The Burn Wheel: a practical guide to fluid resuscitation

Area of Science:

• Emergency Medicine
• Trauma Surgery
• Fluid Resuscitation

Background:

• Mass casualty incidents involving burn victims pose significant challenges for fluid replacement management.
• The Gulf War (1990-91) highlighted the need for rapid, standardized protocols for treating large numbers of burn casualties.
• Existing methods for calculating fluid resuscitation in burns can be complex and time-consuming, especially for non-specialists.

Purpose of the Study:

• To describe the development and refinement of a tool for rapid fluid replacement calculation in burn victims.
• To adapt a military-derived burn management aid for civilian emergency settings.
• To provide a method for non-specialists to prescribe fluid regimens without complex calculations.

Main Methods:

• Development of the 'Battlefield Burns Table' during preparation for the Gulf War.
• Standardization of patient weights and the exclusive use of Hartmann's Solution BP.
• Refinement of the table into a revolving disc format for user-friendly application.

Main Results:

• The 'Battlefield Burns Table' allows for quick estimation of fluid replacement needs.
• The standardized approach simplifies fluid prescription for non-specialist medical personnel.
• The revolving disc design enhances usability in time-sensitive situations.

Conclusions:

• The refined 'Battlefield Burns Table' offers a practical solution for immediate fluid management in burn casualties.
• This tool is particularly valuable in civilian settings where immediate access to burn specialists may be limited.
• Standardized protocols and simplified tools are crucial for effective mass casualty burn care.