Case Study: Integumentary System

A 16 year-old boy was admitted to the emergency room with first and second degree burns over his upper torso, limbs and face.  He had just attempted to remove the radiator cap from his car when it sprayed steam and boiling radiator fluid over the upper part of his body.  When he arrived via ambulance in the local hospital his vital signs were: B/P 138/88, pulse 110, and respiration 20.  He was experiencing significant pain.  His eyelids and face were swollen and red with small scattered blisters.  The ventral aspects of his fore-arms were covered with a predominance of large connecting blisters that extended to his hands and fingers.  His chest and neck were red with scattered blisters ranging from a few millimeters to 5 centimeters.

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• What would your initial assessment be?
• What do you believe the initial treatment would be and how might it differ if the victim was very young or very old?
• Identify ways that the burn would alter normal skin physiology.
• Identify how the alteration in the skin due to a burn would affect the integrity of the body's defense mechanism.
• How would a skin graft affect the body's defense mechanism?
• What might be the most important focus of treatment one week after the accident?
• What should you do if you are the first person at an accident scene with a burn victim?
• Who will be on the burn victim's treatment team?