The skin has three layers, which are the epidermis, the dermis, and the hypodermis. The epidermis is the outermost layer is a water proof wall that establishes the skin tone. The dermis lies beneath the epidermis and it contains hair follicles, tough connective tissues, and sweat glands (Sheridan, 2011). The hypodermis is the deeper subcutaneous layer that is made up of connective tissue and fat.
Using the rule of nines, the body surface burned = (9x2) + (9x2) + (4.5x2) = 45%
First-degree burns are milder compared to other type of burns and only affect the epidermis causing pain and reddening. Second-degree burns are referred to as partial-thickness burns and affect the dermis and epidermis. They are associated with swelling, pain, and blistering. Third-degree burns penetrate the dermis and effete inner tissues. The cause white or charred skin that may be numb (Williams et al., 2012).
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The girl was relatively pain-free in the morning because she suffered third-degree burns, which may lead to a blackened skin that is numb.
Normal vital signs refers to the blood pressure, breathing, pulse, and temperature ranges for the average individual at resting. The normal blood pressure of an 8-10- year old is 85/45, heart rate is 62-130, and respiratory rate is 14-26, while temperature range is 97 0 F to 99 0 F. The blood pressure, respiratory rate, and temperature are lower than normal, while her respiratory rate is higher than normal. Vital signs in burns are abnormal because it causes cardiac stress that is characterized by increased catecholamines, myocardial oxygen demand, and elevated cardiac output (Williams et al., 2012).
It was important to administer intravenous fluids to the girl to prevent burns shock and maintain oxygen supply to all body tissues due to the loss of water, sodium, and proteins (Sheridan, 2011).
The steps involved in wound healing are hemostasis, inflammatory or defensive, proliferative, and maturation phases. The aim of the first phase is to stop bleeding and it involves the blood clotting system. The defensive phase involves prevention of infection and removal of debris, which is the work of neutrophils. The proliferation phase entails filling and covering the wound. In the final stage, the new tissue strengthens and gain flexibility.
Decubitus ulcer are injuries to the skin due to prolonged pressure. Bedridden patient are at risk of these ulcer because their position is rarely changed. Decubitus ulcers occur mainly on the skin covering bony areas such as the hips, ankles, heels, and tailbone.
A keloid is a raised scar that grows larger than the wound that caused it initially.
References
Sheridan, R. (2011). Burns: A Practical Approach to Immediate Treatment and Long Term Care . New York: CRC Press.
Williams, F.N. et al. (2012). Changes in Cardiac Physiology after Severe Burn Injury. J Burn Care Res; 32 (2): 269–274.
