MedBugs: SAQ #107

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Case: Severe burns

A 28-year-old female is brought to your rural ED after dousing herself with accelerant, then setting herself on fire. She has extensive burns. Paramedics have given her 60mg IM ketamine, however she is still screaming in pain. They have been unable to establish IV access.

1. Outline the differentiating clinical features of superficial, partial and full thickness burns. 3 marks

On your assessment you find: A – Soft stridor B – Restricted chest wall movement, RR 22, sats 99% on 10L Hudson mask C – HR 115, BP 110/80, strong radial pulses, hands slightly cool D – GCS 15, PEARL E – Partial or full thickness burns to the entire head and face, entire anterior and posterior trunk including the buttocks, the entire left leg. The arms and right leg have only small patches of superficial burns. Pulses in the left foot are absent and no cap refill in the toes. Temp 35.1

2. Briefly outline (6) important steps in your management of this patient. 6 marks

3. Other than stridor, list (3) indications for urgent RSI in the context of burns. 3 marks

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Case: Severe burns

1. Outline the differentiating clinical features of superficial, partial and full thickness burns. 3 marks

2. Briefly outline (6) important steps in your management of this patient. 6 marks

3. Other than stridor, list (3) indications for urgent RSI in the context of burns. 3 marks

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