ACTIVITY: BURNS

Name: _________________________________________
Section: ________________________________________ Grade: _________________

Direction:
Read the situation carefully and answer the questions provided.

Situation:

Rodel is a 32 year old male. He was cooking in his kitchen when the gas range caught on fire at
2300. The entire house was engulfed in flames when the fire department arrived on scene. The
neighbor called 911 when he smelt smoke. Brad was found unconscious by the firefighters and
was pulled out. He was stabilized on scene and was rushed to Ospital ng Makati via ambulance.
While enroute, the paramedics started an 18 gauge IV in the right C and had Rodel on 100% O2
non-rebreather. Paramedics alerted Emergency Department of an estimated ETA of 5
minutes. Upon arrival at the ED, Brad was found to have stage 3 burn wounds on his anterior
and posterior torso and entire left arm with stage 2 burns on his anterior neck. Rodel was at risk
for smoke inhalation and a compromised airway, so RT intubated him and fluid resuscitation
was initiated. Upon arrival to Emergency Department the nurse assess Rodel and vital signs
were as follows: blood pressure of 92/58, heart rate of 112, oxygen saturation of 91%
respiratory rate of 22, and a temperature of 97.4°F. During transportation an 18 gauge IV was
started in right AC and 1 liter of Lactated Ringers (LR) was administered. A non-rebrether O2
applied on 100% and 15 L to achieve a saturation of 93%. HIs reported weight in the ED was 75
kg, and a body surface area of 2.0 m2.

Rodel was transferred to the Burn Intensive Care Unit (BICU) at 0030, where fluid resuscitation
was continued. At this time Rodel had already received 2 bags of LR. 1,500 mL/m2) + [(25 + %
TBSA burned) x (m2 x 24)] = total maintenance fluid (mL) to be given over 24 hours. (1,500 mL/
2.0) + [(25 + 27% TBSA) x (2.0 x 24) = (750) + [52 x 48] +750 +  2,496 = 3,246 mL to be given
over 24 hours for fluid resuscitation at a rate of 270.5 mL/hr.
Rodel was admitted to the burn unit at 0700 post surgery, and remained a patient on the burn
unit for 4 weeks. Goals of his stay included monitoring vital signs, preventing infection, pain
management, wound care, adequate nutrition, physical therapy, and psychosocial support.

Questions:

1.During the initial fluid resuscitation for Rodel’s burn, lactated ringers was the fluid of choice to
be infused. Why would the nurse choose lactated ringers a the preferred fluid of administration?

2. A nurse is assessing a burn patient that came to the burn ICU. What total body surface area
needs to be burnt in order to administer fluid resuscitation?

3. Determine the total body surface area using the following:

a. Palmer method
b. Wallace Rule of Nines
c. Parkland formula

4. Rodel experienced a variety of complex complications after his burn injury. He suffered
physiological issues with the burns and psychological referrals Rodel would need?

5. What is your plan of care for Rodel? Pls provide an NCP for Rodel.