CICM SAQ 2010.1 Q1
Questions
With respect to the clinical assessment of a patient presenting with a severe burn injury sustained in a house fire:
- a) Outline how burns are classified.
- b) List three methods for estimating the total body surface area affected by a burn injury.
- c) Other than the burn type and extent, list the other important features of the physical examination that should be noted as part of the initial clinical assessment of the patient described above.
Answers
Answer and interpretation
a) Outline how burns are classified.
Burns are classified by depth of injury.
Superficial (formerly first degree):
- Epidermis only
Partial Thickness (formerly second degree):
- Superficial – Epidermis and upper layer of dermis
- Deep – Extend to deeper layer of dermis
Full Thickness (formerly third degree)
- All layers of dermis and may involve underlying tissue
b) List three methods for estimating the total body surface area affected by a burn injury.
- Lund-Browder Chart
- The Rule of Nines
- The Rule of Palm
c) Other than the burn type and extent, list the other important features of the physical examination that should be noted as part of the initial clinical assessment of the patient described above.
- Basic resuscitation status: Airway patency, Breathing, Circulatory status, Conscious level
- Adequacy of resuscitation to date: heart rate, blood pressure, urine output
- Evidence of associated trauma
- Evidence of airway burn and inhalational injury: stridor, burns around nose and mouth, carbonaceous sputum
- Presence of facial and/or corneal burns, perineal burns
- Presence of circumferential burns, evidence of extremity compartment syndrome, ventilator inadequacy
- Evidence of rhabdomyolysis
- Evidence of inhalation of toxic gases eg CO
- Temperature
- Adequacy of analgesia
- Potential problems with vascular access
- Evidence of drug / alcohol ingestion and/or co-morbid conditions eg epilepsy
Examination Library
CICM
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
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