Burns - Dermatology - Medbullets Step 2/3

Snapshot
- A 42-year-old female is rescued from a burning building by firefighters and brought to the hospital. On examination, her pulse is 100/min, blood pressure is 130/60 mmHg, respirations are 34/min, and weight is 60 kg (132 lbs). She has second and third degree burns over her anterior and posterior chest and abdomen, bilateral arms and hands, and second degree burns over her face. She is coughing, spitting out carbonaceous sputum, has singed eyebrows and vibrissae (nostril hair) and a hoarse voice. Because of signs for inhalational burns, she is first intubated and ventilated. Total body surface area (BSA) involved is estimated to be 58.5%. She is given 100% oxygen, and IV lactated Ringer's (58.5% BSA x 60kg x 4ml = 14,040 ml) with 7 L administered in the first 8 hours of admission, and another 7 L in the next 16 hours. She is transferred emergently to a burn center because of facial and inhalational burns.

Presentation

Classification (New)	Degree (Traditional)	Site	Symptoms/Signs
Erythema/Superficial	1st degree	Epidermis	+ Pain Blanchable
Superficial-partial thickness	2nd degree	Into superficial dermis	+ Pain Blanchable Blisters
Deep-partial thickness	3rd degree	Into deep dermis	- Pain NOT blanchable Soft
Full thickness	4th degree	Into underlying muscle/bone	- Pain NOT blanchable Hard

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