BURN INJURIES

A cook in a restaurant was rushed to the emergency department after sustaining burns
on the face, entire torso, anterior right upper extremity, and anterior right lower extremity
including the genitalia. Answer the questions pertinent to the patient’s condition.

1. Compute for the total body surface area affected by the burns.
●FACE: 4.5%
●Entire torso: 36%
●Anterior right upper extremity: 4.5%
●Anterior right lower extremity: 9%
●Genitalia: 1%

2. Using parkland formula, compute for the fluid resuscitation for the
patient on:

a.First 8 hours
15,400 x .50= 7,700 ml

7,700ml/480 mins x 20 =320-321gtts/min

b.Second 8 hours
15,400 x .25= 3,850 ml

3,850 ml/ 480 mins x 20= 160-161 gtts/min

c.Third 8 hours

15,400 x .25 = 3,850 ml

3,850 ml/ 480 mins x 20= 160-161 gtts/min

3. What acid-base imbalance will the patient be predisposed to in the

initial stages of burns?
Burns induces a SIRS and, at first, metabolic acidosis because of tissue
hypoxia brought on by significant volume loss and reduced tissue perfusion.
The acidity worsens later due to sepsis. Additionally, metabolicacidosis is
brought on by acute renal damage. In ARDS, respiratory acidosis results.
4. What is the priority in the different phases of burn management

a.Emergent phase:
First aid
Prevention of shock
Prevention of respiratory distress
Detection and treatment of concomitant injuries
Wound assessment and initial care

b.Acute phase:
Wound care and closure
Prevention or treatment of complications, including infection
Nutritional support

c.Rehabilitative phase:phase:
Prevention of scars and contractures
Physical, occupational, and vocational
Functional and cosmetic reconstruction
Psychosocial counseling

5. Part of the management for burn patient is the administration of Proton-pump

inhibitors (PPIs) –g. Omeprazole. What is the rationale behind the inclusion of
the said drug to the therapeutic management of burn patients?

-Burn injury increases the risk for gastric mucosal damage and ulceration
(oftenknown as Curling’s Ulcers). To mitigate this risk, many burn patients are
administered acid-suppressive agents such as histamine-2-receptor
antagonists(H2RAs) or proton pump inhibitors (PPIs) as prophylaxis against
the development ofstress ulceration.