Burns — Viva

Q1: Jackson zones (2 min)

• Coagulation, stasis, hyperaemia — protect the stasis zone with cooling and resuscitation. Named teaching model; not a millimetre recipe in the abstracts fetched here.^[1]

Q2: Depth clinical signs (2 min)

• Superficial erythema painful; partial blistered moist; full dry leathery insensate (teaching discriminator).^[1]

Q3: TBSA methods (2 min)

• Colson: three established methods — Rule of Nines, Lund–Browder, Rule of Palms. Exclude simple erythema. Do not quote unsourced palm = 1% as Colson.^[1]

Q4: Parkland worked example (3 min)

• ABA 2–4 mL × BSA × kg, half in first eight hours (Bodnar). Parkland 4 mL/kg/%TBSA lactated Ringer (StatPearls). Titrate to least fluid for organ perfusion (Peeters).^[1][2][5]

Q5: Inhalational injury (2 min)

• Closed space, soot, hoarseness → 100% O2, early airway, COHb. No unsourced COHb percentage recipes.^[1]

Q6: Escharotomy vs fasciotomy (2 min)

• Escharotomy divides burned eschar for circumference; fasciotomy opens fascia for true compartment syndrome (electrical).^[1]

Q7: Suxamethonium and Curling (2 min)

• Avoid suxamethonium after major burns (hyperkalaemia) — no unsourced 24-h-to-1-year clock. Curling duodenal stress ulcer — PPI and early enteral feeding in major burns.^[1]

Q8: Referral and late complications (2 min)

• ABA referral criteria exist (sensitive, not specific). EMS severe bands: greater than 10% TBSA children, 20% or more adults. Face/hands/perineum/joints, electrical/chemical, inhalational.
• Marjolin ulcer = SCC in old burn scar years later.^[1]

Q9: Fluid creep (2 min)

• Over-resuscitation → respiratory failure and compartment syndromes (Peeters). Titrate; do not blindly pour the Parkland maximum.^[5]

Q10: Chemical burns (2 min)

• Prolonged irrigation; remove clothing; do not neutralise acid/alkali with the opposite agent.
• Hydrofluoric acid: calcium gluconate gel (Lippert) or soak (Pan).^[4]

Q11: Nutrition and infection (2 min)

• Hypermetabolic; early enteral feed (ESPEN). Infection is a major late threat.
• Early excision/grafting for deep burns reduces the infection burden.^[1]

Q12: Paediatric differences (2 min)

• Lund–Browder (age-adjusted; Colson). Griffin: 20 minutes cool running water within 3 hours reduces grafting (OR 0.6). Safeguarding if history inconsistent.^[3]

References5ShowHide

1. [1]Bodnar D, Parker L, Rashford S, et al. The Pre-Hospital Initial Fluid Therapy Estimate in Early Nasty Burns (PHIFTEEN B, 15-B) Guideline applied to a retrospective cohort of Intensive Care Unit patients with major burns Burns, 2020.PMID 33183830
2. [2]Mehta M, Tudor GJ Parkland Formula StatPearls, 2026.PMID 30725875
3. [3]Griffin BR, Frear CC, Babl F, et al. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children Ann Emerg Med, 2020.PMID 31474480
4. [4]Lippert J, Desai B, Falgiani M, et al. Management of Hydrofluoric Acid Burns in the Emergency Department Cureus, 2020.PMID 32257697
5. [5]Peeters Y, Lebeer M, Wise R, et al. An overview on fluid resuscitation and resuscitation endpoints in burns Anaesthesiol Intensive Ther, 2015.PMID 26480868