Mrs. J. is a 75-year-old woman who sustained a thermal burn injury in a house fire. She was smoking a cigarette in bed while receiving home medical oxygen. She was trapped in the bedroom for approximately 15 minutes before being rescued by firefighters. No smoke alarms were noted.
Questions
1. Once Mrs. J. is removed from the fire, what priorities are essential in her initial management?
2. Mrs. J. 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?
3. What diagnostic tests and assessments do you anticipate once Mrs. J. reaches the emergency department?
4. What can you anticipate about Mrs. J.’s past medical history?
5. Mrs. J. weighs 65 kg. She has burned an estimated 30% of her body. What is her estimated fluid requirement during the first 24 hours?
6. How much fluid will be given in the first 8 hours after the injury?
7. Given Mrs. J.’s age and past medical history, what are important assessments during aggressive fluid resuscitation?
8. Mrs. J. has circumferential, white, leathery burn wounds on both arms. What type of burn wound does she have? What assessments should be performed? What type of surgical treatment and wound care should be expected during the resuscitative phase, and later in the acute care phase?
9. What type and route of pain medication should be administered to Mrs. J.?
10. When and by what route should nutrition be implemented for Mrs. J.?
11. Considering the circumstances surrounding Mrs. J’s injury, what issues will need to be addressed before her discharge from the hospital?