Case History:

8/25/95 A 31 year old white male trapped in a burning apartment building decided to jump from a window. Preassessment by emergency personnel revealed burns to his extremities, scalp, face, thorax, and back (an estimated 90% total body surface area burn). It also appeared he sustained a tibula/fibula fracture of the left leg and a crush injury of the right ankle. He was brought into the emergency room on a 100% oxygen non-rebreathing mask. In the emergency room he was promptly intubated with an oral 7.5 ETT because of suspected inhalation burns. Appropriate analgesics and IV fluids were administered and the patient was placed on mechanical ventilation. He was immediately taken to the burn unit and tanked. He then went to surgery to repair and stabilize his fractures. The following day his total body surface area burns were reassessed from 90% to 60%.