Springfield Technical Community College
Case Study 5: Skin
8 yr old white female, Angela Creighton, brought in unconscious by ambulance, presented with severe 2nd and 3rd degree burns from a house fire. She also has excessive smoke inhalation. 2nd degree burns on 5% of her body and 3rd degree burns on 15% of the rest of her body covering her thoracic and abdomen regions.
Chief complaint, review of systems
* 8 year old white female
* 5% second degree burns
* 15% third degree burns
* Excessive smoke inhalation
* Vital signs were bp: 55/35, hr: 210 bpm resp: 40 at time of admission
* Burns on thoracic and abdomen region
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2. Briefly describe the extent of damage seen in first-degree burns, second degree burns, and third degree burns.
First degree burns are least chronic burn injuries that can be treated outside of a medical facility. Second-degree burns cause damage to the second layer of the skin and causes blistering. Infections may occur because the protective layer of skin is damaged. Third degree burns destroy the outer layer of skin and the entire layer beneath the dermis.
3. Why was this girl relatively pain free when she woke up?
She might have been pain free because she’s numb from the damage of her dermal nerve endings.
4. Explain why the patients’ blood pressure was so low and her heart rate so high upon arrival at the emergency room.
The patients surviving blood vessels in her burned areas leak fluids into surrounding tissues. This causes her blood levels to decrease, but her body tries to raise her blood pressure level by increasing her heart rate, therefore, causing a high heart rate and low blood pressure.
5. Why was it important to immediately administer intravenous fluids to this girl?
She needs fluids to replace the fluid that was lost from her blood stream to avoid hypovolemic shock.
6. What is a “broad-spectrum” antibiotic, and why did she need it? Is healthy skin normally colonized by bacteria?
A broad spectrum antibiotic is a medication given to treat and prevent infections from a wide variety of bacteria. Her third degree burns put her at risk for infection because her protective layer no longer exists and protects her from bacteria....