A knowledge-based information system for advice in the crisis management of the patient with burns

A knowledge-based information system that has been designed to be used as an electronic advisor to guide in fluid resuscitation and in the management of the most frequently occurring complications during the first 48 hours after burn injury is described. The system was also developed for training physicians and nurses and may eventually be used for peer review of the management of patients in the burn unit. Ten data screens are used for entry of the administrative data, the clinical background, and the monitored data. The latter include tables for recording fluid therapy and laboratory results. The knowledge base consists of a series of heuristic decision rules that were formulated by a burn care expert and that express the Uppsala fluid resuscitation program to prevent burn shock. The data recorded for a patient are compared with the data in the knowledge base, and the appropriate conclusions are generated. The system's conclusions, the fluid and ventilation prescription, and other required patient management measures are then displayed as a report. The underlying reasoning for each case may be explored by means of the system's explanation facility. The system has been successfully validated by 125 hypothetic cases that represent typical situations of patients with severe burns.