INTRODUCTION

Patient J.C. is a 4year old from Malinta, Valenzuela City. He was admitted last 13 August 2019 at
Jose R. Reyes Memorial Medical Center. He’s admission diagnosis was Scald burn 10% Total Body
Surface Area (TBSA) Superficial Partial Thickness to Deep Partial Thickness (SPT-DPT).

The objective of our case study is to further understand and gain extensive knowledge regarding
Burn that can provide important information about the disease such as definition, analization, causes, and
other relevant datas that we may use to perform accurate, appropriate and effective nursing interventions
to our patient.

Burn is the damage to the skin or other body parts caused by extreme heat, flame, contact with
heated objects, or chemicals. The treatment of burns depends on the depth, area, and location of the burn,
as well as additional factors, such as material that may be burned onto or into the skin. Treatment options
range from simply applying a cold pack to emergency treatment to skin grafts. Male children are at
increased risk, often due to fire play and risk-taking behaviors. Female children are at increased risk, with
most burns occurring in the kitchen or bathroom. Injury associated with male peer-group activities
involving gasoline or other flammable products, such as fireworks. (https://www.medicinenet.com),
(https://www.hopkinsmedicine.org)

The history of a burn injury can give valuable information about the nature and extent of the
burn, the likelihood of inhalational injury, the depth of burn, and probability of other injuries. The exact
mechanism of injury and any prehospital treatment must be established. A patient's history must be
obtained on admission, as this may be the only time that a first hand history is obtainable. Swelling may
develop around the airway in the hours after injury and require intubation, making it impossible for the
patient to give a verbal history. A brief medical history should be taken, outlining previous medical
problems, medications, allergies, and vaccinations. (https://burnstrauma.biomedcentral.com)

Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and
critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial
therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances,
death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients
in order to develop new treatment avenues and future trajectories associated with increased survival.

Primary causes of death were reviewed from 144 pediatric autopsy reports. Percentages of
patients that died from anoxic brain injuries, sepsis, or multi-organ failure were calculated by comparing
to the total number of deaths. Data was stratified by time, and gender. Statistical analysis was done by
chi-squared, Student's t-test and Kaplan-Meier for survival where applicable. Significance was accepted
as P < 0.05.

Five-thousand two-hundred-sixty patients were admitted after burn injury and of those, 145
patients died after burn injury. Of these patients, 144 patients had an autopsy. The leading causes of death
over 20 years were sepsis (47%), respiratory failure (29%), anoxic brain injury (16%), and shock (8%).
Sepsis is the leading cause of death after burn injury. Multiple antibiotic resistant bacteria now account
for the bulk of deaths due to sepsis. Further improvement in survival may require improved strategies to
deal with this problem. (https://ccforum.biomedcentral.com)
DISCHARGE PLAN

Medication

If you think your medicine is not helping or if you have side effects or allergic to any medicine.
Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you
take them. Carry your medicine list with you in case of an emergency.
Meds. : Vitamin C Syrup 5ml BID
Paracetamol 200mg q6
Nalbupphine 2mg q6 RTCx4 doses then PRN for
breakthrough pain

Exercise

Rest when you feel tired. Getting enough sleep will help you recover. (10-13hrs nighttime sleep
and 1hr nap daytime ). Moderate exercise is healthy like walking for 10mins and let the child play for
20mins.

Treatment

Change the dressing daily (twice daily if possible) or as often as necessary to prevent
seepage through the dressing. On each dressing change, remove any loose tissue. Inspect the
wounds for discoloration or haemorrhage, which indicate developing infection.

Apply a thin layer of anti- inflammatory cream (Mebo).

Use sterile gloves when you applying the cream on the affected area to prevent infection.

Health Teaching

Always keep the wounds clean and dry. When patient J.C. are allowed to bathe or shower,
carefully wash the graft with soap and water. Ask your caregiver for more information about wound care.
Protect the graft site from direct sunlight for at least six months to avoid burning of the skin. If it appears
dry and scaly, keep it moist by applying lotion to it. Ask your caregiver for the type of lotion you may
need to use on your skin. Taking vitamins and eating healthy foods high in protein may improve wound
healing. Poultry, meat, dairy products such as eggs and cheese are high in protein. Ask your caregiver if
you should use vitamins, and for more information about a high-protein diet.
Out Patient Follow Up

For continuing care, treatments or home services, ask for more information. Be sure to make and
go to all appointments, and call the doctor or nurse call line if patient J.C. having problems. It's also a
good idea to know your test results and keep a list of the medicines you take.

Diet

Diet as tolerated. You can eat your normal diet. If your stomach is upset, try bland, low-fat foods
like plain rice, broiled chicken, toast, and yogurt. Eat a well-balanced diet with enough protein to help the
wound heal. Protein is a key nutrient in helping to repair damaged tissue and promote new tissue growth.
Good sources of protein are milk, yogurt, cheese, meat, and beans.

Spirituality

Advice the patient’s parent to keep believing in God’s Holy will.