NURSING PRACTICE 4Situation 1 - Because of the serious consequences of severe burns managementrequires a multi disciplinary approach. You have important responsibilities as anurse.While Sergio was lighting a barbecue grill with a lighter fluid, his shirt burstinto flames. The most effective wayto extinguish the flames with as little further damage as possible is to:a. log roll on the grass/groundb. slap the flames with his handsc. remove the burning clothesd. pour cold liquid over the flamesCORRECT ANSWER: ARATIONALE: Stop, drop and roll is a simple fire safety technique taught tochildren, emergency services personnel and industrial workers as a component ofhealth and safety training. Primarily, it is a method to extinguish a fire on aperson's clothes or hair without, or in addition to, the use of conventionalfirefighting equipment.In addition to extinguishing the fire, stop, drop and roll is an effectivepsychological tool, providing those in a fire situation, particularly children,with a routine that can be used to focus on in order to avoid panic.Stop, drop and roll consists of three components.·Stop - The fire victim must stop still. Ceasing any movement which may fanthe flames or hamper those attempting to put the fire out.·Drop - The fire victim must 'drop' to the ground, lying down if possible.·Roll - The fire victim must roll on the ground in an effort to extinguishthe fire by depriving it of oxygen. If the victim is on a rug or one is nearby,they can roll the rug around themselves to further extinguish the flame.The effectiveness of stop, drop and roll may be further enhanced by combining itwith other firefighting techniques,including the use of a fire extinguisher,dousing with water, or fire beating.2. Once the flames are extinguished, it is most important to:a. cover Sergio with a warm blanketb. give him sips of waterc. calculate the extent of his burnsd. assess Sergio's breathingCORRECT ANSWER: DRATIONALE: Thermal burns are caused by exposure to flames, hot liquids, steam orhot objects. Like this one, 1st priority should go to the assessment of breathingif there are no airway problems, possibility of inhalation of the smoke from theflames may cause smoke poisoning from by products of combustion. A localizedinflammatory reaction may occur, causing a decrease in bronchial ciliary actionand a decrease in surfactant. A compromised breathing may later on lead torespiratory complications. Assess for mucosal edema in the airways, after severalhours, sloughing of the tracheobronchial epithelium may occur, and hemorrhagicbronchitis may develop, ARDS can result.(Source: Saunders Comprehensive Review forthe NCLEX-RN exam 3rd Edition, p. 545)OPTION A: covering Sergio with a warm blanket will not benefit the situation sinceit can only increase heat and compromise comfort that should be provided forSergio.OPTION B: Although giving sips of water may help in the drying of the mucosa ofthe patient, it is first essential to assess the airway and breathing of thepatient as mucosal edema may be present and sips of water may result toaspiration.