SU4.1-4 | Burns — Graded Quiz

Correct. A major burn is a trauma; assess along ABCDE, making airway protection and recognition of inhalation injury the first priority, because airway compromise and fluid loss kill before the skin wound does.

Approach the burned patient as a trauma case along ABCDE; airway protection and recognition of inhalation injury come first. The skin wound, though visible, is rarely the immediate threat to life.

A burned patient is a trauma patient: follow ABCDE with the airway first. Inhalation injury and an at-risk airway must be recognised early, before turning attention to the wound or even %TBSA.

Correct. Full-thickness burns destroy the entire dermis and its nerve endings, producing a dry, leathery, insensate (painless) eschar that does not blanch.

Burn depth: superficial (red, painful, dry, blanches), partial-thickness (blistered, very painful, moist, blanches), full-thickness (dry, leathery, painless, non-blanching). Depth and %TBSA together drive management.

Full-thickness burns are dry, leathery, painless (nerve endings destroyed) and non-blanching. Painful, blistering, blanching wounds are partial-thickness; simple erythema is superficial (first-degree).

Correct. A circumferential full-thickness burn forms a rigid eschar that acts as a tourniquet; escharotomy (incision through the eschar) relieves the constriction and restores distal perfusion.

Circumferential full-thickness burns of a limb (or chest) can constrict like a tourniquet. Loss of distal pulses/perfusion mandates urgent escharotomy.

A circumferential full-thickness eschar can compromise distal circulation. The urgent treatment is escharotomy — incising the constricting eschar to relieve pressure — not amputation, compression or observation.

Correct. A dying declaration is a statement by a person who believes death is imminent, recorded while the patient is conscious and mentally competent; it carries significant medico-legal weight.

A dying declaration must be taken when the patient is conscious and compos mentis, recorded contemporaneously and verbatim where possible. It is a core element of medico-legal burns documentation.

The statement of a patient who believes death is near, regarding the cause of injury, is a dying declaration. Its validity requires the patient to be conscious and mentally competent (compos mentis) when it is made.

Correct. Burn rehabilitation has two arms — physical (contracture prevention, scar management, physiotherapy) and psychological (coping, body image, reintegration) — and good counselling honestly addresses both with empathy.

Burn rehabilitation = physical arm (physiotherapy, contracture prevention, pressure/scar therapy) + psychological arm (coping, body image, reintegration). Counsel honestly and empathically about both, early.

Rehabilitation counselling must cover both the physical arm (preventing/treating contractures and scarring) and the psychological arm (coping, body image, social reintegration), delivered honestly and empathically — not deferred or selectively withheld.

Correct. A large burn triggers a systemic inflammatory response that raises capillary permeability, so plasma leaks into the interstitium, dropping the circulating volume and producing burn shock — the rationale for early fluid resuscitation.

Burn shock results from inflammatory mediators raising capillary permeability → plasma leak → reduced circulating volume. This pathophysiology is the basis of Parkland fluid resuscitation.

Burn shock is a distributive/hypovolaemic state driven by increased capillary permeability from the systemic inflammatory response, causing plasma to leak into the interstitium — not primarily haemorrhage or cardiac injury. This is why crystalloid resuscitation is needed.