EMS arrival

00:00

  • EMS arrival
Call from dispatching: 42-year-old man, burnt, conscious.
EMS arrives in 15 minutes. The man communicates, complains of pain and is restless.
You as a doctor obtain his medical history, find out the mechanism of the injury and examine the patient. The man has severe burns on the left upper extremity, the abdomen, the genitals, the bottom half of the back and on the left lower extremity. Inhalation trauma is not expected.
Now your goal is to estimate the burn surface area. Which rule will you use? Where will you transport your patient?

46 % body surface area – according to the rule of nines – burn center.

Correct answer

To estimate burn surface area we use the Wallace rule of nines. Despite the longer transport we have to transport patients with burns on more than 20 % of body surface area directly to the burn centre. It is the medical facility of definitive treatment. Use of air medical transport can be advantageous and should be considered if the distance is considerably large.


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46 % body surface area – according to the rule of nines – emergency room in the closest regional hospital.

Wrong answer

To estimate burn surface area we use the Wallace rule of nines.
Emergency room in regional hospital isn’t the medical facility of definitive treatment.
We would burden the patient with the secondary transport.


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18 % body surface area – according to the rule of palm – surgical ward in the nearest hospital.

Wrong answer

Surgical ward isn’t the medical facility of definitive treatment.
We would burden the patient with the secondary transport.


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33 % body surface area – according to the rule of palm – burn center.

Wrong answer

Despite the longer transport we have to transport patients with burns on more than 20 % of body surface area directly to the burn centre. It is the medical facility of definitive treatment. To estimate the burn surface area we rather use the Wallace rule of nines.


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Help

EMS - emergency medical services
PMH - past medical history×
 
RR

22 bpm

HR

111 bpm

SpO2

95 %

BP

150/80 mmHg

ECG

sinus rythm, regular pace, BPM 108 bpm

Examination:
PMH: 0
Medication: without chronic medication
Allergies: not known

Gly

results

ABG

not available

CBC

not available

biochemistry

not available