Scenario — Superficial burn injury from cooking oil splash
foundation Trauma · Adult · 35yr · female
Patient Information
| Dispatch | A 35YO female presenting to the FAP with a burn to her right forearm sustained approximately 10 minutes ago. (Sarah Nguyen) |
| Patient | Sarah Nguyen — 35yr (65kg) |
| Incident History | Pt was working at a food stall at the Perth Royal Show when hot cooking oil splashed onto her right forearm. She self-applied a cold drink bottle briefly before walking to the FAP. |
| Emergency Contact | Michael Nguyen (Husband) — 0412 553 891 |
Initial Rapid Assessment
| Response | Alert |
| Airway | Patent. Nil airway obstructions. Nil swelling or stridor. No soot or hoarseness noted. |
| Breathing | Breathing comfortably. No respiratory distress. Rate and effort within normal limits. |
| Circulation | Radial pulse strong and regular. Skin warm and dry. Reddened, blistered area approximately 6 x 8 cm to right volar forearm. Nil active bleeding. |
| Disability | GCS 15 (E4V5M6). Fully oriented to time, place and person. Complaining of significant pain to affected area. |
| Exposure | Isolated burn to right volar forearm — reddened, moist blistering skin with no charring or leathery appearance. No other injuries identified. Jewellery (bracelet) present on right wrist. |
Vitals
| Time | SpO2 | Resp Dist | RR | Pulse | BP | CRT | GCS | PERL | Temp | BGL | Pain |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Initial | 98% (RA) | Nil | 16 | 96 | 122/78 | <2s | 15 | 4 4 ++ | 36.9 | – | 7 |
| 10 mins | 99% (RA) | Nil | 14 | 88 | 118/76 | <2s | 15 | 4 4 ++ | 36.9 | – | 4 |
History Taking
| Signs/Symptoms | Intense burning pain to right volar forearm. Redness and blistering visible. No symptoms elsewhere. No cough, hoarseness, or breathing difficulty. |
| Allergies | Nil known drug or food allergies. |
| Medications | Oral contraceptive pill — no other regular medications. |
| Pertinent History | Nil relevant past medical history. Non-smoker. No history of skin conditions. |
| Last Oral Intake | Ate lunch approximately 2 hours ago. |
| Events Leading | Pt was frying food at a food stall when a pan of hot oil splashed onto her right forearm. She was wearing a short-sleeved shirt at the time. |
| Treatment Prior | Pt briefly held a cold drink bottle against the burn for approximately 2 minutes before walking to the FAP. |
| Onset | Approximately 10 minutes ago during cooking at the food stall. |
| Pain | Intense burning and stinging pain to right forearm. |
| Quality | Burning, stinging sensation — constant. |
| Radiates | Nil radiation. |
| Severity | 7/10 |
Scenario Progression and Treatment Objectives
Diagnosis
This patient is suffering from a superficial partial thickness burn to the right volar forearm caused by a hot oil splash, estimated at approximately 2–3% Total Body Surface Area (TBSA).
Facilitator Triggers — if trainees miss a critical step
- ! (If trainees fail to remove the bracelet from the right wrist within the first 2 minutes, advise that the patient mentions her wrist is beginning to feel tight — prompt removal before oedema develops.)
- ! (If cooling is not commenced within 3 minutes of scene arrival, the patient reports that the pain is worsening and the area looks more inflamed — reinforce the 20-minute minimum cooling requirement.)
- ! (If trainees attempt to apply a dry dressing without cooling first, the patient winces and says 'that's making it worse' — redirect to cooling protocol.)
- ! (If trainees do not assess for inhalation injury — ask about cough, hoarseness, or breathing difficulty — facilitator prompts: 'Is there anything you want to ask about how she was breathing near the stall?')
- ! (If trainees do not perform a distal neurovascular check before and after dressing, prompt: 'Have you checked sensation and circulation in her fingers?')
Treatment Objectives
- 1. Don appropriate PPE — gloves at minimum.
- 2. Perform Primary Survey — confirm airway patent, breathing adequate, no circulatory compromise, GCS 15.
- 3. Assess burn for inhalation injury — ask about cough, hoarseness, black sputum, or breathing difficulty (none present in this scenario).
- 4. Remove jewellery from the affected limb — remove bracelet from right wrist before oedema develops.
- 5. Commence cooling of the burn area immediately — apply cool running water (approximately 15°C) to the affected area for a minimum of 20 minutes.
- 6. Do NOT use ice, iced water, butter, creams, or other home remedies on the burn.
- 7. While cooling, perform Vital Sign Survey — HR, BP, RR, SpO2, GCS, pain score.
- 8. Perform Secondary Survey — confirm burn is isolated to right volar forearm, estimate TBSA using Rule of Nines (approximately 2–3% for this area).
- 9. Document time of burn injury — 10 minutes prior to FAP presentation.
- 10. After cooling is complete (minimum 20 minutes), apply damp sterile dressings to the affected area.
- 11. Assess distal neurovascular observations (colour, warmth, movement, sensation, CRT) before and after dressing application.
- 12. Reassess pain score post-cooling and post-dressing — expect improvement from 7/10 toward 4/10.
- 13. Reassure patient continuously throughout treatment.
- 14. Advise patient that transfer to hospital is recommended for assessment and wound review, as blistering burns require medical evaluation.
- 15. Arrange transport to nearest emergency department — this patient does not meet criteria for direct transfer to tertiary burns centre (TBSA <10%, no airway burns, no involvement of face, hands, feet, perineum, or genitalia).
- 16. Record full observations every 10 minutes.
- 17. Scenario ends on arrival of ambulance and IMISTAMBO handover.
- 18. Attention to hand hygiene will be given throughout the scenario.
Clinical references: Burn Trauma · Primary Survey · Secondary & CNS Survey · Minor Wound Management · Pain Assessment
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