- 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?
Monday, October 27, 2014
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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First I would make sure there are only first and second degree burns. I would make sure there was no exposed tissues. I would first administer some morphine intravenously for pain because the patient will more than likely be hurting. I would then apply burn cream to the affected areas. If it was an older or younger patient I would treat it a little differently because their skin is easier to damage. Also, their immune systems are not as good so they would be more susceptible to infection if any of the burn was open. The parts of the skin that are second degree burns might now leave scar tissue and become white where the blisters were. If a skin graft were to be taken, the burned skin would then be covered but you're adding the possibility of another wound opening up and becoming infected. The most important part of healing for the first week would be to not irritate the blisters so they don't pop. Also to keep the area moisturized with a burn cream or Neosporin. If I were first on scene to a burn victim I would try to keep them as calm as possible. I would assess the burns to see how major they are and call 911. I would then tell the dispatcher whether or not I could see blisters or any white tissues so that the paramedics can alert the hospital and are aware of what they are dealing with. The patients medical team would consist of the doctor, many nurses, and any staff member in the burn unit if necessary.
ReplyDeleteKnowing the deapth of the burn will help you determine how you would need to go about treating the burns. If you are first on the scene you need to call 911 as soon as you see that the person is burned. After you do this you need to take the clothes that are burned on the person off very carefully, be careful that you dont tesr anything off that is stuck on the victim. Next you need to get a damp cloth or towel and place them over the sreas that have been burned if you can. You need to sepearate the victimd fingers and toes so they do not stick together. Place a dry towel ir something that isnt sticky and wrap the fingers and toes. Do not put any ointments on the burns at all and be very careful that you do not pop the blisters. On the staff for s burn victim you have the dr, surgeon,EMT, nurse and paramedics. To avoid shock you need to lay the person flat on there back. A skin graft could get infected if it is not monitered carefully. There is a posibility that itnwill not heal either. After the skin grows back you have a risk of infection while it is growing. Since you have a very thin layer of skin you can get cuts eaier than if you had all three layers. After the first week you need to moniter the pulse,B/P and breathing of the person. Depending on the age of a person like a kid it could be harder to treat there burn due to how little they are. They could have more problems or complications rather than a 30 year old person. The same thing goes for older people. Kids and older people have very low immune systems so that fcators into things as well.
DeleteWhat would your initial assessment be? To assess the situation
ReplyDeleteWhat do you believe the initial treatment would be and how might it differ if the victim was very young or very old?
Children require more fluid per TBSA burns
Elderly may die from small (<15% TBSA) burns
Identify ways that the burn would alter normal skin physiology. Make it red or sensitive
Identify how the alteration in the skin due to a burn would affect the integrity of the body's defense mechanism. Make it more permeable to infections
How would a skin graft affect the body's defense mechanism? Easier to get diseases
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? Call someone with better knowledge of the situation and do what you can to comfort them
Who will be on the burn victim's treatment team? Verified Burn Centers provide advanced support for complex cases
Certified by the American College of Surgeons (ACS) Committee on Trauma and the American Burn Association (ABA)
Resources will give advice or assist with care
I would first ensure that the burns were only first and second degree burns, and then administer a form of painkiller (most likely morphine) because the patient would be in pain.
ReplyDeleteThe sections of the skin that are second degree burns might be permanently scarred, as such if a skin graft were to be taken, the burn would be covered, but you run the risk of having it open up and getting infected.
Not irritating the burned area would be the number one priority for the first week of the healing process. It would also be vital to keep the burned areas moisturized with burn creams.
If I were the first person to see the accident, I would make sure the scene was safe and call 911 to have the ambulance come and take over to make sure the kid is safe.
The treatment team would be a number of doctors, nurses, and people from the burn team
My initial assessment would be to make sure they are second and third degree burns, then to do the rule of nines. I believe my initial treatment would be to rid the body of dead, charred skin and give an IV. I would also give a younger child more fluids. Burns would alter the skin physiology by the skin being more likely to get infections. If the body gets infections/virus's inside, you are most likely to get sick. The bodies graft makes you more susceptible to bacteria and infections. The most important treatment during the first week is to be careful with the skin and make sure it does not re-open and avoiding irritation. If I were a witness to the accident of the radiator I would first make sure that the scene is clear of any danger and then call 9-1-1. The care team for the patient would be any doctors and nurses or specialists from a burn unit. Physical trainers would also be included.
ReplyDelete- Jocelyn Muro
My first initial assessment would be to look for the rule of nines and see how much percent of his body is burned. Then while he is the ambulance we would give him some breathing help and some morphine, but when we arrive at the hospital he will get more breathing help and more morphine to help with pain while we are looks for debris and cleaning out the burns. He also need fluids to help him hydrate. Younger children are more deceptive to infection, if the patient needs a skin graft that could cause infection and make the whole thing worse, so if he needed one then we would monitor him carefully and make sure the skin grafts are healing properly. In the first week of treatment, I would monitor him closely and make sure nothing irritates his blisters that would cause them to pop or anything that could irritate the other burns and make it worse. If I was the first one on scene I would make sure it was safe and call 911 and keep the patient calm. The people that would care for the burn patient would probably be a burn unit in a hospital and if he needed skin grafts then they healed a physical therapist would help him gain back what he lost.
ReplyDeleteThe first initial step I would take is to see if the burn is a first, second, or third degree burn. In this case the boy has first and second degree burns. These burns are different and each burn is treated differently. A first degree burn is the least serious burn and only the outer layer of the skin is burned, but not burned all the way through. The skin is red, often swelling, and pain is sometimes present. This is a minor burn unless it involves portions of the hands, feet, face, groin, or buttocks in which requires emergency medical attention. A second degree burn is a little different except the first layer of skin has been burned through and if it is large and major then medical treatment is needed. If I was the first person at the accident of the burned victim I would make sure to get all the radiator fluid off of the boy and then check to see what kind of burn it was. After finding out they were first and second degree burns, I would want to make sure that he has a clear air way and that he is getting enough oxygen. Then I would make sure his fingers were spread apart, start cooling the burn (with tepid water), cover it with sterile gauze, drive him to the hospital or call an ambulance, get his B/P back up, and then get him a over the counter pain reliever. Minor burns usually heal without further treatment; just make sure there aren’t any signs of infection and avoid re-injuring the burn.
ReplyDeleteI would make sure that the car had stopped spraying steam and radiator fluid and then call for help right away. According to the rule of nines, it sounds like about 20-23% of the boy was burned, so he would need fluid resuscitation. If he got burned on the face, I think I would want to check if the radiator fluid got in his eyes or affected his sight. Since they are first and second degree burns the boy will feel a lot of pain, so it would be good to give him something to help ease it. I would also try to run the burned areas under some cool water, which can also help ease the burning sensation. Then we need to make sure the burned area is clean and put some antibiotic cream on, to help prevent any infections that might occur while the body defense system is weak. Warp loosely with nonstick dressing, avoid breaking or tearing the blisters, and changing daily. If areas with second degree burns are serve, skin grafts maybe needed, but may not help keep infections and bacteria from entering the body. The burns may leave scarring, so the skin may be a little tight and not as flexible as before.
ReplyDeleteThe initial assessment of this patient would be his overall percent of his body burned, check for 3rd degree burns and then administered a type of pain killer. Do to the age of this patient he his still growing and in rather good shape despite his burns. His skin is blistered, red and very painful. By running cool water over the burned area and applying antibiotic cream will help heal his wounds. Also applying bandages to prevent protection but remember to never take off these bandages once placed. His body's so called "wall" is damaged making him susceptible to infection. A skin graft would only be necessary in very serious second degree burns. If a skin graft isn't necessary the best treatment would be proper bandages applied frequently to the effected areas. Infection is the main problem for most victims and the most dangerous. If you arrive on the scene of an accident where a victim is burned you should call 911 and make sure the scene is safe. Get to the patient as soon as you can. Check for the total percent burned and get him to the hospital ASAP. A burn victims team should consist of multiply doctors and surgeon for if a skin graph is needed and multiple experts able to assess the burns.
ReplyDeleteMy initial assessment would be to see how much of his body is burned and what degree the burns are. I would use the rule of nines to determine what percentage of his body is burned. I would immediately call 911 and wait for help if I was the first person to the scene. Once the paramedics arrive he will probably be taken to by flight to the parkland hospital burn unit. At the hospital he will be given fluids through an IV and they will attempt to get his respiration up. The biggest risk involved would be if a skin graft is needed. If this was necessary there would be a risk for infection. In the weeks following the burn, a physical therapist will scrub off the dead skin and attempt to gain back blood circulation. If the patient was very young or very old, the doctors may be reluctant to use a skin graft because of a greater risk for infection with an old or young persons weaker immune system.
ReplyDelete1. is the scene safe, call 911, pour water on burn to get radiator fluid off and carefully wrap burned area and wait for help.
ReplyDelete2. Clean burned area, keep air/breathing under control, give pain reliever, amount depending on age
3. 1st degree burns is mostly a sunburn, 2nd degree burns might leave a scar because it did damage to the dermis, and might leave scaly skin.
4. The body will have a high risk of infection because the epidermis that protects you from infections and germs is gone.
5. There will be a very high chance of infection, because the movement of skin from one part of the body to another or even from person to person.
6. Give the victim antibiotics for infections, keep burn wounds covered.
7. Is the scene safe, call 911, pour water on burn to get radiator fluid off and carefully wrap burned area and wait for help.
8. Physicians, nurses, physical therapists, occupational therapists, and social workers.
If you're first on the scene, make sure it is clear. Dial 911 and keep the victim calm. Then, i would carefully remove and clothing that could stick to the skin and rip the skin or pop and blisters. I would also pour some cool water on the victim, but I would avoid his face. To help prevent infection, a cream or an ointment is used for treatment. Use a sterile gauze wrap to cover the burns. BP is a little high, pulse is a little high, and respiration is normal. The immune system is weakened by the burns. For pain, the boy can just take some over the counter medicines such as ibuprofen or acetaminophen.
ReplyDeleteIf I were first on the scene I would check the scene and be sure it is safe, then keep the boy calm and call 911. Then I would carefully take off any clothing that could possibly stick to any of his burns, avoiding ripping any part of clothing that was already stuck to the burns, and being careful not to pop any blisters. Younger children are more deceptive to infection, if the patient needs a skin graft that could also cause infection. Since the boy is in pain he would be administered some pain medicine.In the weeks following the burn, a physical therapist will scrub off the dead skin and attempt to gain back blood circulation.
ReplyDeleteIf I was the first person to arrive on this scene I would suspect major burns and lots of future scaring. Maybe have an extreme loss of blood. To take care of this patient I would give them fluids and major intensive care. Skin therapy might help if eligible. Someone older might require more care because of already scared and sensitive tissue. Someone young would require more care because their bones and skin are a lot more fragile. The skin cells would just heal and have scars. In the future, the burns might burn or scar cells that have a major effect on physical and chemical mechanisms. It would be vital that they secure the burnt area with a healing medicine. Tell them you know first aid and offer your help then, call 911. To help this patient an occupational therapist, surgeons, doctors, nutritionalists, and maybe even mental health professionals.
ReplyDeleteUpon arrival of the burn victim, I would insert an endotracheal tube, IV tube for fluid resuscitation, and a catheter into the bladder for urine output. The next priority is to treat burn shock. Burn shock is typically treated by 24 hours of intravenous fluids of a balanced salt solution. A skin graft is a risky solution, the potential for infection is high. Finally the patient is stuck in a special tube filled with derivatives of sulfa, mild soap, and antibiotics. Then I would bandage the wounds and place the patient in an isolation unit. The skin performs a number of tasks, including; internal and external barrier from the environment, secretion, sensory and temperature perception, and the synthesis of vitamin D. Vitamin D is formed by the action of sunlight on certain cholesterol compounds in the dermis. One week after the initial burn, typically the normal physiological functions start to alter.
ReplyDeleteAfter the victim was taken to the emergency room, I would check for the overall burned percentage of the body and for third degree burns or evidence of any other serious injuries. I would run cool water over and apply burn cream to the affected areas. I would also apply bandages to prevent infection. The patient is very young, so the skin will most likely experience little to no scarring from the burns. The most important things to focus on for treatment would be to prevent infection and not irritate the blistering. If I was the first person on this scene, I would make sure that the scene is safe, check for the severity of the burns, call 911 and thoroughly inform the dispatcher of the situation, and stay with the victim. The treatment for the burn patient should include nurses, doctors from the burn unit, and a plastic surgeon if a skin graft is deemed necessary.
ReplyDeleteThe first thing I would do is call 911, after that I would carefully try to remove as much clothes as possible from the boy to avoid them sticking on the burns. Next, I would pour some water on the burns. This situation might differ from an adult's because younger people are more exposed to infections and their more fragile. If I'm the first on the scene, I would try to keep the boy calm, helping him regulate his breathing, while the EMT and paramedics get there.
ReplyDeleteThe initial assessment would be that he burned 22.5 percent of his body. I would make sure he had only 1st or second degree burns and call 911 immediately.I would use a clean cloth soaked in water to cool the burns if available.At the hospital I would give them pain medication,put them on an if to get their fluid up and make sure that the burns would not get infected.I would check the burns to see if they needed a skin graft. If the person was older there could be a greater risk of infection by taking a skin graft. If they're very young doing a skin graft could cause problems in the future as they grow.after a week the biggest concern is infection. When the patient arrived at the hospital his team would have consisted of a few doctors,nurses, physicians assistant,residents,nurse care coordinator,occupational therapists,physical therapists, and a dietician.
ReplyDeleteMy initial step, after patient has been admitted to the emergency room, would be to make sure the patient does not have any worse than a third degree burn by the rule of nines. After checking the percentage of body burned I would apply water to the burns. (Though making sure not to soak the burns in water, this might cause the patient to contract hypothermia). I would then wrap the burn of the extremities with clean bandages. I would avoid any pressure to the blisters that may result in popping. Because the patient is young This burn will result into less scar tissue than it would if the patient was older. Along with scarring the patients destruction of pigment will also alter the skins physiology. Because of the scar tissue the burned areas will have little to no elasticity, creating an alteration to the body's defense mechanism. One week after the incident, the patient should be on medication and avoiding any destruction of the blisters. If you are the first to arrive to a burn victim scene it is important you call 911.
ReplyDeleteBurn Treatment Cream upon at the kind of burn. First-diploma burns commonly are dealt with pores and skin care products like aloe vera cream or an antibiotic ointment and pain remedy such as acetaminophen (Tylenol).
ReplyDelete