.

He was singing "Billie Jean" when the pyrotechnics went off early and ignited his hair. He suffered second and third degree burns and needed scalp surgery.