Question

Case Scenario based upon the Integumentary System: Simon and his wife, Sarah, were in a house fire and barely escaped with their lives. Sarah received second degree burns on the anterior and posterior surfaces of her arms and legs. Simon, in trying to save their cat, suffered third degree burns on the anterior and posterior surfaces of his arms, legs, and torso. Please describe in depth..first, second, and third degree burns. Using the rule of nines, what percentage of their bodies were burned? What is the initial treatment for burn victims and what outcome may they expect from their injuries? What are the two major threats to any burn victim, that could possibly be fatal? What may the long term prognosis be for Simon and Sarah? (They were both burned on the anterior and posterior surfaces.)

Answer 1

An injury that is caused due to the exposure to heat or flame is called as burn.Depending upon the thickness of the skin involved, burn can be classified into

FIRST DEGREE

--epidermis looks red and painful, no blister formation, heals rapidly in 5-7 days by epithelialization without scarring.

Second degree burns.

affected area is red, mottled, painful, blister formation is present, heals within 14-21 days by epithelialization with scarring.

THIRD DEGREE BURNS

affected area is painless and insensitive, thrombosis of superficial muscles, requires grafting.

RULE OF NINES

it is also called as the Wallace rule of nines.,which is a tool used to asses the percentage of total body surface area involved in burn.

Each upper limb is 9%TBSA

Each lower linb is 18% TBSA

Torso 18% each side

Head and nech 9%

Perineum 1%

In children head and neck is 18%,lower limb is 13.5%,

according to this rule for simon it is 27% and his wife is 18% burn has occured.

MANAGEMENT OF BURNS

PREHOSPITAL CARE

Stop the burning process--stop, drop and roll is a good method of extinguishing fire.

Cool the burn wound--this provides analgesia and slows the microvascular damage which occur after a burn injury.Cooling should be for minumum 10 minutes and upto 1 hour to avoid hypothermia.

Give oxygen if there is an altered level of consiousness.

ELEVATE

asking the patient to sit in an elevated posture can be life saving, it also reduces swelling and discomfort

HOSPITAL CARE

Admit the patient, airway control, breathing and ventilation, circulation, disability, exposure with environmental control, fluid resuscitation, sedation and proper analgesia

MAJOR TREATS THAT CAN BE FATAL

hypovolemia and shock

renal failure

pulmonary edema and ARDS

septicemia

multiorgan failure

Major burns may have long lasting impact on the quality of people's lives, with persisting problems related to scarring, contractures, weakness, thermoregulation, itching, pain, sleep, body image and psychosocial wellbeing.Simon ans sarah wull recover soon by proper nursing and managemant