Title: Burn Case Scenario
1Burn Case Scenario
- Lee Faucher
- Sarah Larson
- Kim Maerz
2Setting the scene
- You are one of a two person crew with same
training. No driver. Nearest burn center 3
hours by ground. Nearest trauma center 15
minutes by ground. Two air ambulances could be
requested. No weather problems.
3Page (T -8 minutes)
- Please respond to structure fire, City fire
already present. One patient extricated from
building.
4Arrival (T 0)
- Find one 30 year old male with burns to face,
bilateral upper extremities, chest and back.
Moaning to pain, not responsive to verbal stimuli.
5Begin assessment of patient
- Do you need help?
- Is there an airway concern?
- Does he need an IV?
6At scene ( T 2 minutes)
- Fire fighters bring out three more victims from
the building - 5 year old, not breathing, no pulse, minimal
burns - 12 year old, crying in pain, answers questions,
burns to bilateral arms and hands - 32 year old, answers questions, only areas not
burned is chest and back
7Now what?
8Patients needing help
- 30 year old male with burns to face, bilateral
upper extremities, chest and back. Moaning to
pain, not responsive to verbal stimuli. - 5 year old, not breathing, no pulse, minimal
burns - 12 year old, crying in pain, answers questions,
burns to bilateral arms and hands - 32 year old, answers questions, only areas not
burned is chest and back
9Primary Triage
- 30 year old male with burns to face, bilateral
upper extremities, chest and back. Moaning to
pain, not responsive to verbal stimuli.
10Primary Triage
- 5 year old, not breathing, no pulse, minimal
burns
11Primary Triage
- 12 year old, crying in pain, answers questions,
burns to bilateral arms and hands
12Primary Triage
- 32 year old, answers questions, only areas not
burned is chest and back
13Patient classification after triage
- 30 year old male with burns to face, bilateral
upper extremities, chest and back. Moaning to
pain, not responsive to verbal stimuli. - 5 year old, not breathing, no pulse, minimal
burns - 12 year old, crying in pain, answers questions,
burns to bilateral arms and hands - 32 year old, answers questions, only areas not
burned is chest and back
Priority 1
Dead
Priority 2
Priority 2
14Priority 1 patient 30 year old male with burns
to face, bilateral upper extremities, chest and
back. Moaning to pain, not responsive to verbal
stimuli.
- Airway
- Breathing
- Circulation
15Priority 1 patient
- How much do you need to do to make him good
enough and stable for transport?
16Priority 2 patient12 year old, crying in pain,
answers questions, burns to bilateral arms and
hands
- What is the potential for airway problem?
- How soon will resuscitation need to be started?
- How much do you need to do to make him good
enough and stable for transport?
17Priority 2 patient32 year old, answers
questions, only areas not burned is chest and
back
- What is the potential for airway problem?
- How soon will resuscitation need to be started?
- How much do you need to do to make him good
enough and stable for transport?
18Dead patient5 year old, not breathing, no
pulse, minimal burns
19September 11, 2001
- 820am
- American Airlines Flight 77 Departed Washington
Dulles at 820am - 58 passengers, crew of 6
- 938am
- A 757-200 crashes into the Pentagon
20Patient Admissions
Patient Gender TBSA Arrival
1 F 0 lt1
2 F 21 lt1
3 M 22 lt1
4 F 66 lt1
5 M 49 lt1
6 F 68 lt1
7 M 41 7
8 M 42 10
9 M 32 28
10 M 10 31
21Start getting the burn off
- 23 excision and grafting procedures done in the
first 96 hours - Supplies delivered by car from as far away as
Dallas, TX
22Products consumed
IV Fluids 141 Liters
Silvadene cream 950 Jars
Burn Dressing Gauze 2006 packs
4X4 gauze 18,490
Kerlix gauze 3108 rolls
Ace Bandages 2111
Allograft 26,700 sq cm
Synthetic skin 30,365 sq cm
Autograft 22,087 sq cm
PRBCs 269 units
23Post-Burn Weeks
24Outcomes
Patient Gender TBSA Age TBSA Mortality Risk Outcome
1 F 0 32 N/A Survived
2 F 21 74 11 Survived
3 M 22 61 4 Survived
4 F 66 115 62 Survived
5 M 49 100 41 Survived
6 F 68 109 44 Died
7 M 41 80 15 Survived
8 M 42 71 9 Survived
9 M 32 63 1 Survived
10 M 10 82 23 Survived