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File:IPLab12Burns13.jpg|The damage to the tracheal epithelium and the black carbonaceous material is present down to the level of the terminal bronchioles.
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== Study Questions ==
* <spoiler text="What was the immediate cause of death (COD) in this patient? What other factors played a role in this patient's demise?">The immediate cause of death for this patient is thermal injury involving 80% body surface area. This large body surface area of burn injury is very severe and has a poor prognosis. The gross and microscopic evidence of smoke inhalation and burn injury to the nose, throat and lungs are indicative of severe lung injury. Inhalation injury is seen in over 80% of patients with a burn size of 85% or more of the total body surface area. Carbon monoxide poisoning also contributes to the early death in inhalation injury. The manner of death in this case would have been accidental - unless someone deliberately set the fire.
This additional factor of the severity and the extent of the body surface area burn would likely have lead to death of this patient. Clinical management of a patient with burns this severe would be very difficult. Shock and sepsis are common problems in these patients.</spoiler>
* <spoiler text="What is the significance of the fatty liver and the blood alcohol level noted in this patient?">The fatty liver and the elevated blood alcohol level indicate that this patient was severely incapacitated by alcohol prior to the fire. The patient was likely in an alcoholic stupor when the fire broke out and could not escape.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/1278244-overview eMedicine Medical Library: Thermal Burns]
* [http://emedicine.medscape.com/article/769193-overview eMedicine Medical Library: Emergent Management of Thermal Burns]
* [http://www.merckmanuals.com/professional/injuries_poisoning/burns/burns.html Merck Manual: Burns]
=== Journal Articles ===
* Fukuzuka K, Rosenberg JJ, Gaines GC, Edwards CK 3rd, Clare-Salzler M, MacKay SL, Moldawer LL, Copeland EM 3rd, Mozingo DW. [http://www.ncbi.nlm.nih.gov/pubmed/10363899 Caspase-3-dependent organ apoptosis early after burn injury]. ''Ann Surg'' 1999 Jun;229(6):851-8; discussion 858-9.
* Robert L. Sheridan, M.D.[http://www.nejm.org/doi/pdf/10.1056/NEJMra1601128 Fire-Related Inhalation Injury]. ''NEJM'' 2016 Aug;375:464-469.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/2171-burn PEIR Digital Library: Burn Images]
{{IPLab 12}}
[[Category: IPLab:Lab 12]]