Nancy's Surgical Procedure

As cited by Jarvis (2012, p.203), “the skin is the sentry that guards the body from environmental stresses and adapt it to other environmental influences.” Maintaining the elderly patient’s skin integrity requires a holistic care approach. As a nurse, one of our best practices is performing a thorough skin assessment of the whole body of our patients. A detailed head-to-toe skin assessment and clear documentation can help the interdisciplinary team in generating individualize plan of care. I perform a thorough assessment by inspecting the patient’s skin color, temperature, texture, moisture, and for presence of wounds. I ensure that the information I obtained from the skin inspection is clearly documented in the patient’s chart and plan of care, and any skin changes are communicated to the physician or nurse practitioner.

Most of the patients in the burns clinic have undergone surgery and came in for follow up, rehabilitation, and tissue expansion. Family dynamics were also discussed to determine the family’s needs for referral or health promotion teaching as well as emotional support.

Skin tears are traumatic wounds, which usually occur on the extremities of the elderly. Not to mention the amount of deaths that occur when skin breakdown doesn’t get treated. The article, “Preventing in –facility Pressure Ulcers, “ states that, “60,000 U.S. patients will die from complications related to hospital-acquired Pus”. (Preventing, 2013). When you think about all the different diseases and illness that can kill someone, pressure ulcer don’t normally come to mind. If we have less skin breakdown with the elderly, we can keep our facilities safer, less life-threatening problems, and have a more successful career as a nurse. There are many ways that you can treat pressure ulcers or skin breakdown in general, but people need to realize what patients are at more risk to develop skin integrity, the ways to prevent skin breakdown from the beginning, and how to treat skin tears when they appear before they can say that they know what skin integrity is. This concept paper will provide the key points on what to know about skin integrity. Who is more at risk, how to prevent them from occurring, and what to do if it does happen.

Inhalation injury is the leading cause of death in fire victims. It is estimated that half of these deaths could have been prevented with use of a smoke detector. Often, burn victims make it out of a burning home safely. However, once they are outside, they may realize that their loved ones, pets, or valuable items are still inside the burning home. They then re-enter the burning home and are overcome with toxic smoke and fumes and become disoriented or unconscious. Inhalation injury has a significant impact on survivability of a burn patient. Deterioration in severely burned patients can occur without evidence of a smoke inhalation injury.

Situation: You are working the day shift on the medical-surgical unit in a small district hospital. Your assignment includes an 18-year-old female college student, admitted the previous night. She was caught in a house fire and sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back.

Great post. I like the points you outlined about assessment of Mr. J. You started with maintaining ABC’s to checking lower extremities pulses to ensure that it is not cut off by the tight constrictive band of the eschar. ECG should be monitored at least the first 24 hours because Mr. J is prone to cardiac arrest due to high electrical voltage injury. Fluid resuscitation with 14 or 16 gauge preferably through unburned tissue, and infusion of lactated Ringer’s solution will help to prevent shock. Assessment of vital signs and pain is very important, the nurse should also assess for history of tetanus immunization because burn wounds are prone to tetanus. Mr.’s brief medical history is important in case he has any allergies, current medical

Recently, I had a pretty bad burn on the palm of my hand. I was in the middle of straightening my hair, when the lights suddenly turned off. I was so shocked, that I dropped the tool and it landed on my hand. I had no idea what to do; my first instinct was to wash my hand with cold water and to put on a band-aid. I had no idea if that would help, but sure enough the band-aid came

There are three main types of burns, beginning with first degree burn, the most minor burn, this degree of burn only affects the epidermis, it will cause redness, swelling and pain, as the burn is healing dry skin will begin peeling off. The next type of burn is a second degree burn; these burns are more harmful because they damage more than the epidermis, it will blister and become extremely red and sore. Over time a thick, soft called tissue fibrinous exudate may develop over the wound. Excluding fourth degree burns, third degree burns are the most severe, they cause the most damage, extending through every layer of skin, there is a misconception that third degree burns are the most painful, however, with this type of burn the damage is so extensive that there may not be any pain because of nerve damage. This degree results in white or blackened, charred skin that

Sustaining a burn injury is a distressing experience for the patient and their family. Stress is an outcome of burn injuries that has physical, physiological, and psychological effects. Addressing the stress of the patient and their family is a responsibility of the nurse. Using CINAHL as a database, key articles were found by searching the following key words: stress, burn patient, anxiety, coping, music therapy, family, pain, anticipatory teaching, and anticipatory information. In order to alleviate stress in burn patients, music therapy, including family members in dressing changes, and providing

A burn is a type of injury to skin, or other tissues, caused by heat, cold, electricity, chemicals, friction, or radiation. Most burns are due to heat from hot liquids, solids, or fire. While rates are similar for males and females the underlying causes often differ. When the injury extends into some of the underlying skin layer, it is a partial-thickness or second-degree burn. The burn is often black and frequently leads to loss of the burned part. Burns are generally preventable. Treatment depends on the severity of the burn. Tetanus toxoid should be given if not up to date. In the United States, approximately 96% of those admitted to a burn center survive their injuries. The long-term outcome is related to the size of burn and the

Mortality rate in burn patients continues at a steady 5-10%, 75% of those deaths are related to sepsis (2). In order to understand why, we must elucidate the nature of the innate immune system in these patients. The innate immune system is the first line defense versus pathogens from the outside world. Burn patients receive a double hit to their first line defenses due to the nature of thermal injury to tissue. The skin barrier is breached, the inflammation begins, and though the numbers of neutrophils increases substantially in response to the elevations in compliment activation at the tissue level (1), it seems that the behavior of these neutrophils is aberrant (2). Neutrophils in burn patients were found to be impaired in their ability

For children and infants, the Lund and Browder chart is used to assess the burned body surface area. Different percentages are used because the ratio of the combined surface area of the head and neck to the surface area of the limbs is typically

Third-degree burns are the most severe level only involving the skin. They cause thickening of the skin with a white, leathery appearance. Severe scarring occurs with third-degree burns along with contracture of the skin.

She trained in plastic surgery and became Head of the Royal Perth Hospital Burns Unit. Wood gained media recognition in 2002 when 28 victims of the Bali Bombings were sent to Perth to receive treatment for their burns. She had developed the spray-on skin earlier, which greatly reduced the permanence of scarring of the skin in burns victims. Wood utilised her method in 1993 and later co-founded a company with scientist Marie Stoner, to promote spray-on skin internationally. Royalties from the product are used to fund further research into burns treatment through the McComb Foundation, which pursues Wood’s goal of a treatment that promotes ‘scarless, woundless healing’. Dr Wood is a Clinical Professor with the School of Paediatrics and Child Health at the University of Western Australia and Director of the Western Australia Burns Service. She was also Australian of the Year in

The first surgery I observed was a skin graft placement. The patient was a five-year-old male who had an accident on his mother’s treadmill three weeks prior to his surgery. The patient’s mother stated that the patient was walking on her treadmill when he fell and got his hand stuck in the belt of the treadmill. The accident resulted in deep partial and full thickness burns and loss of skin on four of the patient’s fingers. The mother stated that the wounds on her son’s