![]() The subcutaneous layer aids the body by functioning as a shock absorber, anchoring skin in position, and forms a layer of insulation to further aid in regulating body temperature. Larger blood vessels and nerves can also be found in this layer of skin. Lying below the dermis is the subcutaneous ( hypodermis) layer, comprised of fat and connective tissue. A burn that penetrates into the dermis can compromise both of these mechanisms. The blood vessels found in the dermal layer help to control temperature by vasoconstricting to preserve core temperature and vasodilating to release heat from the body. When uninjured, the sudoriferous (sweat) glands help to cool the body by producing fluid that help cool the body when it evaporates. Burns that penetrate into this region are painful and can interfere with the skin’s ability to help in regulating the body’s temperature. The epidermis has five of its own layers (the stratum corneum, stratum lucidum, stratum granulosum, stratum spinosum and stratum basale) that help serve as a barrier to infection, absorb Vitamin D from sunlight and give skin its pigment ( melanin).ĭirectly beneath the epidermis is the dermal layer, which contains blood vessels, nerves, glands, connective tissue and hair follicles. The skin is comprised of identifiable layers, which include the epidermis (outermost layer), dermis (middle layer), and subcutaneous tissue (innermost layer). The skin is the largest organ of the body and performs several critical functions, such as helping to regulate body temperature, providing a barrier to infection, serving as a sensory organ, storing water and fat, and preventing water loss. Illustration Brook Wainwright DesignsĪlthough burns can affect any part of the body, the primary area subjected to insult is the skin. Had it not been for the coordinated effort of emergency workers, hospital staff and the burn care-unit team, the outcome could have been dramatically worse.įigure 1: Layers of the skin. Though it takes several months, the patient is able to make a full recovery. Within minutes, the ambulance arrives at the hospital and the patient is transferred to the ED that continues care until the patient is later transferred to a regional burn unit. While additional assessments are performed, the hospital is notified of the “trauma alert” patient, which activates a specialized crew of caregivers. The pulse oximeter reads 99%, and the remaining vital signs are stable. The paramedic prepares for intubation and closely monitors the airway status to detect signs of airway compromise. The burns are dressed, and the patient’s body temperature preserved. Using the rule of nines, the lead paramedic determines the second-degree burns encompass approximately 27% of the man’s body. No other burns are discovered during the rapid trauma exam. Partial thickness burns are noted to the anterior aspect of both upper extremities, and further examination reveals burns to the chest and abdomen. High-flow humidified oxygen is provided through a non-rebreather mask as the patient is rapidly loaded into the ambulance.Įn route to the hospital, IV access is established while another caregiver removes the patient’s clothing to assess the injuries. Soot is noted in the patient’s mouth and nose, and the patient’s voice is hoarse. The Rescue 52 crew works swiftly to assess the ABCs (airway, breathing and circulation) to detect life threats. Firefighting crews swiftly conduct a search and emerge carrying a young man with multiple burns. A woman waves frantically and points to an area of the store where a man is trapped inside. Moments later, emergency vehicles from multiple fire stations arrive to find a local hardware store engulfed in the blaze. A peaceful Sunday morning is transformed into a scene of chaos as a commercial structure bursts into flames from an intentionally set fire.
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