A male patient arrives in the casualty with predominant burns to his face, chest and arms form an explosion while cooking He presents with difficulty in breathing and chest pain. What is your priority intervention?

Question

Question

This question was previously asked in

KGMU Nursing Officer 2023 Memory-Based Previous Year Paper

Answer 1

Correct Answer: Assess his airway

Rationale:

The priority intervention for a male patient presenting with burns to the face, chest, and arms, along with difficulty in breathing and chest pain, is to assess his airway. This is because airway management is critical in burn injuries, especially when facial burns are involved, as they may lead to swelling, obstruction, or inhalation injuries.
Burn injuries to the face and chest heighten the risk of airway compromise due to edema, soot inhalation, or thermal injury to the upper airway. This can result in respiratory distress or failure if not promptly addressed.
Difficulty in breathing suggests potential airway obstruction, smoke inhalation, or damage to the respiratory tract, necessitating immediate evaluation and possible interventions such as oxygen administration, intubation, or securing the airway.
Airway assessment includes inspecting for signs of facial burns, singed nasal hairs, soot in the mouth or nose, hoarseness, stridor, and respiratory effort. Early intervention can prevent life-threatening complications.

Explanation of Other Options:

Clean the burn wound

Rationale: Cleaning the burn wound is important for infection control and wound management. However, it is not the priority in this scenario. The patient’s immediate airway and breathing must be stabilized before addressing burn wound care.
Cleaning the wound can be delayed until after the patient is stabilized and life-threatening issues are addressed.

Monitor his cardiovascular status

Rationale: Monitoring cardiovascular status is essential in burn patients because severe burns can lead to hypovolemia and shock. However, this step comes after ensuring the airway is secure and breathing is adequate. Immediate airway assessment takes precedence over cardiovascular monitoring.
Once airway and breathing are stabilized, cardiovascular status can be monitored for signs of hypovolemic shock or fluid loss.

Start IV fluid

Rationale: Initiating IV fluid resuscitation is crucial in burn patients to prevent hypovolemic shock and maintain tissue perfusion. However, this is not the first priority in this scenario. Securing the airway and addressing breathing difficulties must be the initial focus before fluid resuscitation.
Fluid therapy is typically guided by the Parkland formula, but it is implemented after life-threatening airway and breathing issues are managed.

Conclusion:

In the given scenario, assessing the airway is the immediate priority because of the risk of airway compromise due to facial burns and difficulty in breathing. While other interventions like wound cleaning, cardiovascular monitoring, and IV fluid resuscitation are important, they are secondary to securing the airway and ensuring proper ventilation. Early airway management is critical to prevent potentially fatal complications.