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    Lapjag

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    anon_65353286
    1) A 59-year-old female presented to the emergency department after being exposed to an explosion from a gas stove. 2) On examination, she had burns on her face, neck, arms and legs covering 38% of her total body surface area. 3) Laboratory tests and chest x-ray were normal with no signs of airway obstruction or inhalation trauma.

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    Lapjag

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    anon_65353286
    45 views11 pages
    1) A 59-year-old female presented to the emergency department after being exposed to an explosion from a gas stove. 2) On examination, she had burns on her face, neck, arms and legs covering 38% of her total body surface area. 3) Laboratory tests and chest x-ray were normal with no signs of airway obstruction or inhalation trauma.

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    lapjag

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    1) A 59-year-old female presented to the emergency department after being exposed to an explosion from a gas stove. 2) On examination, she had burns on her face, neck, arms and legs covering 38% of her total body surface area. 3) Laboratory tests and chest x-ray were normal with no signs of airway obstruction or inhalation trauma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    45 views11 pages

    Lapjag

    Uploaded by

    anon_65353286
    1) A 59-year-old female presented to the emergency department after being exposed to an explosion from a gas stove. 2) On examination, she had burns on her face, neck, arms and legs covering 38% of her total body surface area. 3) Laboratory tests and chest x-ray were normal with no signs of airway obstruction or inhalation trauma.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 11

    Casualty Report

    Day/ date: Sunday / July 22nd 2018


    Doctors on duty: Rizka, MD / Tika, MD / Tara, MD – Dessy, MD /
    Gita, MD – Rindy, MD

    Consultant on duty:
    Mirta Hediyati, MD, ORL, PhD
    Bronchoesophagology Consultant on Duty :
    Elvie Zulka, MD, ORL, PhD
    Identity & Chief Complaint

    Female, 59 years old

    Patient consulted from


    Plastic Surgery Department
    for evaluation due to
    suspect of inhalation
    trauma
    Medical History

    Patient exposed to explosion of gas stove in


    the kitchen (closed room) 15 hours prior
    admission and got burnt on face, neck, both
    arms and legs (VAS 5)

    Patient was taken to Primary Health Care


    Service and referred to RS Arya Medika
    and treated with IV Fluid 2000ml and
    observation of fluid balance with catheter

    Patient was referred to CMER and has


    difficulty of breath and hoarseness 
    suspect of inhalation trauma
    Primary Survey

    A: Clear, burn injury in the face

    B: Spontan, RR: 20, SaO2: 100% on NRM

    C: BP 120/90, HR 82x/m

    D: Compos Mentis, E4M6V5

    E: Mid dermal burn injury 38%TBSA


    ENT Examination

    Ear Nose Throat


    • Right and left • Right and left nasal • Symmetric
    ear: cavity : nose hair is pharyngeal arch,
    • wide ear canal, burned, there were uvula in the middle,
    no discharge, no carbon soot, wide hyperemic posterior
    minimal nasal cavity, inferior pharyngeal wall,
    cerumen, intact turbinate eutrophic, there were no carbon
    tympanic no discharge, no soot
    membrane septal deviation, • Lung : Vesicular
    good air passage sound symmetric, no
    rhales nor wheezing.
    ENT Examination

    Face : swelling, and


    hyperemic, there was
    crust
    RFL CMER (February, 19th 2018)
    Laboratory Examination CMER
    (February 19th, 2019)

     Hb : 16,1 mg/dl  pH : 7,4


     Ht : 50,2 %  pCO2 : 38,2
     WBC : 6090 u/l  PO2 : 164
     Platelet : 255.000 u/l  SO2 : 99.4
     PT : 9,5 (10,0)
     BE : 0,4
     APTT : 31,6(33,4)
     Std HCO3 : 24,8
     Ureum : 18,3 mg/dl
     HCO3 : 24,3
     Creatinine : 0,738 mg/dl
     AST : 18  Total CO2 : 25,5
     ALT : 15
     BGL : 141 mg/dl
     Sodium : 139 mEq
     Potassium : 3,8 mEq
     Chlorida : 111 mEq
    Radiological Findings CMER
    (February 19th, 2019)
     Chest X Ray:
     There were no abnormality
    in the heart and lung
    Working Diagnosis

    There were no sign of airway


    obstruction and inhalation trauma

    Mid dermal to full thickness


    burn injury 38.5% TBSA (T31.2)
    Management
     Report to Susyana Tamin, MD, ORL, PhD :
    ▪ Antibiotic and analgetic according to Surgery
    Department
    ▪ Epinephrine inhalation according to Surgery
    Department
    ▪ Suggestion:
    ▪ Diagnostic Bronchoscopy  Currently ENT-
    Bronchoesophagology Division is not able to this due to the
    malfunctioned of equipment  Consult to Pulmonology if
    needed

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