Calling Hospital Staff (Mainly Regarding Severe Burns)

DavidBrett

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Okay, this might sound weird, but I need to know a few things I don't think I can just walk into my local hospital and ask, so here I am!

In my story, my protagonist makes a stupid pact with an ifritt (fire spirit/djinn) to gain the supernatural powers of his parents. This results in the ifritt rushing to his home and blowing it up, killing his parents and catching him in the explosion as he was racing there to try and save them. First question, where would he be situated in the hospital, assuming he's unconscious whilst in critical condition in ER and wakes up... where? Intense Care, or a specialised Burns unit/ward?

Secondly, he has visible white, spiderweb-like scarring down his left side, thus gaining the title "The Burned Orphan" amongst the otherworldly creatures he'll go on to face... what degree of burns would achieve this, and how long would he be in hospital before reaching a functional state, assuming he refuses to undergo skin grafts or any other kind of surgery to cover his scars?

Third and finally, by becoming "The Burned Orphan" he's now become a prophecy figure, and other supernatural beings want to deal with him before he gets too powerful, so they force the hospital into a lock down and fill it with monsters, spirits and possessed people (both patients and staff), hunting him and a small band of survivors down through the hospital. My question is, would such a lock down be possible? Is there a quarantine system that would affect the entire buillding, or would I have to make one up?

Thanks in advance, and also I may have further questions as the drafts progress, so please let me know in your replies if it's okay for me to PM you in future. Thanks again!

Dave
 

MaeZe

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First stop, emergency department where the patient is assessed and stabilized. You'll be able to pick the scenario you want and go from there.

Burn care is a specialty, patient goes to a burn unit when one is available.

Head trauma is a specialty, some hospitals have neurological intensive care units.

Hospitals can have cardiac intensive care units, bone marrow transplant units, pediatric and neonatal intensive care units.

Take your pick, but since you want burns to be the major feature, I'd expect you would minimize the other trauma.

As for no skin grafts, that may not be a viable choice, you can't just grow back large patches of skin if the burns were third degree.

Look up first, second and third degree burns to get basic knowledge of the injuries. You won't get a decent understanding from a couple answers on a forum.

First degree burns will leave little to no scarring. Second degree can leave scars like any other trauma. I had the pattern of a barbecue grill in my forearm for about 30 years though it is faded now. I rode my tricycle off the porch landing on the grill. It wasn't bad enough my parents took me to a doctor for.

Third degree is a full skin thickness burn. There are no skin cells left to grow back. The wound would need to fill in from the edges and that is not practical if the burns are over wide areas of skin. Refusing a skin graft or sometimes when a patient has no good skin to graft from, donor grafts or skin substitutes are used temporarily to cover the wound until connective tissue fills in.

You have to keep infection out, but also with no skin over large areas of your body you have to keep fluids in. You can't do that with bandages.

Regardless of the skin graft, with third degree burns you end up with scar tissue as the wound heals with a lot of connective tissue rather than skin cells.

But again, just tailor your character's injuries to the story you want, not the other way around.
 
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Anna Iguana

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I don't have answers for you, but I know that there is medical literature beyond AW about treating burn victims, which would address at least some of your questions. (ETA: +1 what MaeZe said.) I'd urge you to consult it; people who survive severe burns go through harrowing physical and psychological recoveries; their lives can be permanently changed.

(I interned with a young man who survived a fire and went into specialized inpatient counseling to assist other severe burn survivors, who sometimes contemplate suicide because of chronic pain and how people treat them after their appearances change.)
 
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Brightdreamer

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But again, just tailor your character's injuries to the story you want, not the other way around.

+1

Your explosion was caused by supernatural means. The resulting injuries could be quite different from normal burns; the white web scarring you want could be a "mark" of the ifritt's power, sort of a spiritual brand or signature, or it could be a result of the fire interacting with the supernatural powers your character bargained for. You might contrive a way for him to do a significant portion of his healing outside the hospital, so it isn't remarked upon by the medical staff... or maybe the webbing only appears after he's healed naturally, a magical reminder. It's your story, and you're the god - you find a way and make it so.
 

DavidBrett

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Thanks everyone, so many good points and information! I'll be sure to read into the different burn degrees, how they're treated and heal, and the accompanying processes both physical and mental.

Dreamer, you're actually on the right track! The scars are somewhat supernatural in nature, and in later books (the one I originally started writing showed this origin story was necessary) it goes on to be a "spider-sense" of sorts, prickling/itching in the presence of supernatural danger or hostile intent. So, like MaeZe pointed out, maybe Third degree burns wouldn't make this possible as he'd already be in constant pain, or numb altogether from the extensive damage?
 

GeorgeK

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Adding to MaeZe's comments, skin will generally only grow about roughly a centimeter in from the edge so any gap over 2 cm, or an inch or so will likely need some other means to close it. That could be a flap or a graft, or could be mobilizing skin and actually stretching (for small gaps) plus or minus relaxing incisions (for larger gaps) depending upon location. Regarding spider web like scarring, I've only seen that from meshed skin grafts. Meshing makes a bunch of sieve like slits in a skin graft so it can be expanded in an accordion like manner so a smaller graft can cover a larger gap.

Most hospitals don't have a burn unit. Larger communities might have a burn hospital.
 
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