Spoiler alert! EM-CCM next week will continue on this very seasonal topic. A fire breaks out in a fictional borough in a fictional metropolis. A family of 4 is brought from a fire in a townhouse.The three children disappear into the loving care of the pediatric ED and you are left to take care of their mother. She is awake, alert and oriented, but rather distrought. There is soot at the nares, she is tachypneic, and has faint wheezing on primary survey. You expose her by removing her seared pyjamas to find a burn on her upper leg the diameter of a grapefruit, blistered, with surrounding erythema. Vital signs show tachycardia to 134, oxygen saturation in 98% on a non-rebreather at 10L/min.

 

1) what are three signs that a patient with an inhalation injury has laryngeal edema?

answer
“brassy cough, stridor, hoarse voice

2) All of the following interventions are shown to have mortality benefit in the treatment of burns except:

a) early debriedment   b) analgesia c) antibiotics d) fluid rescusitation

answer
Prophylactic antibiotics are not indicated in an acute burn. All of the other three interventions are shown to have mortality benefit. 

Tintinalli, 7th edition.

 

By: Andy Grock and Sally Bogoch

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Categories: EM Principles

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