Need help with HW!

[Nursing_excellence]

Hello!

Hi, I'm supposed to make a case study presentation about burn victims with complications! I would love to hear your experiences about burn complications and how you handled the situations. The hardest part of this assignment is that we should use humor in presentation and that is where I am gonna need help.

Any help would be appreciated. For those who's gonna call me lazy student, you're not being helpful. I do my readings I just want to come up with a realistic story and one with HUMOR..

[audreysmagic, RN]

I agree with the others - I deal heavily in gallows humor, but there's just nothing funny about burns, if you're trying to do a genuine and accurate presentation. A lot of my peds psych patients have been burn victims, often abuse, and to see their scars just breaks even my jaded heart, honestly.

However, as someone who delighted in adding pop culture references appropriately to any paper possible to amuse myself in college (I think I managed to work Beauty and the Beast's mob scene into a paper on mob mentality once)...I like the Jeopardy idea. Not funny, but interaction. Also, if you really want to drive home the "it's not a funny topic" but still be funny, there is that one clip in The Santa Clause first film you could use at the start. I think it's the scene where they're doing career day, and it just has a firefighter telling a class of small children, "There is NOTHING more painful than third-degree burns" and cutting to their overwhelmed faces. It's not making fun of the burns itself but the audience that was chosen for the story.

[Scottishtape]

I almost died from playing with matches and lighting myself on fire when I was a child. I wasn't supposed to live, lost a breast, lost the ability to have children, and I'm still dealing with the ramifications and 3rd degree scars 44 years later. My first hospital stay was 2 years long, and there were countless stays and surgeries for many years afterwards, and still ongoing.

Please tell your instructor/school that there is NOTHING humorous about a burn patient. Or better yet, let ME tell them.

I realize that I am very biased, but the HUMOR component of this assignment seems insulting, unprofessional and irrelevant.

I'm so sorry. *big hugs*

[~Mi Vida Loca~RN, ASN, RN]

This topic got me thinking about the first 4 months of my nursing career I spent in a pediatric burn unit. The unit did not only function as a burn unit. We also did Step Down kids (anything non cardiac and non vented kids) and regular peds. But the very first patient I advocated for as a brand new nurse was one of these little kids. First time I got into it with a doctor and I stood my ground. Granted I have never been one to be intimidated regardless. The other nurse that night on the unit felt I should just let it go, but I didn't.

Little FYI a lot of people aren't aware of you could educate your class with depending on what you end up picking as a case, the year I worked over 80% of the burns children came in with in that region consistently each year were caused by Top Ramen and Soup. After that were from fire pits.

4th of July always brought in our drunken cowboys playing with fireworks (Reminds me how much I loathe Morgan Lenses) and roman candle wars in the neighborhoods.

Have actually had a patient come in that fell asleep on an old 70's couch (highly flammable) with a cigarette and caught fire. The smell in the ER for hours was terrible. It smelled like human beef jerky. There is a member here that I can't remember if he was working that shift with me that night.

Children if they have bilateral burns on the bottoms of their feet or hands are red flags for abuse.

Can go on and on, so as you can see it's hard to find a lot of humor in any of it.

[bgxyrnf, MSN, RN]

is parkland formula the one recommend by ABA?

what i have is 4ml/kg/%TBSA

1/2 is given in 8h

the other half is given in next 16 h

Why is there a 900 seconds wait to comment?

Per the ABLS class and the burn fellow with whom I consulted, as well as the nurses: the Parkland formula is simply an initial target for pre-hospital and initial ED treatment. After that (say, >2-3 hours), it's guided by urine output.

It's very common, so I'm told from the burn ICU nurses, to over-resuscitate patients with the Parkland formula.

[Nursing_excellence, ADN, BSN]

Thanks! Is there also a formula for that? I mean how much urine output would say the patient is not tolerating fluids and how much would you have to decrease the fluids? or infusion rate?

[amoLucia]

To the mods - there's been requests for more threads/posts about real nursing experiences. I would suggest that this be moved to "Burn Nursing" and let respondents continue to relate their experiences with real burn nsg care and pearls of wisdom gained. I'd like to continue -

My first response to assist a code had me running to the ER. On the way there, I could smell that 'fire' or 'burn' smell in the halls. As soon as I hit the ER bay, I did a dead stop. There was the gurney with the body of the victim having just been declared DOA because of smoke inhalation. A little, petite 5 y/o adorable princess in her underpanties just lying there, not a burn on her pale, grey, blue body. Nobody else in the room.

It was some time much, much later that I learned that the little one was the relative of a nurse at one of my previous jobs. I had worked with the grandmother.

I can still remember that night and the 2 victims.

I'm also thinking about Michael Jackson. I'd have to check out the timeline for coordinating his PEPSI hair-on-fire commercial and the start of his preoccupation with facial surgeries.

[Nursing_excellence, ADN, BSN]

Guys help me out with my meds for my burn patient!!!

superficial and deep partial thickness burns covering 36% of body (Chest, head, and right arm)

For pain management I have narcotics, ketamine, clonidine, dexmedetomidin, or acetaminophen

abx prophylaxis for the wound, im not sure if they need systemic or powder or cream like mafenide acetate, silver sulfadiazine, silver nitrate solution, and silver-impregnated dressings (Mepilex?)

And I also read about benefits of propanolol in burn patients. Has anyone seen this ordered for their burn patients?

Other orders that I thought I might see:

LR

COHB Test

BMP

ABGs

CBC

insert foley

Two large gauge IV access

VS (whats the frequency?)

100% O2

NPO

NG tube

tetorifice prophylaxis

Thoughts????

Thank you guys in advance!!!

[Nursing_excellence, ADN, BSN]

There are so many sad stories in out profession. I dont think I could handle these situations. I'll prolly be around well patients. I salute you guys that stay on the frontline and help patients and their families during those tough times.

[mattedub]

Yea can you stop pushing the humor angle? I've worked in a burn unit for 7 years and it's upsetting to read your comments