Acute Management of Burns in Children
Added on 2021-04-21
13 Pages3941 Words57 Views
Healthcare and Research
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Running head: BURN MANAGEMENT IN CHILDRENBURN MANAGEMENT IN CHILDRENName of the student:Name of the university:Author note:
1BURN MANAGEMENT IN CHILDRENOverviewBurn injuries are responsible for about 1, 80, 000 deaths per year globally and majority ofthem occurs in low and middle income countries (World Health Organization 2018). They pose ahuge number of challenges to the healthcare professionals for properly managing the situationsdue to a number of facts. The assessment of the spectrum of burn injuries has to be done firstwhere the nursing individuals have to assess the burns which may range from simple first-degreeburns that have no sequel to that of third degree burns which are seen to have a hypermetabolicresponse (Morton et al. 2017). Usually, in case of severe burn injuries, initial management of thewounds is seen mainly to focus on the early recognition of the potential airways, circulatorycompromise as well as potential resuscitation. In order to manage successfully burns in children,health care professionals should have proper knowledge about pathophysiology, epidemiology,initial resuscitation, associated injuries, social concerns for child and many others (Gauglitz andWilliams 2015). This assignment will thereby show the sequential procedure of burnmanagement from recovery approach for the concerned child named Zyhnab. Psychosocial careof the children and ethical and legal considerations will be also discussed in the paper in details. Airway managementZaynab is a five-year child who has faced second-degree burn on her upper arms andchest. These types of the burn are quite serious as the damage extends beyond the uppermostlayer of the skin. These types of burns are seen to cause a blister in children that becomeextremely sore and red with time (Bi et al. 2017).Superficial partial thickness burns are not onlypainful but also have blisters with a brisk capillary refill (Gandhi et al. 2010).These burns aremainly seen to comprise of the epidermis along with the superficial parts of the dermis
2BURN MANAGEMENT IN CHILDREN(Heyneman et al. 2016). They are mainly seen to heal within 1 to 3 weeks without causing anytype of scarring. The airway must be assessed, and if the professionals find it necessary, theairway can be secured (Morton et al. 2017). Initial management of the burn would require an evaluation of the potential airwaycompromise, ventilation and oxygenation. The chief aspect of the airway management forZaynab would be to rapidly secure the airway before considering overt airway closure(Kishikova, Smith and Cubison 2014). The management of difficult airway can be addressedwith the help of video laryngoscopes, fiberoptic intubation, and laryngeal mask airway (LMA) -guided intubation (Richtsfeld and Belani 2017). However, the route of tracheal intubation is to beindividualized as per the need of the patient. Ventilator strategies for managing hypoxia andARDS (Acute Respiratory Distress Syndrome) in the patient might be challenging. For Zyanba,the ideal process would be a lung-protective ventilation strategy with the help of low-tidalvolumes, positive end-expiratory pressure, and permissive hypercarbi. The rationale is that is ifeffective in minimizing the impact of lung injury which is ventilator induced. Pediatric RapidSequence Intubation (RSI) would be a useful tool that is a sequential process of preparing,sedating and paralyzing the patient for facilitating safe and emergency tracheal intubation.Research indicates that RSI is beneficial for providing optimal conditions for emergentintubation (Kerrey et al. 2015). Pediatric rapid sequence intubation can be fixed in Zaynab bymaking her conscious and using neuromuscular block. Secondly, good preparation needs to bedone for safe induction and step needed to be taken in case the intubation fails. Choice ofinduction agent and neuromuscular blocking agent are also important (Kerrey et al. 2012). Maintenance of homeostasis
3BURN MANAGEMENT IN CHILDRENCare should also be taken so that the patient does not remain in an environment that ishypothermic. The patient should be treated in a warm environment by giving warm fluids(Pruskowski et al. 2017). Fluid resuscitation can be applied to Zaynab is the professional findsthat burn involves more than 10 to 12% of the total body surface area. Researchers are of theopinion that about 3 to 4 mL of a warmed crystalloid solution should be given such as theHartman solution. This should be given for about per kg per percent of the TBSA in thepreliminary 24 hours (Gandhi et al. 2010). 50 % of the volume is given in the first 8 hoursexperienced researchers are also of the opinion that for children under 30 kg of weight can beadministered with glucose containing maintaining fluid which are called half normal saline with5 % glucose (Haberal, Abali and Karakayali 2010). As Zaynab is a five year old child, he can beadministered with similar fluid (McGarry et al. 2014). Surgical intervention According to Vincent et al. (2016), urgent surgery for a pediatric patient suffering burn isto be considered beneficial is the patient has suffered vascular injury or if there is a risk ofcompartment syndrome. In case these conditions are absent, surgical intervention can be carriedout normally after the team has prepared for the same. In such a case, the surgery is to be carriedout within 72 hours of the burn (Von Keudell et al. 2015).Definite surgical management for Zaynab would include excision, grafting andreconstruction. Burn reconstruction process would have the aim of covering the burn wound andrestoring the body functions. Preservation of esthetics would also be an objective of the surgicalprocess. Further, the reconstruction is to be completed in different phases, and this would dependon the severity of the burn that the patient has suffered (Rowan et al. 2015). The use of skin
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