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Treatment before transfer: the patient with burns
H L Ashworth1, T C Cubison, P M Gilbert
1McIndoe Burns Centre, Queen Victoria Hospital, East Grinstead, West Sussex RH19 3DZ, UK.
Emergency Medicine Journal : EMJ
|September 18, 2001
Summary
Initial management of severe burns varied significantly, with common issues in assessing burn size and applying fluid resuscitation formulas. A new proforma aims to standardize pre-burns centre care for better patient outcomes.
Area of Science:
- Trauma Care
- Emergency Medicine
- Burn Management
Background:
- Pre-burns centre management is critical for severe burn patients.
- Inconsistent initial care can lead to suboptimal outcomes.
- Standardization of assessment and resuscitation is needed.
Purpose of the Study:
- To review pre-burns centre management practices.
- To identify challenges in burn assessment and fluid resuscitation.
- To evaluate the effectiveness of initial interventions before transfer to a specialized centre.
Main Methods:
- Retrospective analysis of patient records from a UK Burns Centre.
- Inclusion criteria: adults with >15% body surface area (BSA) burn, children with >10% BSA burn.
- Data collected on burn size assessment, fluid resuscitation, and transfer times.
Main Results:
- 31 patients analyzed (21 adults, 10 children) with an average burn size of 32% BSA.
- Burn size was frequently overestimated (14 patients) or underestimated (13 patients).
- Fluid resuscitation formulas were often misapplied, with only 10 of 18 patients using a formula applying it correctly.
Conclusions:
- Significant variation exists in initial burn management standards.
- Problems identified in burn percentage assessment and resuscitation formula application.
- A new proforma has been implemented to address these inconsistencies and improve care.