Case Scenario:
Molly is a 28-year-old female, recently graduated from an Esthetician program at the community college. Currently she is working part time in the kitchen of a local restaurant, while trying to find full time employment in her chosen profession.
She lives with her partner of 4 years; the partner's name is Chris. One-night Molly stayed late at work to empty the fryer; her co-worker was supposed to turn the heat off before leaving, but they forgot. When Molly went to empty the fryer, the oil spilled on her. Immediately after the incident, she was rushed to the hospital by ambulance with the following injuries:
- Full thickness burns to the entire right side of her face (anterior)
- Full thickness burns to both arms (anterior and posterior) from the shoulder to the wrist as well as both hands.
- Partial thickness burns bilaterally to her legs (anterior - groin to foot).
On route to hospital the paramedics inserted a large bore angiocath into the right antecubital fossa with 0.9%NaCl is infusing at 150mls/hr. Molly remained alert and orientated in the ambulance explaining what occurred.
On arrival to hospital, in the resuscitation room:
Molly is complaining of severe pain to her legs. She reports no pain to her face or arms. She is alert, orientated and responds appropriately to questions.
Vital signs: T: 35.9, HR: 132, RR. 24, B/P: 88/42, SPO2: 95% (r/a)
Weight: 62 kg
Lab Values:
? Serum sodium is 130 (135-145)
? Serum potassium is 3.7 (3.5-5.0)
? Creatinine is 120 mmol/L (60-110 mmol/L)
? BUN is 12 mmol/L (2.5-7.1 mmol/L)Consider the following 6 questions and answer fully:
1. Identify what the total body surface area (TBSA) is for Molly using the Rule of Nines. (Show your work)
2. Based on your calculation, using the Parkland formula, what is the 24-hour fluid resuscitation that should be given to Molly? (Include complete formula and breakdown of fluid delivery over the 24 hours) Want Professional Help?
3. Create 3 relevant cue/data clusters and identify what the cluster infers/suggests and why that is significant.
4. Identify one data gap for each cluster and explain how this data would further inform the cluster. (Support your work)
5. Based on the clusters created in question #3, what would be your
Priority area of assessment during the Emergent phase of Molly's burn injury? (Explain why and support your answer).
6. Incorporating the inference from the clusters identify the Priority Problem and explain why this is the priority. (Explain why and support your answer)