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Major burn resuscitation — MCCQE Part 1 MCQ

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ModerateBurnsMajor burn resuscitationMCCQE Part 1

45-year-old woman presents with thermal burns from a house fire. She has circumferential partial-thickness burns to both arms and hoarse voice. Which of the following is the most appropriate next step?

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Correct answer: D — Assess airway early, start burn resuscitation and consult/transfer to a burn centre

Assess airway early, start burn resuscitation and consult/transfer to a burn centre is best because possible inhalation injury and significant burns need early airway and burn-centre care. Wait for confirmatory testing before any stabilisation is suboptimal because resuscitation and time-critical treatment should not wait when instability is present; Discharge once symptoms temporarily improve is suboptimal because temporary improvement can precede deterioration; Give an adjunctive medication as the sole first-line treatment is suboptimal because adjuncts do not replace definitive stabilisation; Delay escalation until cardiac arrest or respiratory failure occurs is suboptimal because early escalation is central to emergency care. Airway oedema can progress rapidly after inhalation injury.

Reference: Canadian Burn Association guidance