NUR2755: Multidimensional Care IV Burn Victim Assessment

Burn Victim Assessment Burns and fires account are a common cause of accidental death in children and adults. They account for an estimated 3,500 adult and child deaths each year (Stanford Children's Health, n.d.). Nearly 75% of all scalding burns in children are preventable (Stanford Children's Health, n.d.). There has been a decrease in the amount of burn injuries in the last 30 years. This is due to an increase use of smoke detectors, the flammability of consumer products being federally regulated, a decrease in smoking, and fewer open fires. A 19-year-old woman was admitted early this morning for burn injuries. She sustained burns over 30% of her body surface area, with partial thickness burns on her legs and back. The patient was sleeping when the fire started but managed to make her way out of the house through thick smoke. The first 24 hours are crucial in fluid replacement to reduce the end organ issues related to hypotension from hypovolemia. Using the parkland formula, the patient should receive a total of 6,000 ml in the first 24 hours (4ml x 30% x 50kg). In the first 8 hours, the flow rate should be set at 500 ml/hour (3,000 ml/6 because she arrived 2 hours before being admitted). For the remaining 16 hours, the flow rate should be set at 187.5 ml. Smoke inhalation can cause many signs and symptoms that range in severity. The respiratory tract secretes more mucus when it becomes irritated. Increased mucus production and tightening of muscles in the airway can lead to a reflex cough (Healthline, 2018). The mucus may also be clear, gray, or black depending on the amount of burned particles that were inhaled. Smoke inhalation can interfere with the body’s ability to carry oxygen, causing rapid breathing and shortness of breath (Healthline, 2018). Exposure to carbon monoxide from the fire can cause a headache. Chemicals from the fire can irritate the vocal cords and cause swelling and tightening of the upper airway, causing hoarseness or noisy breathing (Healthline, 2018). The eyes may be red from irritation due to the smoke. Confusion, fainting, and decreased alertness can also happen from smoke inhalation