Mr. John Smith, age 40 sustained multiple injuries when he jumped from the second story of a burning house. He was treated at the scene by emergency medical services and transported to the emergency department of the local medical center where he was assessed and treated. It was estimated that burns covered 25% of his total body surface area (TBSA). He was also diagnosed with an inhalation injury. It was necessary to insert a breathing tube for mechanical ventilation. A central intravenous line was inserted for the administration of medication and fluid resuscitation. A urinary catheter was also inserted. Mr. Smith was then transferred to a regional burn center. Three primary medical issues were identified; second degree burns of the face, upper extremities, head and neck, respiratory injury and a fracture of his right femur (leg bone). Three operative procedures were performed; a tracheostomy (an incision in the trachea that is made to accommodate a breathing tube), two procedures to debride and graft burn wounds and a repair of the fracture of his right leg. He was hospitalized for one month and experienced complications of immobility including weakness, pneumonia and severe constipation leading to bowel blockage.
Mr. Smith was unable to function independently when he was discharged from the burn unit. He was transferred to a rehabilitation hospital for continued care. He received physical, occupational and speech therapy. He was seen by a psychologist and was diagnosed with PTSD related to the trauma of the fire. Mr. Smith was discharged after three weeks of treatment at the rehabilitation facility. He was not cleared to return to work and continued treatment as an outpatient at the burn center. His treatment consisted of moist heat, manual therapy for scar and edema management and range of motion and strengthening exercises. He was medically cleared to return to work with restrictions after one month of outpatient treatment. A year after his initial injury he was working full time without restriction and was taking medication to manage symptoms of anxiety and depression.
An investigation revealed that smoke detectors were installed in the home but did not function. Mr. Smith retained an attorney to represent him in a civil case against the manufacturer of the smoke alarm. A legal nurse consultant assisted the attorney by organizing the medical records, providing a comprehensive medical chronology and locating expert witnesses.
This month we are discussing Burn Injuries. The blog topics for this month are:
- Case Study: Burn Injuries (3/4/16)
- Burns: Initial Treatment (3/11/16)
- Burns: Long Term Treatment (3/18/16)
- Burns: Complications (3/25/16)
Note: To see all posts in this topic, click here