Scenario
A 65 year old man is brought to your emergency department.
He was starting a fire in his fireplace when his clothes caught on fire.
Question
a. Describe and interpret his photograph (50%) b. Outline the principles of his fluid management (50%)
Answer
FACEM VAQ Exam 2008.2 – Question 4
- The overall pass rate for this question was 48/81 (59.2%).
- Clinical photograph showing extensive burns of variable thickness
- to the anterior neck, chest and abdomen plus face in a middle aged male receiving oxygen and non-invasive monitoring.
- Both examiners felt that this was a good question testing core emergency medical knowledge.
- Good answers described the burn in terms of area, depth and the likelihood of airway, other special area and circumferential limb burns. Fluid management principles included use of a recognised fluid replacement regime and monitoring response with vital signs, urine output and CVP.
- Poor answers failed to recognise the risk of airway injury, the need to monitor fluid therapy response and/or suggested hypotonic fluids.
- Some failed candidates seemed to ignore the suggested 50/50 time allocation or failed to answer the question as set.
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