Evolving Changes in the Management of Burns and Environmental Injuries
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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As in trauma, a formatted initial evaluation of burn patients will minimize missed opportunities for optimal care. Fluid resuscitation of burns continues to evolve. Colloid and hourly adjustment play an increasingly important role. Critical care of the burn patient has several unique components, particularly pain and anxiety control, environmental control, inhalation injury management, transeschar fluid and electrolyte losses, and nutritional support issues. Burn care can be divided into four phases initial evaluation and resuscitation, initial wound care, definitive wound closure, and rehabilitation and reconstruction. Rehabilitation should begin coincident with initial care. Injuries due to heat and cold have both systemic and local priorities. Freeze-thaw-refreeze should be avoided in frostbite patients. In rare patients with frostbite, there may be a role for thrombolytics.
- Medicine and Medical Research