Medical History. Chief Complaint: Following a rescue from a burning house, a 9-year-old boy admitted for severe second- and third-degree burns. History: Jamal Smith was asleep when an electrical fire started. He was trapped in his bedroom. Jamal was transported by ambulance to the emergency room after being rescued from his burning house. He had suffered severe burns and excessive smoke inhalation by the time the fire crew arrived. Upon admittance to the hospital, Jamal was unconscious. He presented with second-degree burns over \( 10 \% \) of his lower body, and third-degree burns over 15\% of his body over his abdominal and thoracic regions as well as his left elbow. The following were his vital signs Blood pressure \( =50 / 35 \); Low Heart rate \( =220 \) beats / min.; High Respiratory rate \( =45 \) breaths / min.; High To prevent circulatory failure, two IVs were inserted and fluids were administered through each. Once his vital signs stabilized, he was admitted to the pediatric ICU.

Based on the provided medical history of Jamal Smith, we can extract the following known conditions and details: ### Known Conditions: 1. **Patient Information:** - Name: Jamal Smith - Age: 9 years old 2. **Chief Complaint:** - Severe second- and third-degree burns following a rescue from a burning house. 3. **History of Incident:** - Jamal was asleep when an electrical fire started. - He was trapped in his bedroom and suffered severe burns and excessive smoke inhalation. - He was unconscious upon admittance to the hospital. 4. **Burn Assessment:** - Second-degree burns over \(10\%\) of the lower body. - Third-degree burns over \(15\%\) of the body, specifically in the abdominal and thoracic regions and the left elbow. 5. **Vital Signs:** - Blood Pressure: \(50/35\) (Low) - Heart Rate: \(220\) beats/min (High) - Respiratory Rate: \(45\) breaths/min (High) 6. **Immediate Treatment:** - Two IVs were inserted for fluid administration. - Fluids were administered to prevent circulatory failure. - Once stabilized, he was admitted to the pediatric ICU. ### Analysis: 1. **Burn Severity:** - Second-degree burns affect the outer layer (epidermis) and part of the underlying layer (dermis), causing pain, swelling, and redness. - Third-degree burns extend through the dermis and affect deeper tissues, potentially leading to numbness due to nerve damage. 2. **Vital Signs Interpretation:** - The low blood pressure indicates possible shock, likely due to fluid loss from burns. - The high heart rate may be a compensatory response to low blood pressure. - The elevated respiratory rate could be a response to smoke inhalation and hypoxia. 3. **Fluid Resuscitation:** - Given the extent of burns, fluid resuscitation is critical to restore blood volume and prevent shock. ### Next Steps: - Continuous monitoring of vital signs in the ICU. - Assessment of burn wounds for potential infection. - Pain management and supportive care. - Consideration for surgical interventions, such as debridement or skin grafting, depending on the healing progress of the burns. This detailed assessment provides a comprehensive overview of Jamal's condition and the immediate medical response required for his severe burns and associated complications.