Authors Question: Treatment of Burns in Children

I got this question in my blog comments and thought I would also provide the answer here.

Latedra asks:

How would they treat burns in children? I imagine as they grow the burn scar would shrink right? My heroin received a burn as a child and I write it like she still has this big burn that is a part of her life. Is that possible? Maybe I'm over thinking it. I'm just now taking her burn seriously.

Jordyn Says: 

Hi Latedra!

Thanks for leaving a question. It depends on what kind of burn you're talking about. Burns that need a higher level of care would be those that would inhibit function. We get concerned about burns that cover a large portion of the feet, hands, face or genitalia (including breasts). The larger the burn area or the deeper the burn-- the more it may require skin grafting to heal.

Let's take a simple burn. Red with some blisters but covers maybe a palm size of the thigh. We would wash it with mild soap and water. Apply a copious layer of triple antibiotic ointment. Then we put something over top that won't stick to it-- we use a Vaseline impregnated gauze called Adaptic-- then it won't stick as the dressing comes off. More extensive burns would be referred to a burn center.

Scars generally stay the same size. They don't grow as the child grows so it may appear that they are shrinking because the child is bigger but really they are the same size.

Hope this helps!

Author Question: Cardiac Catheritization

Sandy Asks:

Hi, Jordyn. Wondering if you could help me with a couple details for my WIP. I have an 82 year old character, he had a heart attack in the presence of a couple trained in CPR. They save him, he's had an angioplasty, and doctors are shocked because all the prayer got him through this.
 
1. How long does he need to lie still?
2. When would the nurses move him to a chair?
3. How would he feel?
4. How long would he remain hospitalized if he's got folks to care for him at home?
 
Any help you can give would be appreciated.

Jordyn Says:

I actually pulled in a couple of my medical colleagues for your question since adult cardiac care isn't my main focus and I wanted to get you the best answer possible.

Here are the answers I got through a nursing friend, Crystal, from a Cardiac Unit Educator at the hospital in North Carolina where she works. Thanks, Andrea W., RN, CCRN!

1.  Well, bedrest varies per the doctor and the closure method after pulling the sheath. I guess I have seen anywhere from 2-6 hours for bedrest after pulling the sheath. Nowadays, they use closure devices most of the time and this lessens the amount of bedrest. A good average would be 4 hours.

2.  They can get him up to a chair as soon as the bedrest ordered timeframe is up and if the patient has not had any further bleeding from the site or if they have not developed a hematoma at the site.

3.  He should feel pretty good, some patients complain of soreness in their chest from the procedure.

4.  He should stay in the hospital 2-3 days max if no complications.

Sandy, best of luck to you and this book. Keep me posted on how your road to publication is going!

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Sandy Nadeau loves to go on adventures, photograph them and equally loves to write about them. She and her husband do a lot of four-wheeling in the back country of Colorado and share those experiences with others by taking them up in the mountains. With a background in writing a column about her community for a local newspaper, she also has had several magazine articles published. She loves to write novels about adventure, mystery, romance, but most importantly sharing God’s love. She is currently a member of the American Christian Fiction Writers and Vice President of the ACFW South Denver Chapter. Married for 37 years, she and her husband are loving life as grandparents to their two grandchildren. 

Forensic Question: Solving Cold Cases

My question is about cold cases. Are you able to test for DNA from blood on a knife or clothes from 30-40 years old? Also, if the remains of a body were found in a mine shaft, could you tell the manner of death from that same time or even older, say, 150 years old? How would you do this and how long would it take? Thanks so much for your help!

Amryn Says:

Cold case investigations have come a long way with the use of DNA technology. Answers that would have been impossible 20 years ago are now commonplace. The problem with cold cases is often in the handling of the evidence. On the knife or clothes that you mentioned, when they were first collected from a crime scene 30-40 years ago, the investigator may not have worn gloves. That seems shocking given what we know now, but it wasn’t all that routine a few decades ago.

What that might mean for your DNA results is that you get a mixture—say, the victim’s blood and another unknown profile. Now, does that profile belong to the killer or just the detective or crime scene tech that handled the evidence without gloves? Without something to compare back to, you won’t be able to say.

Let’s assume best case scenario, though. If the bloody evidence was stored and handled properly, it is definitely possible to get a DNA profile from the blood present on a knife or on clothes. This can usually be done with routine DNA testing, which generally takes 2-3 weeks. Of course, for the purposes of fiction, the DNA could be “rushed” and then results would possibly be available as soon as 48 hours. This testing will probably be done at the police department’s or state’s crime lab.

As far as a body in a mine shaft, unless the body is frozen, it’s likely to be not much more than a skeleton by the time it’s found 30-40 years later, and certainly 150 years. However, if the manner of death was some sort of trauma (i.e. broken neck from a fall or stab wound where the knife grazes the bone), a lot can still be determined from bones.

In most cases, a forensic anthropologist would be the person to make that determination. Some states have one on staff while others call in an expert like Dr. Bass (founder of the Body Farm) when they are needed.  I would say the time frame for that sort of determination is at least a couple weeks, though I’m sure there are cases where it could be done faster. And I should also mention, many forensic anthropologists like to be present when the team is recovering the bones to make sure none are missed and to make observations based on the position of the bones.

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Amryn Cross is a full-time forensic scientist and author of romantic suspense and mystery novels. Her first novel, Learning to Die, is available on Amazon. The first book in her latest series, loosely based on an updated Sherlock Holmes, is available for pre-order on Amazon. Look for Warzone in January 2015. You can connect with Amryn via her website, Twitter and Facebook.

Book Review: In The Name of God

In The Name of God delves into the ramifications of religious shield laws which (thank heavens this is changing) grant protection under the law if a child dies of a treatable medical illness and due to the parent's religious beliefs-- they refused medical care.

This touches close to me as a pediatric ER nurse seeing parents refuse some aspects of medical care-- immunizations would be the largest. As a parent, I believe in my right to make decisions for my children, but as a pediatric nurse, I also believe that children deserve a certain level of medical care to grow up strong and healthy. The line between these two are not always clear.

Refusing immunizations pales in comparison to what these religious groups do-- who believe that God is the ultimate healer and that if God decides-- their child will be healed from illness. Sadly, these kids die from highly treatable conditions like pneumonia, cysts, prematurity, diabetes, and urinary obstructions. The strange thing is, The Followers don't seem to have trouble going to the dentist or eye doctor.

The book alternates perspective between the legal side (those trying to change these laws) and inside views of The Followers as a religious group.

The book is interesting but really needed to be pared down. I don't need to read a play by play of a child's vomiting and throwing up each meal over two days to get the point that they couldn't hold anything down. Also, I don't think it's necessary to give gory details about a pediatric autopsy-- using words like, "This doctor was going to eviscerate . . . " I think it's disrespectful of a pediatric victim to do that. The intimate look into The Followers, in my opinion, became overindulgent and tedious to read.

That being said, I do think this is an important, challenging book and in this era of religious extremes, I think those of us that have faith need to speak out against the extremes of our faith and I applaud this book for doing so in a balanced way.