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Burn fluid management

Sara Smith, Jane Hunt
Reflection can help nurses make sense of their clinical surroundings and understand risks, challenges and opportunities. Learning the art required for reflective practice begins as a student when critical reflection is particularly important during practice placements. A suitable reflective framework is provided by Rolfe et al ( 2011 ). Adopting this framework, this article draws on the placement experiences of a second-year undergraduate children's nursing student in an acute setting, caring for a toddler with 13% partial and full-thickness burns...
March 7, 2018: Nursing Children and Young People
A K W Cheah, T Kangkorn, E H Tan, M L Loo, S J Chong
Background: Accurate total body surface area burned (TBSAB) estimation is a crucial aspect of early burn management. It helps guide resuscitation and is essential in the calculation of fluid requirements. Conventional methods of estimation can often lead to large discrepancies in burn percentage estimation. We aim to compare a new method of TBSAB estimation using a three-dimensional smart-phone application named 3D Burn Resuscitation (3D Burn) against conventional methods of estimation-Rule of Palm, Rule of Nines and the Lund and Browder chart...
2018: Burns and Trauma
Katie Wiggins-Dohlvik, Binu Tharakan
The management of burn patients is an extremely complex and clinically challenging for patient care. Aside from the increasing reports of burn injury and morbidity and mortality directly related to it, the pathobiology of burn trauma is not clearly understood. The rat model of burn trauma described here is currently used in research laboratories to study various aspects of burn injury, including vascular dysfunctions. This model demonstrates the infliction of thermal injury in Sprague-Dawley rats using a well-established boiled water approach...
2018: Methods in Molecular Biology
R Martinez, A D Rogers, A Numanoglu, H Rode
BACKGROUND: Telemedicine is increasingly applied in developed settings to facilitate transfer of information to and from burn surgeons across vast geographic areas. WhatsApp is a widely available and extremely user-friendly encrypted smartphone application that does not require the expensive physical and personnel infrastructure that characterizes many of these telemedicine systems. The aim of this study was to review the use of WhatsApp to facilitate paediatric burn injury consultations to a regional burn centre in a developing country, where burn care continues to be thwarted by administrative apathy, poor resource allocation and lack of attention to medical and nursing education at all levels...
January 27, 2018: Burns: Journal of the International Society for Burn Injuries
Hao-Yu Chiao, Chang-Yi Chou, Yuan-Sheng Tzeng, Chih-Hsin Wang, Shyi-Gen Chen, Niann-Tzyy Dai
BACKGROUND: Adequate fluid titration during the initial resuscitation period of major burn patients is crucial. This study aimed to evaluate the feasibility and efficacy of a goal-directed fluid resuscitation protocol that used hourly urine output plus the arterial waveform analysis FloTrac (Edwards LifeSciences, Irvine, Calif) system for major burns to avoid fluid overload. METHODS: We conducted a retrospective cohort study of 43 major burn patients at the Tri-Service General Hospital after the Formosa Fun Coast Dust Explosion on June 27, 2015...
February 2018: Annals of Plastic Surgery
Juliana Tolles, Nachi Gupta, Jeffrey Nusbaum
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 1, 2018: Emergency Medicine Practice
Kristina Watterson, Maggie Jo Hauck, Amanda Auker, Rebecca Burns, Julianne Greider, Melissa Marlin, Natalie McAlpin, Shannon Melville, Jennifer Shirley, LaQuisha Stevens, Cathy Logan, Erika Fenimore
Peripheral intravenous (PIV) catheters are commonly used in pediatric medical-surgical orthopedic and neurology populations but are at risk of dislodgement with subsequent infiltration of fluids and/or medications. This quality improvement project sought to decrease the incidence of infiltration by creating an educational awareness program for both staff nurses and families using the S.T.I.C.K. mnemonic bundle. Rates of PIV catheter infiltration on a pediatric medical-surgical orthopedic and neurology unit were found to decrease when staff nurses utilized the S...
January 19, 2018: Journal of Pediatric Nursing
Juliana Tolles
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 2018: Emergency Medicine Practice
Michael Gottlieb, Brit Long, Alex Koyfman
BACKGROUND: Toxic shock syndrome (TSS) is a severe, toxin-mediated illness that can mimic several other diseases and is lethal if not recognized and treated appropriately. OBJECTIVE: This review provides an emergency medicine evidence-based summary of the current evaluation and treatment of TSS. DISCUSSION: The most common etiologic agents are Staphylococcus aureus and Streptococcus pyogenes. Sources of TSS include postsurgical wounds, postpartum, postabortion, burns, soft tissue injuries, pharyngitis, and focal infections...
January 20, 2018: Journal of Emergency Medicine
Edward Kuzmack, Travis Inglis, David Olvera, Allen Wolfe, Kona Seng, Daniel Davis
BACKGROUND: Difficult-airway prediction tools help identify optimal airway techniques, but were derived in elective surgery patients and may not be applicable to emergency rapid sequence intubation (RSI). The HEAVEN criteria (Hypoxemia, Extremes of size, Anatomic abnormalities, Vomit/blood/fluid, Exsanguination, Neck mobility issues) may be more relevant to emergency RSI patients. OBJECTIVE: To validate the HEAVEN criteria for difficult-airway prediction in emergency RSI using a large air medical cohort...
January 10, 2018: Journal of Emergency Medicine
S J Dickson, K A Clay, M Adam, C Ardley, M S Bailey, D S Burns, A T Cox, D G Craig, M Espina, G Fitchett, J Grindrod, D E Hinsley, S Horne, E Hutley, A M Johnston, R L C Kao, L E Lamb, S Lewis, D Marion, A J Moore, T C Nicholson-Roberts, A Phillips, J Praught, P S Rees, I Schoonbaert, T Trinick, D R Wilson, A J Simpson, D Wang, M K O'Shea, T E Fletcher
BACKGROUND: Limited data exist describing supportive care management, laboratory abnormalities and outcomes in patients with EVD (Ebola virus disease) in West Africa. We report data which constitute the first description of the provision of enhanced EVD case management protocols in a West African setting. METHODS: Demographic, clinical and laboratory data were collected by retrospective review of clinical and laboratory records of patients with confirmed EVD admitted between 5 November 2014 and 30 June 2015...
December 14, 2017: Journal of Infection
Lisieux Eyer de Jesus, Alana Bandeira Martins, Pablo Baptista Oliveira, Fernanda Gomes, Thais Leve, Samuel Dekermacher
INTRODUCTION: Negative pressure wound therapy (NPWT) has been widely adopted to treat laparostomy, abdominal compartment syndrome (ACS) and complicated wounds associated with tissue loss. The method presents specific aspects, advantages and indications in Pediatrics. Our aim is to review the evidence available about NPWT in children. METHODS: Active search for papers about NPWT in Pediatric patients. Papers referring to orthopedic problems, wound complications after Cardiac Surgery or burns were excluded...
November 21, 2017: Journal of Pediatric Surgery
Elton Mathias, Madhu Srinivas Murthy
Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population...
December 11, 2017: Medicines (Basel, Switzerland)
Miao Huang, Jun-Feng Chen, Li-Ying Chen, Li-Qin Pan, Xiao-Jian Li, Jie-Yu Ye, Hui-Yi Tan
OBJECTIVE: Pediatric burn patients are more susceptible to burn shock than adults, and an effective fluid management protocol is critical to successful resuscitation. Our research aim was to investigate the safety and efficacy of two protocols for pediatric burn patients for use within the first 24h. METHODS: A total of 113 pediatric burn patients were enrolled from January 2007 to October 2012. Of those patients, 57 received fluid titration regimens of alternating crystalloids and colloids once within 2h in the first 24h after burn (Group A), whereas the remaining patients received regimens of alternating crystalloids and colloids once within 1h in the first 24h after burn (Group B)...
February 2018: Burns: Journal of the International Society for Burn Injuries
Omnia S Zaki, Marwa M Safar, Afaf A Ain-Shoka, Laila A Rashed
Sepsis is a systemic inflammatory disorder which often occurs during extremely stressful conditions such as trauma, burn, shock, and infection. This study investigated the curative effects of bone marrow-derived mesenchymal stem cells (BM-MSCs) against hepatic, renal, and pulmonary responses caused by a single administration of lipopolysaccharide (LPS) (10 mg/kg, i.p) in rats. Treatment with BM-MSCs (5 × 105 in 0.1 ml PBS, i.p.) 3 h after LPS antagonized the LPS-induced increment of the liver enzymes (ALT, AST) and kidney functions (BUN, sCr)...
December 4, 2017: Inflammation
Frederike J C Haverkamp, Gordon G Giesbrecht, Edward C T H Tan
BACKGROUND: Accidental hypothermia concerns a body core temperature of less than 35°C without a primary defect in the thermoregulatory system. It is a serious threat to prehospital patients and especially injured patients, since it can induce a vicious cycle of the synergistic effects of hypothermia, acidosis and coagulopathy; referred to as the trauma triad of death. To prevent or manage deterioration of a cold patient, treatment of hypothermia should ideally begin prehospital. Little effort has been made to integrate existent literature about prehospital temperature management...
February 2018: Injury
Yuanhai Zhang, Xingang Wang, Yuezhen Liu, Xinhua Jiang, Chunjiang Ye, Liangfang Ni, Liping Zhang, Jianfen Zhang, Bin Xu, Chunmao Han
Hydrofluoric acid (HF), a dangerous inorganic acid, is widely used in various industries and in daily life. Chemical burns caused by HF exposure occur more frequently in some regions worldwide. It has been reported that some cases with HF burns can be lethal due to the hypertoxicity of HF. In this article, we present a case of a 24-year-old worker who suffered HF burns by 53% HF solution to his face, neck, and nasal cavity. This patient quickly developed electrolyte disturbance, that is, hypocalcemia, and hypopotassemia, and myocardial injury after exposure...
December 2017: International Journal of Lower Extremity Wounds
Ronald Mbiine, Rose Alenyo, Olive Kobusingye, Job Kuteesa, Cephas Nakanwagi, Hervé Monka Lekuya, Olivia Kituuka, Moses Galukande
BACKGROUND: Severe burns have been shown to be a risk factor for developing intra-abdominal hypertension (IAH). Fluid resuscitation practices used in burns management further predispose patients to intra-abdominal hypertension. The mortality associated with IAH in severe burns is estimated to be more than 74.5% once organ dysfunction occurs. Despite 95% of all burns occurring in Low and Middle income countries (LMIC), there is paucity of published data on this topic in sub-Saharan Africa...
2017: International Journal of Burns and Trauma
Spencer Greene, Laura Ann Galdamez, Richard Tomasheski
BACKGROUND: Snakebites are common in many regions of the United States. Bites from exotic species, however, are rare. The white-lipped tree viper, Cryptelytrops (formerly Trimeresurus) albolabris, is a pit viper native to Southeast Asia. Bites are common in countries such as Myanmar, India, Thailand, Indonesia, and China. In this report, we describe an envenomation in an American viper keeper. CASE REPORT: A healthy 28-year-old right-handed man who collects venomous snakes experienced a bite to the distal left thumb from a neonatal C...
December 2017: Journal of Emergency Medicine
Yuan Kao, El-Wui Loh, Chien-Chin Hsu, Hung-Jung Lin, Chien-Cheng Huang, Yun-Yun Chou, Chieh-Chun Lien, Ka-Wai Tam
OBJECTIVES: Fluid resuscitation is the mainstay treatment to reconstitute intravascular volume and maintain end-organ perfusion in patients with severe burns. The use of a hyperosmotic or isoosmotic solution in fluid resuscitation to manage myocardial depression and increased capillary permeability during burn shock has been debated. We conducted a systematic review and meta-analysis to compare the efficacies of hyperosmotic and isoosmotic solutions in restoring hemodynamic stability after burn injuries...
October 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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