Burns Case Study #1
Mrs. J. is a 70-year-old woman who sustained a thermal burn injury in a house fire. An
electric heater ignited her bedspread while she was asleep. She was trapped in the room
for approximately 15 minutes before being rescued by firefighters.
Questions
1. Once Mrs. J. is removed from the fire, what priorities are essential in her
initial management?
The immediate concern for Mrs . J is to: ensure adequate breathing and circulation
and limit the extent of her injuries while maintaining her organ function. Mrs. J will
need O2, a blanket to prevent for temperature control, maintained NPO. Vitals will
need to be assessed and IV access for fluid resuscitation to support circulation. She
will need to be given analgesics for pain control and a prophylactic tetanus shot.
Additionally, she will need to be assessed head-to-toe to determine the extent of her
injuries and provided wound care.
2. She has singed nose hair and is coughing up sooty sputum. The
emergency department is 15 minutes away. Based on this assessment,
what should the paramedics do?
The paramedics should intubate Mrs. J if able. The singed nose hairs and
sooty sputum indicated that she is like suffering from inhalation injuries which
could severely compromise her respiratory status very quickly.
3. What diagnostic tests and assessments do you anticipate once Mrs. J. reaches
the emergency department?
Upon arrival to the ED I would suspect Mrs. J would get and ECG to monitor
heart function and possible changes from baseline. Kidney function monitoring
will begin with specific gravity, BUN and creatinine monitoring. TBSA burned
will be assessed for the amount and extent of damaged skin, doppler imaging may
be used to precisely measure tissue perfusion. The GI system will be assessed for
bowel sounds and paralytic ileus. Additionally, stool and vomit will be assess for
occult blood.
Labs: CBC, Electrolytes, ABGs, Protein and
albumin. Other: possible CT, US, MRI and
bronchoscopy
Mrs. J. is a 70-year-old woman who sustained a thermal burn injury in a house fire. An
electric heater ignited her bedspread while she was asleep. She was trapped in the room
for approximately 15 minutes before being rescued by firefighters.
Questions
1. Once Mrs. J. is removed from the fire, what priorities are essential in her
initial management?
The immediate concern for Mrs . J is to: ensure adequate breathing and circulation
and limit the extent of her injuries while maintaining her organ function. Mrs. J will
need O2, a blanket to prevent for temperature control, maintained NPO. Vitals will
need to be assessed and IV access for fluid resuscitation to support circulation. She
will need to be given analgesics for pain control and a prophylactic tetanus shot.
Additionally, she will need to be assessed head-to-toe to determine the extent of her
injuries and provided wound care.
2. She has singed nose hair and is coughing up sooty sputum. The
emergency department is 15 minutes away. Based on this assessment,
what should the paramedics do?
The paramedics should intubate Mrs. J if able. The singed nose hairs and
sooty sputum indicated that she is like suffering from inhalation injuries which
could severely compromise her respiratory status very quickly.
3. What diagnostic tests and assessments do you anticipate once Mrs. J. reaches
the emergency department?
Upon arrival to the ED I would suspect Mrs. J would get and ECG to monitor
heart function and possible changes from baseline. Kidney function monitoring
will begin with specific gravity, BUN and creatinine monitoring. TBSA burned
will be assessed for the amount and extent of damaged skin, doppler imaging may
be used to precisely measure tissue perfusion. The GI system will be assessed for
bowel sounds and paralytic ileus. Additionally, stool and vomit will be assess for
occult blood.
Labs: CBC, Electrolytes, ABGs, Protein and
albumin. Other: possible CT, US, MRI and
bronchoscopy
