Acute Resuscitation & the Major Burn

Chapter 24 of Volume 3, Skin, Burns & Surgical Principles. Revision notes and examiner-style viva questions with model answers for the FRCS (Plast).

29 viva questions in this chapter

1. What do you mean by a major burn?
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2. A GP rings you. A 30-year-old has scalded her forearm 40 minutes ago. What do you tell her to do?
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3. A 34-year-old man is brought in from a house fire, intubated at scene, with burns to his chest, abdomen and both legs. Take me through your primary survey.
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4. When would you intubate this patient at the front door?
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5. How do you work out the burn size, and how accurate is it?
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6. What about the Mersey Burns app — is it NICE approved?
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7. How do you assess the depth?
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8. Why does a burn patient need so much fluid?
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9. Is burn shock just hypovolaemia?
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10. A 32-year-old, 80 kg, with 35 percent TBSA burns. How much fluid, and what?
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11. The patient arrived four hours after the burn. What do you do about the missed fluid?
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12. What about a child? And why maintenance fluid?
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13. How do you know your resuscitation is working?
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14. Six hours in, he has passed 10 mL in the last hour. What now?
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15. Would you use a cardiac output monitor to guide this?
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16. Is there a role for albumin in burn resuscitation?
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17. What is fluid creep?
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18. What is the Ivy index?
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19. How would you measure an intra-abdominal pressure, and what are the thresholds?
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20. When would you perform an escharotomy?
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21. Show me where you would make the incisions.
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22. Take me through the technique.
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23. What about the fingers?
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24. When is it a fasciotomy instead?
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25. What is the difference between a burn facility, a burn unit and a burn centre?
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26. A district general hospital rings you about a 45-year-old with 30 percent burns. Where should this patient go, and what do you tell them to do?
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27. What has to be in place before the patient leaves?
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28. This man is 68 with 55 percent burns and an inhalation injury. What is his chance of surviving?
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29. When is it appropriate to consider limiting treatment?
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