case study 818

Case History 3: Severe Burn Injury

Chief Complaint: 8-year-old girl admitted for severe second- and third-degree burns following her rescue from a burning house.

History: The 8-year-old white female, was transported by ambulance to the emergency room after being rescued from her burning house. She was asleep at night when a spark from the family fireplace started a fire, leaving her trapped in her bedroom. By the time the fire rescue squad arrived, she had suffered severe burns and excessive smoke inhalation.

In the emergency room, the patient was unconscious. She had second-degree burns over 5% of her body and third-degree burns over 15% of her body — both covering her thoracic and abdominal regions and her entire right arm. Her vital signs were quite unstable: blood pressure = 55 / 35; heart rate = 210 beats / min.; and respiratory rate = 40 breaths / min; temperature 101.5 degrees Farhenheight. She was quickly deteriorating from circulatory failure. Two IVs were inserted and fluids were administered through each. Her vital signs stabilized and she was transported to the pediatric intensive care unit (ICU).

The patient regained consciousness the following morning, surprisingly complaining of only minor pain over her trunk. Following debridement of her burns and application of a broad-spectrum, topical antibiotic, a plastic epidermal graft was applied over the burned areas. Despite treatment with a broad-spectrum antibiotic, she developed a systemic staphylococcal infection, necessitating a switch to a different antibiotic.

The 8-year-old female began a long, slow recovery. Her position in bed had to be changed every 2 hours to prevent the formation of decubitus ulcers (i.e. bedsores). She lost 9 pounds over the next 3 weeks, despite nasogastric tube feeding of 5000 calories (“Kcals”) per day. After 9 weeks, sheets of cultured epidermal cells were grafted to her regenerating dermal layer. By the 15th week of her hospitalization, her epidermal graft was complete, and she was back on solid foods, her antibiotics were discontinued, and she was discharged from the hospital with a rehabilitation plan for both physical and occupational therapy at home, as well as twice-weekly visits by a nurse.


The Assignment must be submitted in APA format.

Title page, Running header, in-text citations, reference page, 12 point font double spaced, etc.

Refer to HCC Handbook regarding Academic Honesty.

Total 25 points


  • Briefly describe the layers of the epidermis (thin & thick skin), dermis, & hypodermis (3pts)
  • Use the Rule of Nines to calculate the total Body Surface Area (BSA) burned. (1pt)

3. Briefly describe the extent of damage seen in first-degree burns, second-degree burns, and third-degree burns. (6pts)

4. Why was this girl relatively pain-free when she woke up? (1pts)

5. What are normal vital signs? Are Angela’s vital signs normal? If not explain is the vital sign higher or lower than normal. Explain why the vital sign(s) is/are abnormal. (6pts)

6. Why was it important to immediately administer intravenous fluids to this girl? (1pts)

7. Describe the series of events that occur in skin which is healing. In other words describe the steps involved in wound repair. (3pts)

8. Define a decubitus ulcer/pressure sore. Why are bedridden patients at risk for developing decubitus ulcers? Where on the body do such ulcers most commonly occur? (3pts)

9. Define a keloid. (1pts)

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The case study must be in APA format which includes title page, no hypothesis, in text citation, no website research, do not rewrite the question, just answer in a few sentences and make sure all answers all numbered. You must use Human anatomy & physiology book by Marieb Hoehn (Pearson) 10th or 11th edition

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