Elective Diaries: Her mattress was on fire!
My first day in the emergency department was one to remember. My peer and I had barely introduced ourselves to the doctor in charge when a crowd of people came rushing into the emergency room pushing a stretcher which carried an old woman draped in shawls. We immediately followed the doctor into the triage room, who informed us that she was a burn victim. Upon taking her history we learned that as she was feeling cold the previous night, she lit some firewood under her bed which resulted in the mattress catching fire. As they started exposing her, I was confused at first as to what I was looking at because all I could see was pink flesh, then it slowly dawned on me that what I was looking at was the underlying dermal layer of the burned off the epidermis. The burnt area looked pink and white with loose strands of charred off skin hanging from the ends.
I was appalled at the magnitude of her burns, as they covered her entire back from the base of her neck to her gluteus, posterior aspect of her right leg, and half of her left breast along with her nipple. Fortunately, there were no burns on her head or her perineum. The burns covered 70% of her body, most of them being 2nd-degree superficial burns and some being 2nd degree deep. We barely had time to process the extent of her injuries, before we had to start pouring saline solution and cleaning the wounds with sterile gauzes. Any loose skin was peeled or cut off with a scalpel, as they are potential breeding grounds for microorganisms. This task was challenging as every groan from the old woman made me feel a pang of pain.
We applied sulfadiazine cream on the burnt areas, which is especially used to prevent infections in 2nd and 3rd-degree burns. Then, she was dressed with sterile gauzes and bandaged. Susceptibility to infections, hypothermia, and dehydration are some of the most common complications of burn victims. The doctor was unsuccessful in cannulating the patient as her veins were collapsed, due to the severe dehydration. The whole procedure took almost 2 hours, and by the end, I was in awe at what I had just witnessed and participated in. The rush of adrenaline that came with an emergency case made me more passionate about the department.
Featured image: Abc.net
Bithiah is a medical student at the Royal College of Surgeons in Bahrain (RCSI Bahrain).