A 35-year-old man is admitted six hours after a house fire with burns to 25% of his body surface area, including a burn encircling the entire right forearm where the skin is pale, dry, firm and insensate to pinprick. Intravenous fluid resuscitation is running according to protocol and urine output is 60 mL/hr. Over the past hour the right hand has become cool with a capillary return of four seconds, and he reports pins and needles in the fingers; the radial pulse is palpable but weaker than the left. Which one of the following is the most appropriate next step in management?
More from AMC
See allA 17-year-old girl presents six hours after a deliberate ingestion of tablets taken from the family bathroom cabinet. She complains of nausea, repeated vomiting…
A 28-year-old woman is brought in by ambulance 90 minutes after being found drowsy next to an empty box of amitriptyline. Her Glasgow Coma Scale score is 12, he…
A 21-year-old man collapses at the 14 km mark of a city fun run on a 34°C day. In the trackside medical tent he is confused and agitated with a Glasgow Coma Sca…
A 26-year-old backpacker is snorkelling off Port Douglas in far north Queensland in December when she feels a mild sting on her forearm, leaving only faint redn…
A 34-year-old man in suburban Sydney felt a sharp pinprick on the back of his hand while moving pot plants stacked against the house. Over the next two hours he…