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Bhushan Sudhakar Wankhade, Wasim Shabbir Shaikh, Zeyad Faoor Alrais, Adel Elsaid ElKhouly, Ammar Ali Salman
Carbon monoxide poisoning (COP) is a common cause of death due to poisoning. After COP, a significant number of patients may develop a distinct type of neurological dysfunction called delayed neurological sequel (DNS). Recently, we came across a disaster of COP cases after a fire in a shared accommodation. The hostel was overcrowded and had a faulty air-conditioning/exhaust system. A total of five patients with loss of consciousness and shock were brought to us. They were diagnosed with acute COP based on their history of exposure to carbon monoxide (CO) and elevated carboxyhemoglobin levels in blood gas measurements...
January 2024: Curēus
#22
REVIEW
Cory Tremblay, Kathryn A Albrecht, Christiaan C Sonke, Sanjay Azad
OBJECTIVE: To outline an approach to the assessment and initial management of patients with burns in the rural emergency department setting. Three mnemonics are presented that can be used for both the assessment and the initial management of patients with burns in rural settings. QUALITY OF EVIDENCE: Current and local guidelines compiled by a plastic surgeon were reviewed to develop a systematic approach to the treatment of patients with burns. PubMed and other databases were also searched for current literature on emergency care of patients with burns...
February 2024: Canadian Family Physician Médecin de Famille Canadien
#23
JOURNAL ARTICLE
Habib Abla, Vivie Tran, Alan Pang, Stephanie Stroever, Chip Shaw, Sharmila Dissanaike, John Griswold
We find minimal literature and lack of consensus among burn practitioners over how to resuscitate thermally injured patients with pre-existing liver disease. Our objective was to assess burn severity in patients with a previous history of liver disease. We attempted to stratify resuscitation therapy utilised, using it as an indicator of burn shock severity. We hypothesized that as severity of liver disease increased, more fluid therapy is needed. We retrospectively studied adult patients with a total body surface area (TBSA) of burn greater than or equal to 20% (n = 314)...
January 22, 2024: Burns
#24
JOURNAL ARTICLE
A A Birkun
OBJECTIVES: Misinformation is currently recognised by the World Health Organization as an apparent threat to public health. This study aimed to provide an outline of published evidence on misinformation related to the potentially life-saving interventions - first aid and cardiopulmonary resuscitation (CPR). STUDY DESIGN: A scoping review. METHODS: The review was conducted in accordance with the PRISMA Extension for Scoping Reviews. English-language publications describing original studies that evaluated the quality of publicly available information on first aid and/or CPR were included without limitations to the year of publication...
February 13, 2024: Public Health
#25
JOURNAL ARTICLE
Timing to First Whole Blood Transfusion and Survival Following Severe Hemorrhage in Trauma Patients.
Crisanto M Torres, Kelly M Kenzik, Noelle N Saillant, Dane R Scantling, Sabrina E Sanchez, Tejal S Brahmbhatt, Tracey A Dechert, Joseph V Sakran
IMPORTANCE: Civilian trauma centers have revived interest in whole-blood (WB) resuscitation for patients with life-threatening bleeding. However, there remains insufficient evidence that the timing of WB transfusion when given as an adjunct to a massive transfusion protocol (MTP) is associated with a difference in patient survival outcome. OBJECTIVE: To evaluate whether earlier timing of first WB transfusion is associated with improved survival at 24 hours and 30 days for adult trauma patients presenting with severe hemorrhage...
January 31, 2024: JAMA Surgery
#26
JOURNAL ARTICLE
Eloise Stanton, Yvonne Karanas, Tam Pham, Justin Gillenwater, Clifford C Sheckter
Methamphetamine intoxication frequently complicates inpatient burn admissions. While single-institution studies describe adverse outcomes during resuscitation, little is known about the risks of amphetamine intoxication on inpatient complications and perioperative management. The US National Trauma Data Bank was queried for burn encounters between 2017-2021. Amphetamine intoxication was identified on admission. Primary outcomes included death, stroke, and myocardial infarction (MI). Secondary outcomes included organ failure and surgical management...
January 29, 2024: Journal of Burn Care & Research: Official Publication of the American Burn Association
#27
JOURNAL ARTICLE
Qin Yalan, Liu Yinzhou, Tang Binfei, Cao Yunxing, Huang Wenqi, Zhang' An
BACKGROUND: Volume resuscitation is often required in critically ill patients. However, we have no clear consensus on the choice between crystalloid solution and colloidal solution. This study aimed to explore the effect of albumin administration in massive fluid resuscitation. METHODS: This was a retrospective cohort study based on the Medical Information Mart for Intensive Care IV (MIMIC-IV) database (2008 and 2019). The prognosis of patients receiving albumin in combination with crystalloids and those receiving crystalloids alone was compared to assess the benefits of albumin in fluid resuscitation...
January 19, 2024: Burns
#28
REVIEW
Taylor Chiang, Amanda L Teichman
According to trauma resuscitation guidelines, intraosseous (IO) access is appropriate when failure to gain intravenous (IV) access is present in trauma, burn, shock, or resuscitation settings for adults or when two failed attempts have been made in the resuscitation of a pediatric patient. However, their effectiveness and use have been debated due to concerns on flow rates, extravasation, compartment syndrome, and osteomyelitis. The objective of this review is to examine the current literature regarding intraosseous access in trauma resuscitation, focusing on interventions and complication rates...
January 10, 2024: American Surgeon
#29
JOURNAL ARTICLE
The use of intraosseous infusion in the early resuscitation of patients with extremely severe burns.
Yuwei Wang, Shuaishuai Zhou, Lizhu Wang, Jue Fang, Yukun Zhang, Lili Shi, Gaoxing Lin, Mangwei Zhang, Sa Wang
According to research, shock, the most common complication of extremely severe burns, is also the leading cause of mortality among patients with such burns. The case fatality rate reaches 83.45% when the total burn area exceeds 90%. The American Heart Association in 2020 recommended the intraosseous route after the peripheral route and prior to the central venous route when venous cannulation is either difficult or delayed. The use and experience with intraosseous infusion (IO) in extremely severe burns are still limited...
January 5, 2024: Journal of Burn Care & Research: Official Publication of the American Burn Association
#30
JOURNAL ARTICLE
Marianne Kruse, Konrad Ernst Liesenborghs, David Josuttis, Philip Plettig, Denis Guembel, Ida Katinka Lenz, Claas Guethoff, Volker Gebhardt, Marc Dominik Schmittner
Adequate fluid therapy is crucial for resuscitation after major burns. To adapt this to individual patient demands, standard is adjustment of volume to laboratory parameters and values of enhanced hemodynamic monitoring. To implement calibrated parameters, patients must have reached the intensive care unit (ICU). The aim of this study was, to evaluate the use of an auto-calibrated enhanced hemodynamic monitoring device to improve fluid management before admission to ICU. We used PulsioflexProAqt® (Getinge) during initial treatment and burn shock resuscitation...
January 3, 2024: Journal of Intensive Care Medicine
#31
JOURNAL ARTICLE
Shawn Tejiram, Jeffrey W Shupp
Patients with large burn injuries remain a challenge. The loss of skin barrier integrity and induced immunosuppression after injury increases their vulnerability to infection. Sepsis remains the primary cause of death for burn-injured patients who survive their acute injury and resuscitation. The objective of this work is to describe the current understanding and management of sepsis in the burn-injured patient and newer strategies to approach its management. Current understanding of the systemic inflammatory response to burn injury and sepsis, preventative strategies, and novel research will be discussed...
April 2024: Surgery
#32
REVIEW
Jumanah Y Nassar, Abdullah A Al Qurashi, Ibrahim Abdullah Albalawi, Houriah Y Nukaly, Ibrahim R Halawani, Abdulaziz F Abumelha, Adnan M Osama Al Dwehji, Mahinar M Alhartani, Alanoud Asaad, Arwa Alnajashi, Imad M Khojah
Pediatric burns pose a significant public health concern, ranking as the fifth most common nonfatal injury globally. This review consolidates data on the epidemiology, outcomes, and management of pediatric burns presenting to emergency departments. A systematic review was conducted across multiple databases, yielding 22 articles from 1992 to 2020. Utilizing the methodological index for non-randomized studies (MINORS) instrument, non-comparative studies scored from 2 to 11 with an average of 6.87, while comparative studies ranged from 12 to 16, averaging 13...
November 2023: Curēus
#33
JOURNAL ARTICLE
Luis Gajate, Inés de la Hoz, Mercedes Espiño, Maria Del Carmen Martin Gonzalez, Cristina Fernandez Martin, Ascensión Martín-Grande, Diego Parise Roux, Oscar Pastor, Judith Villahoz, Miguel Ángel Rodriguez-Gandía, Javier Nuño Vazquez
BACKGROUND: Liver transplantation is the last therapeutic option for patients with end-stage liver disease. Postreperfusion syndrome (PRS), defined as a fall in mean arterial pressure of more than 30% within the first 5 minutes after reperfusion of at least 1 minute, can occur in liver transplantation as a deep hemodynamic instability with associated hyperfibrinolysis immediately after reperfusion of the new graft. Its incidence has remained unchanged since it was first described in 1987...
December 15, 2023: JMIR Research Protocols
#34
JOURNAL ARTICLE
Andrew R Yates, Maryam Y Naim, Ron W Reeder, Tageldin Ahmed, Russell K Banks, Michael J Bell, Robert A Berg, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph A Carcillo, Todd C Carpenter, J Michael Dean, J Wesley Diddle, Myke Federman, Richard Fernandez, Ericka L Fink, Deborah Franzon, Aisha H Frazier, Stuart H Friess, Kathryn Graham, Mark Hall, David A Hehir, Christopher M Horvat, Leanna L Huard, Tensing Maa, Arushi Manga, Patrick S McQuillen, Ryan W Morgan, Peter M Mourani, Vinay M Nadkarni, Daniel Notterman, Murray M Pollack, Anil Sapru, Carleen Schneiter, Matthew P Sharron, Neeraj Srivastava, Bradley Tilford, Shirley Viteri, David Wessel, Heather A Wolfe, Justin Yeh, Athena F Zuppa, Robert M Sutton, Kathleen L Meert
OBJECTIVES: Cannulation for extracorporeal membrane oxygenation during active extracorporeal cardiopulmonary resuscitation (ECPR) is a method to rescue patients refractory to standard resuscitation. We hypothesized that early arrest hemodynamics and end-tidal Co2 (ETco2) are associated with survival to hospital discharge with favorable neurologic outcome in pediatric ECPR patients. DESIGN: Preplanned, secondary analysis of pediatric Utstein, hemodynamic, and ventilatory data in ECPR patients collected during the 2016-2021 Improving Outcomes from Pediatric Cardiac Arrest study; the ICU-RESUScitation Project (ICU-RESUS; NCT02837497)...
December 13, 2023: Pediatric Critical Care Medicine
#35
JOURNAL ARTICLE
Felipe Teran, Frances Mae West, Tom Jelic, Lindsay Taylor, Zan M Jafry, Katharine M Burns, Clark G Owyang, Claire Centeno Emt, Benjamin S Abella, Phillip Andrus
INTRODUCTION: Over the past two decades, transesophageal echocardiography (TEE) has been used with increasing frequency to evaluate critically ill patients outside of traditional settings. The purpose of this study was to characterize the number of programs, users, practice characteristics, training and competency requirements and barriers for the current use of resuscitative transesophageal echocardiography (TEE) in Emergency Departments (EDs) in the United States and Canada. METHODS: A closed internet-based, cross-sectional, point-prevalence survey was administered via email to 120 program directors of emergency ultrasound fellowships (EUSF) and 43 physicians from EDs without EUSF from the United States and Canada...
November 29, 2023: American Journal of Emergency Medicine
#36
K Yashaswini, A V Lalitha, Gs Naresh Kanna, Abha Rani Kujur, Raj John A Michael
BACKGROUND: Optimal resuscitation measures and outcome predictors in cases of burns are not studied in pediatric population, though it accounts for one of the leading causes of non-fatal injuries in the pediatric age group. OBJECTIVE: We describe the clinical profile and outcome predictors in children admitted with burns. MATERIALS AND METHODS: This retrospective cohort study included all children between 1 month and 18 years admitted to pediatric intensive care unit (PICU) with burns from January 2015 to December 2020...
December 2023: Indian Journal of Critical Care Medicine
#37
JOURNAL ARTICLE
Beatrix Wulkersdorfer, Felix Bergmann, Lisa Amann, Alexandra Fochtmann-Frana, Valentin Al Jalali, Elizaveta Kurdina, Edith Lackner, Sebastian G Wicha, Christoph Dorn, Bruno Schäfer, Gerald Ihra, Thomas Rath, Christine Radtke, Markus Zeitlinger
BACKGROUND: Pathophysiological changes in severely burned patients alter the pharmacokinetics (PK) of anti-infective agents, potentially leading to subtherapeutic concentrations at the target site. Albumin supplementation, to support fluid resuscitation, may affect pharmacokinetic properties by binding drugs. This study aimed to investigate the PK of piperacillin/tazobactam in burn patients admitted to the ICU before and after albumin substitution as total and unbound concentrations in plasma...
February 1, 2024: Journal of Antimicrobial Chemotherapy
#38
JOURNAL ARTICLE
Shairbanu S Zinna, Ryan W Morgan, Ron W Reeder, Tageldin Ahmed, Michael J Bell, Robert Bishop, Matthew Bochkoris, Candice Burns, Joseph A Carcillo, Todd C Carpenter, Kellimarie K Cooper, J Michael Dean, J Wesley Diddle, Myke Federman, Richard Fernandez, Ericka L Fink, Deborah Franzon, Aisha H Frazier, Stuart H Friess, Kathryn Graham, Mark Hall, Monica L Harding, David A Hehir, Christopher M Horvat, Leanna L Huard, William P Landis, Tensing Maa, Arushi Manga, Patrick S McQuillen, Kathleen L Meert, Peter M Mourani, Vinay M Nadkarni, Maryam Y Naim, Daniel Notterman, Murray M Pollack, Anil Sapru, Carleen Schneiter, Matthew P Sharron, Neeraj Srivastava, Bradley Tilford, Shirley Viteri, David Wessel, Heather A Wolfe, Andrew R Yates, Athena F Zuppa, Robert A Berg, Robert M Sutton
AIM: Pediatric cardiopulmonary resuscitation (CPR) guidelines recommend starting CPR for heart rates (HRs) less than 60 beats per minute (bpm) with poor perfusion. Objectives were to (1) compare HRs and arterial blood pressures (BPs) prior to CPR among patients with clinician-reported bradycardia with poor perfusion ("BRADY") vs. pulseless electrical activity (PEA); and (2) determine if hemodynamics prior to CPR are associated with outcomes. METHODS AND RESULTS: Prospective observational cohort study performed as a secondary analysis of the ICU-RESUScitation trial (NCT028374497)...
December 3, 2023: Resuscitation
#39
JOURNAL ARTICLE
Robert Cartotto, Laura S Johnson, Alisa Savetamal, David Greenhalgh, John C Kubasiak, Tam N Pham, Julie A Rizzo, Soman Sen, Emilia Main
This Clinical Practice Guideline (CPG) addresses the topic of acute fluid resuscitation during the first 48 hours following a burn injury for adults with burns ≥20% of the total body surface area (%TBSA). The listed authors formed an investigation panel and developed clinically relevant PICO (Population, Intervention, Comparator, Outcome) questions. A systematic literature search returned 5978 titles related to this topic and after 3 levels of screening, 24 studies met criteria to address the PICO questions and were critically reviewed...
December 5, 2023: Journal of Burn Care & Research: Official Publication of the American Burn Association
#40
JOURNAL ARTICLE
Jasmine Peters, Paul Won, Julie Herrera, T Justin Gillenwater, Haig A Yenikomshian
BACKGROUND: Patients with large burns must be carefully resuscitated to balance adequate tissue perfusion with the risk of end-organ damage. One devastating complication of overresuscitation is abdominal compartment syndrome. Reducing the volume of fluids given during resuscitation may reduce the incidence of abdominal compartment syndrome and improve outcomes. OBJECTIVE: To determine whether decreasing fluid resuscitation volume in a burn center reduced the incidence of abdominal compartment syndrome...
December 1, 2023: Critical Care Nurse
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