NMJ10004 ANATOMY & PHYSIOLOGY SA2023/2024

Assignment 1
Nama: SYLVIA ANNE A/P ROMAN
Matric number: 231151624

1. In Emergency Room, two fire victims have arrived. 1 st victim’s chest looks white and
black, blister and part of hand’s bone is visible. Meanwhile, 2 nd victim with a charred
and leathery chest and blister on both legs. Classified a degree of burn of both patient
and suggest a suitable treatment for them.
(10 marks)

First and foremost, the 1st victim. As it is stated the 1 st victim’s chest looks white and
black which indicates that they received third-degree burns which destroy the
epidermis and dermis and the blisters are second-degree burns where the epidermis
and superficial part of the dermis are damaged. Since the victim’s hand’s bone was
visible it shows that he received a fourth-degree burn. Fourth-degree burns go through
both layers of the skin and underlying tissue possibly involving bone.

Continuing with the 2nd victim. The 2nd victim received a fourth-degree burn which
can be also called a full-thickness burn, on his chest which shows that his chest was
charred and leathery. Both legs that were blistered can be classified as the patient
receiving a second-degree burn which is also called a partial thickness burn.

The suitable treatment for the 1st victim is excising the full-thickness burns and
regularly debriding to prevent ischemia and infections and to create a viable base for
grafting. This is because 1st victim received a very severe burn which is the fourth-
degree burn which has no sensation and the burn won’t heal as long as that person
doesn’t go through a surgical intervention. If the burn is really severe and won’t heal
even with the surgeries it means that the affected area has to be amputated to avoid
further infections on the other body parts. Other than that early cleaning and debriding
of the dead skin, or eschar and tissue from the burned area to a healthy level is the
suitable treatment for the third-degree burn on the victim’s chest. The wound bed is
kept clean and moist to allow epithelial regeneration and to accept transplanted tissue
called a skin graft regeneration is not possible. Following the second-degree burn of
the victim the burns are cleansed, covered with a sterile dressing and monitored
regularly for infection.

The suitable treatment for 2nd victim is surgical debridement. Surgical debridement is
the removal of dead tissues on the body part that went through fourth-degree burns.
Reconstructions are also necessary. For this treatment, it might involve multiple
surgeries and skin grafts. Skin grafting is a surgical procedure in which a piece of skin
is transplanted from one area to another. As for the second-degree burn, treatment
depends on the severity of the burn such as dressing one or two times a day depending
on the severity of the blisters on the victim’s legs and daily cleaning of the wound to
remove dead skin or ointment.
NMJ10004 ANATOMY & PHYSIOLOGY SA2023/2024

2. In cases of extensive burns (third-degree and fourth degree), how is fluid balance and
electrolyte management crucial for the patient's prognosis, and what potential
complications can arise if not managed properly.

(10 Marks)

Fluid balance and electrolyte management are crucial in cases of extensive burns
especially third-degree burns and fourth-degree burns due to the profound impact
these injuries have on the body’s physiology. Proper management is essential for the
patient’s prognosis as complications can be life-threatening if not managed
effectively.

First and foremost, the complication that might arise if not managed properly is
hypovolemic shock. This is because extensive burns can result in the loss of large
amounts of plasma and fluid through the damaged skin which can lead to
hypovolemic shock. Hypovolemic shock is a condition where there is insufficient
blood volume to adequately perfuse vital organs. Maintaining fluid balance is crucial
to prevent shock.

Moreover, it can even cause electrolyte imbalance. Burn injuries can disrupt the
balance of electrolytes such as sodium, potassium, and chloride in the body of the
patient. Significant shifts in these electrolytes can affect cardiac and neuromuscular
function. Proper electrolyte management is essential to prevent complications like
arrhythmias and muscle weakness.

Furthermore, renal complications might occur. Third-degree burns and fourth-degree

burns can stress the kidneys, leading to acute kidney injury (AKI) or renal failure.
Maintaining fluid balance is crucial to prevent overloading the kidneys with excessive
fluid and maintaining renal function.

Not only that poor management can even cause complications of overhydration.
While maintaining fluid balance is crucial, excessive fluid resuscitation can lead to
complications such as oedema, increased intracranial pressure, and abdominal
compartment syndrome. Therefore, a delicate balance is necessary.

Last but not least, is infection risk. Prolonged fluid resuscitation can weaken the
immune system and increase the risk of infection. Effective fluid and electrolyte
management can help prevent complications related to infections.

Burn care is a complex and specialized field, and the management of extensive burns
often requires a multidisciplinary approach involving burn specialists, critical care
physicians, and other healthcare professionals. Timely and appropriate fluid and
electrolyte management is vital to improving a patient's prognosis and reducing the
risk of complications associated with extensive burns.
NMJ10004 ANATOMY & PHYSIOLOGY SA2023/2024

3. Suggest any emerging technologies or treatments in the field of burn care that may
improve outcomes for burn patients and families in the future.

(5 marks)

There are a lot of merging technologies and treatments in the field of burn care that
are showing promise for improving outcomes for burn patients.

Firstly, smart dressings. Smart dressings are a type of intelligent wound dressings
equipped with sensors that can monitor wound status, detect infections, and provide
real-time data to healthcare providers, enhancing care and reducing complications.

Burn Wound Imaging is also one of the technologies and treatments in the field of
burn care. Advances in imaging technologies, such as thermal imaging and
hyperspectral imaging, are being investigated to aid in the early detection and
assessment of burn wounds.

Not only that, topical oxygen therapy is also one of the merging technologies and
treatments. Hyperbaric oxygen therapy (HBOT) and topical oxygen therapy are being
explored to accelerate wound healing and improve tissue oxygenation.

Moreover, telemedicine. Telemedicine is becoming more important for post-burn care

and follow-up appointments, for those who suffer from burns, and especially for
patients who live far from specialized burn centres.

Finally, 3D printing and bioprinting. 3D bioprinting is a technology where bioinks,

mixed with living cells, are printed in 3D to construct natural tissue-like three-dimensional
structures 3D printing technology is being used to create customized skin grafts and
scaffolds where researchers are also exploring the use of bioprinting to produce
functional skin tissue for transplantation.