Paramedic National Registry Practice

What is the most significant concern for an 84-year-old with full thickness burns to the mouth, chest, and abdomen?

1. Risk of infection

2. BSA of the burns

3. Pain management

4. Fluid resuscitation

The correct answer is: BSA of the burns

The most significant concern for an 84-year-old with full thickness burns to the mouth, chest, and abdomen is fluid resuscitation. In burn patients, especially elderly individuals, there is a substantial risk of fluid loss and dehydration due to the damage to skin integrity and the potential for significant evaporation of body fluids. Full thickness burns affect all layers of the skin, leading to disruption of normal fluid balance. Patients with extensive burns often require careful monitoring and management of their fluid status to prevent hypovolemic shock and ensure adequate perfusion to vital organs. The amount of fluid needed for resuscitation can be calculated using the total body surface area (BSA) affected by the burns; however, in this case, the immediate concern leans more heavily towards the management of fluid intake since the body can quickly become compromised without it. While the risks of infection, the total body surface area damage, and pain management are important considerations, in the acute phase of treatment for a patient with extensive burns, ensuring proper fluid resuscitation is critical for survival and recovery.