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Burn resuscitation

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https://www.readbyqxmd.com/read/29321048/danish-first-aid-books-compliance-with-the-new-evidence-based-non-resuscitative-first-aid-guidelines
#1
Theo Walther Jensen, Thea Palsgaard Møller, Søren Viereck, Jens Roland, Thomas Egesborg Pedersen, Freddy K Lippert
BACKGROUND: The European Resuscitation Council (ERC) released new guidelines on resuscitation in 2015. For the first time, the guidelines included a separate chapter on first aid for laypersons. We analysed the current major Danish national first aid books to identify potential inconsistencies between the current books and the new evidence-based first aid guidelines. METHODS: We identified first aid books from all the first aid courses offered by major Danish suppliers...
January 10, 2018: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29258727/the-role-of-preliminary-hospitals-in-the-management-of-a-mass-burn-casualty-disaster
#2
Ling-Wei Kuo, Cheng-I Yen, Chih-Yuan Fu, Chun-Hao Pan, Chih-Po Hsu, Yen-Chang Hsiao, Chi-Hsun Hsieh, Yu-Pao Hsu
PURPOSE: The Formosa Fun Coast explosion is an internationally-known event that occurred in Taiwan on June 27th, 2015. The blast involved 495 casualties in total, with 253 patients receiving 2nd degree or deeper burns on greater than 40% of the total body surface area (TBSA). Questions were raised regarding whether these victims were sent to the appropriate hospitals or not. Therefore, we analyzed the effect of the initial admission destination in this study. MATERIAL AND METHODS: We retrospectively reviewed all of the victims from the explosion who were sent to the emergency department of Linkou and Keelung Chang Gung Memorial Hospitals...
December 16, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29238847/which-pre-hospital-triage-parameters-indicate-a-need-for-immediate-evaluation-and-treatment-of-severely-injured-patients-in-the-resuscitation-area
#3
K O Jensen, R Heyard, D Schmitt, L Mica, C Ossendorf, H P Simmen, G A Wanner, C M L Werner, L Held, K Sprengel
PURPOSE: To find ways to reduce the rate of over-triage without drastically increasing the rate of under-triage, we applied a current guideline and identified relevant pre-hospital triage predictors that indicate the need for immediate evaluation and treatment of severely injured patients in the resuscitation area. METHODS: Data for adult trauma patients admitted to our level-1 trauma centre in a one year period were collected. Outpatients were excluded. Correct triage for trauma team activation was identified for patients with an ISS or NISS ≥ 16 or the need for ICU treatment due to trauma sequelae...
December 13, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29229195/a-comparison-of-two-different-fluid-resuscitation-management-protocols-for-pediatric-burn-patients-a-retrospective-study
#4
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)...
December 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29226160/the-significance-of-changes-in-platelet-concentration-during-the-early-phase-after-severe-burn-injury-in-a-chinese-mass-casualty
#5
Beiming Shou, Junqiang Li, Chenqi Tang, Qian Tan, Dongfeng Zheng, Binwei Sun, Lanjun Nie, Hongwei Zhang, Yanan Jiang, Chunming Wang, Yanwen Wu
Background: Changes in platelet concentration are common in severe burn patients. Platelets play a key role in the course of disease. This study aims to explore the significance of platelet concentration during the course of the disease in victims of a mass burn casualty. Methods: A total of 180 patients were involved in the "8.2" Kunshan explosion accident in China. The examined data included age, gender, total burn area (% TBSA), third-degree burn area (% TBSA), and platelet concentration within the first 5 days after the burn injury...
2017: Burns and Trauma
https://www.readbyqxmd.com/read/29166709/-effects-of-dexmedetomidine-on-myocardium-of-rats-with-severe-burn-at-early-stage
#6
D Wang, P L Yang, X Zhang, Y Liu
Objective: To investigate the effects of dexmedetomidine on myocardium of rats at early stage after severe burn. Methods: Twenty specific pathogen free male SD rats were immersed in 90 ℃ hot water for 20 s, causing 30% total body surface area (TBSA) full-thickness scald (hereafter referred to as burn) on the back. And then they were divided into burn resuscitation group (BR) and burn resuscitation+ dexmedetomidine group (BRD) according to the random number table, with 10 rats in each group. Sodium lactate Ringer's solution (2 mL·kg(-1)·%TBSA(-1)) were intraperitoneally injected into rats of both groups after burn...
November 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29140950/development-of-clinical-process-measures-for-pediatric-burn-care-understanding-variation-in-practice-patterns
#7
Lewis E Kazis, Robert L Sheridan, Gabriel D Shapiro, Austin F Lee, Matthew H Liang, Colleen M Ryan, Jeffrey C Schneider, Martha Lydon, Marina Soley-Bori, Lily A Sonis, Emily C Dore, Tina Palmieri, David Herndon, Walter Meyer, Petra Warner, Richard Kagan, Frederick J Stoddard, Michael Murphy, Ronald G Tompkins
BACKGROUND: There has been little systematic examination of variation in pediatric burn care clinical practices and its effect on outcomes. As a first step, current clinical care processes need to be operationally defined. The highly specialized burn care units of the Shriners Hospitals for Children system present an opportunity to describe the processes of care. The aim of this study was to develop a set of process-based measures for pediatric burn care and examine adherence to them by providers in a cohort of pediatric burn patients...
November 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29132247/management-of-a-rare-case-with-severe-hydrofluoric-acid-burns-important-roles-of-neutralizers-and-continuous-renal-replacement-therapy
#8
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
https://www.readbyqxmd.com/read/29119060/intra-abdominal-hypertension-in-severe-burns-prevalence-incidence-and-mortality-in-a-sub-saharan-african-hospital
#9
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
https://www.readbyqxmd.com/read/29113868/a-case-of-influenza-type-a-myocarditis-that-presents-with-st-elevation-mi-cardiogenic-shock-acute-renal-failure-and-rhabdomyolysis-and-with-rapid-recovery-after-treatment-with-oseltamivir-and-intra-aortic-balloon-pump-support
#10
Eleni Geladari, Vasilios Papademetriou, Hans Moore, David Lu
We present a 59-year-old black male with history of type-1 diabetes and alcohol abuse. Patient became critically ill after a 5-day period of burning throat discomfort. On arrival patient was lethargic, in cardiogenic shock with a blood pressure of 81/47mmHg. Immediate diagnoses included diabetic ketoacidosis, acute renal failure, and possible septic shock. He was intubated, resuscitated with intravenous fluids, maintained on three inotropic agents, and given empiric wide spectrum antibiotics. An ECG showed a new ST elevation MI and an echocardiogram showed severe LV dysfunction...
May 2, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29068759/severe-burns-in-a-patient-after-out-of-hospital-cpr
#11
Nir Biterman, Arthur Kerner, Doron Aronson, Yaron BarLavie, Yehuda Ullmann, Michael Kapeliovich
We present a case of a patient after prolonged cardio-pulmonary resuscitation on hot asphalt, who suffered from first and second degree burns which worsened during hospitalization. The patient was treated with therapeutic hypothermia. Possible effect of therapeutic hypothermia on the course of burns is discussed.
October 25, 2017: Acute Cardiac Care
https://www.readbyqxmd.com/read/29052820/evaluation-of-different-treatment-protocols-for-combined-injury-induced-lung-injury-in-rabbits
#12
Xiao Bing Li
BACKGROUND: This study aims to evaluate the effectiveness of different treatment regimens on combined injury-induced lung injury. METHODS: Rabbits were subjected to non-lethal closed-chest bilateral lung contusion followed by a 30% total body surface area scald burn. The rabbits were randomly assigned to resuscitation groups that maintained a minimum mean arterial blood pressure of 70 mmHg using one of the following three methods: normal saline plus polygeline injection in a ratio of 1:1 (1:1G), normal saline plus polygeline injection in a ratio of 1:2 (1:2G), and normal saline plus polygeline injection in a ratio of 1:3 (1:3G), After injury, lung injury was assessed using lung wet-to-dry (W/D) weight ratio, enzyme-linked immunosorbent assay, and real-time PCR...
September 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29024269/fluid-resuscitation-in-patients-with-severe-burns-a-meta-analysis-of-randomized-controlled-trials
#13
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
https://www.readbyqxmd.com/read/29023362/glycocalyx-shedding-is-enhanced-by-age-and-correlates-with-increased-fluid-requirement-in-patients-with-major-burns
#14
Akinori Osuka, Hirofumi Kusuki, Kazuhiro Yoneda, Hiroshi Matsuura, Hisatake Matsumoto, Hiroshi Ogura, Masashi Ueyama
BACKGROUND: Massive fluid shift following severe burn injury leads to edema and intravascular fluid loss that may result in burn-induced compartment syndrome (BICS) when corrected by aggressive fluid resuscitation. Factors causing this fluid shift remain unclear. Because glycocalyx regulates endothelial permeability, we hypothesized that glycocalyx shedding would increase fluid requirements in burn patients. This prospective cohort study aimed to identify relationships between shedding of the glycocalyx and fluid requirements following burn injury...
October 11, 2017: Shock
https://www.readbyqxmd.com/read/28982177/adipose-derived-stem-cells-attenuate-pulmonary-microvascular-hyperpermeability-after-smoke-inhalation
#15
Koji Ihara, Satoshi Fukuda, Baigalmaa Enkhtaivan, Raul Trujillo, Dannelys Perez-Bello, Christina Nelson, Anita Randolph, Suzan Alharbi, Hira Hanif, David Herndon, Donald Prough, Perenlei Enkhbaatar
BACKGROUND: Pulmonary edema is a hallmark of acute respiratory distress syndrome (ARDS). Smoke inhalation causes ARDS, thus significantly increasing the mortality of burn patients. Adipose-derived stem cells (ASCs) exert potent anti-inflammatory properties. The goal of the present study was to test the safety and ecfficacy of ASCs, in a well-characterized clinically relevant ovine model of ARDS. METHODS: Female sheep were surgically prepared. ARDS was induced by cooled cotton smoke inhalation...
2017: PloS One
https://www.readbyqxmd.com/read/28969436/acquired-methemoglobinemia-after-hydroxocobalamin-administration-in-a-patient-with-burns-and-inhalation-injury
#16
Alisha Z Jiwani, Vikhyat S Bebarta, Leopoldo C Cancio
CONTEXT: Hydroxocobalamin is an effective cyanide antidote. While erythema, hypertension, and chromaturia are recognized side effects, methemoglobinemia has not been reported. Methemoglobin levels are most accurately measured by co-oximetry. We describe an extensively burned patient who developed methemoglobinemia within an hour of hydroxocobalamin administration. CASE DETAILS: A 47-year old man without genetic deficiencies or abnormal hemoglobin variants presented with 61% body surface area thermal burns and grade 1 inhalation injury sustained during a tugboat engine explosion...
October 3, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28964882/the-effects-of-major-burn-related-pathophysiological-changes-on-the-pharmacokinetics-and-pharmacodynamics-of-drug-use-an-appraisal-utilizing-antibiotics
#17
Andrew A Udy, Jason A Roberts, Jeffrey Lipman, Stijn Blot
Patients suffering major burn injury represent a unique population of critically ill patients. Widespread skin and tissue damage causes release of systemic inflammatory mediators that promote endothelial leak, extravascular fluid shifts, and cardiovascular derangement. This phase is characterized by relative intra-vascular hypovolaemia and poor peripheral perfusion. Large volume intravenous fluid resuscitation is generally required. The patients' clinical course is then typically complicated by ongoing inflammation, protein catabolism, and marked haemodynamic perturbation...
September 28, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28955423/variations-in-injury-characteristics-among-paediatric-patients-following-trauma-a-retrospective-descriptive-analysis-comparing-pre-hospital-and-in-hospital-deaths-at-kamuzu-central-hospital-lilongwe-malawi
#18
Laura Purcell, Charles E Mabedi, Jared Gallaher, Steven Mjuweni, Sean McLean, Bruce Cairns, Anthony Charles
BACKGROUND: Trauma is a major cause of paediatric mortality in sub-Saharan Africa. In absence of pre-hospital care, the injury mechanism and cause of death is difficult to characterise. Injury characteristics of pre-hospital deaths (PHD) versus in-hospital deaths (IHD) were compared. METHODS: Using our trauma surveillance database, a retrospective, descriptive analysis of children (<18 years) presenting to Kamuzu Central Hospital in Lilongwe, Malawi from 2008 to 2013 was performed...
June 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
https://www.readbyqxmd.com/read/28951113/update-on-metabolism-and-nutrition-therapy-in-critically-ill-burn-patients
#19
E Moreira, G Burghi, W Manzanares
Major burn injury triggers severe oxidative stress, a systemic inflammatory response, and a persistent hypermetabolic and hypercatabolic state with secondary sarcopenia, multiorgan dysfunction, sepsis and an increased mortality risk. Calorie deficit, negative protein balance and antioxidant micronutrient deficiency after thermal injury have been associated to poor clinical outcomes. In this context, personalized nutrition therapy with early enteral feeding from the start of resuscitation are indicated. Over the last four decades, different nutritional and pharmacological interventions aimed at modulating the immune and metabolic responses have been evaluated...
September 23, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/28926876/-advances-in-the-research-of-characteristics-and-treatment-of-burns-in-the-elderly
#20
R Liu, Z Y Li
With the development of society and the improvement of medical level, the average life span of human has been increasing year by year. The proportion of elderly burn patients is also increasing yearly, which has become a social problem that can not be ignored. Because of physiological characteristics, such as decreased function of heart, lung, and kidney, degenerative changes of neural system, reduced gastrointestinal function and immunological function, and mostly accompanied by primary diseases of diabetes and cardiovascular diseases, elderly burn patients suffer from high shock rate and mortality, and their wounds are not easy to heal...
September 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
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