RT Book, Section
A1 Levi, Benjamin
A1 Vercruysse, Gary A.
A2 Feliciano, David V.
A2 Mattox, Kenneth L.
A2 Moore, Ernest E.
SR Print(0)
ID 1175135639
T1 Burns and Radiation
T2 Trauma, 9e
YR 2020
FD 2020
PB McGraw Hill
PP New York, NY
SN 9781260143348
LK accesssurgery.mhmedical.com/content.aspx?aid=1175135639
RD 2023/03/29
AB KEY  POINTSEarly  resuscitation  after  burn  injury  is  key  to  mitigate  shock.  Follow  the  Parkland  formula  for  resuscitation  in  burns  greater  than  20%  total  body  surface  area  (TBSA).Use  lactated  Ringer’s  solution,  not  normal  saline,  as  a  resuscitation  fluid  to  avoid  hyperchloremic  metabolic  acidosis.Do  not  administer  bolus  intravenous  fluids  during  initial  burn  resuscitation.  This  can  lead  to  abdominal  compartment  and  secondary  extremity  compartment  syndromes.Consider  early  use  of  colloid  (packed  red  blood  cells,  fresh  frozen  plasma,  or  albumin)  in  patients  with  low  urine  output  despite  adequate  fluid  resuscitation.Communicate  with  local  burn  center  before  performing  escharotomy.Intubate  prior  to  transfer  in  patients  with  extensive  head,  neck,  or  facial  burns;  elevated  carbon  monoxide  levels  (>30%),  large  burns  (>40%  TBSA),  obtundation,  or  symptoms  of  early  airway  obstruction.In  austere  conditions,  resuscitate  orally  when  possible,  graft  only  full-thickness  burns  and  in  small  aliquots,  and  minimize  ventilator  use.