Angela Creighton, an 8-year-old white female, was transported by ambulance to the emergency room after being rescued

Angela Creighton, an 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, Angela was unconscious. She had burns to her epidermis and dermis over the right and left arms front and back. She also sustained burns to her front and back epidermis and dermis and underlying subcutaneous tissue covering her thoracic and abdominal regions as well as her right elbow. Her vital signs were unstable: BP 55/35; HR 210, RR 40. She was quickly deteriorating from circulatory failure. Two IV lines were inserted and fluids were administered through each. Her ABG’s upon admission were pH 7.47, PaCO2 33, HCO -3 23.

When her vital signs stabilized, Angela was transported to the pediatric intensive care unit (ICU).
Angela regained consciousness the following morning, voicing only minor pain over her trunk.

Angela began a long, slow recovery. Her position in bed was changed every 2 hours to prevent the formation of pressure sores. 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, she was back on solid foods, and she was discharged from the hospital with a rehabilitation plan for both physical and occupational therapy at home. Community nursing visits, twice-weekly, were also arranged

1. What types of burns does Angela have? Explain using degrees and thickness.

2. Using Lund Brower and the Rule of 9’s what percentage of Angela’s body is burned?

3. Explain what you are seeing in Angela’s vital signs on admission. What is your interpretation of her presentation what is she experiencing? Explain using pathophysiology of burns