case study #1: j.b. 6 y.o. female pulled from burning house, apneic upon arrival to rural clinic;...
TRANSCRIPT
Case Study #1: J.B.Case Study #1: J.B.
• 6 y.o. female pulled from burning house, apneic upon arrival to rural clinic; intubated by GAT
• Flight estimated 60% TBSA, Burn ED placed at 75% TBSA
• Escharotomies to bilat thighs, fascio to calves, Dobhoff with enteral feedings (11.18.09)
• Amputation of all left digits, albumin continued (11.18.09)
• 6 y.o. female pulled from burning house, apneic upon arrival to rural clinic; intubated by GAT
• Flight estimated 60% TBSA, Burn ED placed at 75% TBSA
• Escharotomies to bilat thighs, fascio to calves, Dobhoff with enteral feedings (11.18.09)
• Amputation of all left digits, albumin continued (11.18.09)
• MRSA cultured from ET tube (11.17.09), trached (11.20.09)
• Acute septicemia (11.23.09)• Burns evolved to 95% TBSA
at time of death (11.30.09)• Final diagnosis at time of
death: rhabdomyolysis, hypokalemia, MRSA septicemia, fungemia, hyperchloremic metabolic acidosis, hypoxic encephalopathy
• MRSA cultured from ET tube (11.17.09), trached (11.20.09)
• Acute septicemia (11.23.09)• Burns evolved to 95% TBSA
at time of death (11.30.09)• Final diagnosis at time of
death: rhabdomyolysis, hypokalemia, MRSA septicemia, fungemia, hyperchloremic metabolic acidosis, hypoxic encephalopathy
Case Study #2: D.W.Case Study #2: D.W.
• 2 y.o. female pulled from house fire by mother and taken via EMS to rural clinic
• Intubated by flight crew p/ carbonaceous sputum noted
• Flight estimated 80% TBSA, Burn ED placed at 60%
• Pt admitted to Burn ICU, underwent immediate excision and xenografting on back, arms, legs and trunk (12.8.09)
• 2 y.o. female pulled from house fire by mother and taken via EMS to rural clinic
• Intubated by flight crew p/ carbonaceous sputum noted
• Flight estimated 80% TBSA, Burn ED placed at 60%
• Pt admitted to Burn ICU, underwent immediate excision and xenografting on back, arms, legs and trunk (12.8.09)
(Case Study #2: D.W., cont.)
(Case Study #2: D.W., cont.)
• Multiple xenografts, aquaseal dressings and transcyte (wk 3)
• Fem art line developed clot secondary to compartment syndrome, requiring amputation of all right toes (week 2-4)
• Developed hypertrophic scarring and MRSA infection to back, responsive to abx (week 6)
• Transferred to med-surg, continuing therapy (week 9)
• Multiple xenografts, aquaseal dressings and transcyte (wk 3)
• Fem art line developed clot secondary to compartment syndrome, requiring amputation of all right toes (week 2-4)
• Developed hypertrophic scarring and MRSA infection to back, responsive to abx (week 6)
• Transferred to med-surg, continuing therapy (week 9)