小烧伤也需要注意:评估成人15%的烧伤复苏门
Ashleigh Bull1,2, Mala Sharma1,2, Alexander Kurjatko1,2
1Department of Surgery, University of Iowa, Iowa Health Care, Iowa City, IA 52246, USA.
概括
15-19.9%的TBSA之间的烧伤的液体复苏可能会使患者受益,因为一半的患者接受了超过维护液体. 需要进一步的研究,以优化烧伤复苏协议,用于较小的烧伤伤害.
科学领域:
- 烧伤复苏的协议.
- 创伤和重症监护医学 创伤和重症监护医学
- 烧伤患者的液体管理
背景情况:
- 美国烧伤生命支持课程建议对TBSA≥20%进行液体复苏.
- 我们的中心对烧伤>15%的TBSA进行协议化液体复苏.
- 描述这种患者群体对于完善治疗指南至关重要.
研究的目的:
- 为了描述15%至19%的烧伤患者接受协议化液体复苏的TBSA.
- 分析这一队列中液体复苏体积和患者结果.
- 评估当前对较小烧伤的复苏实践的必要性和有效性.
主要方法:
- 在2019年1月1日至2023年3月31日期间入院的15%至19%的TBSA烧伤患者的回顾性评估.
- 基于帕克兰公式 (PF) 和尿液输出 (UOP) 范围的液体复苏的分类.
- 人口统计数据,住院过程,接收的液体和复发症之间的复苏组之间的比较.
主要成果:
- 分析了33名患者;大多数是男性 (81.8%),TBSA的中位数为17%,年龄为57岁.
- 随着布鲁克,PF或其他配方的流体复苏,15名患者处于PF范围,15名患者处于PF范围以下,3名患者处于PF范围以上.
- 两组之间没有观察到人口统计学,烧伤变量或并发症的显著差异;50%接受了>维持液体.
结论:
- 患有较小烧伤的患者 (15% - 19.9% TBSA) 可能受益于液体复苏,其中一半接受超过维护液体.
- 目前的复苏策略似乎是安全的,在治疗后24小时内,肌素和乳酸盐水平正常.
- 需要进一步调查,以确定较小烧伤患者的最佳液体复苏策略.
相关概念视频
01:21Cardiopulmonary Resuscitation I: Adult
586
Cardiopulmonary resuscitation, or CPR, is a life-saving emergency procedure performed when a person's heart has stopped beating or they are no longer breathing. The foundation of CPR is Basic Life Support (BLS), which focuses on the early recognition of cardiac arrest, the immediate start of high-quality chest compressions, and the timely use of an automated external defibrillator (AED).Assessing Responsiveness and Checking the Carotid PulseWhen approaching an unresponsive person, first ensure...
586
01:22Burn Injuries
4.2K
Burn injuries occur when the skin and underlying tissues are damaged due to exposure to heat, electricity, chemicals, radiation, or friction. They can vary in severity, from minor superficial burns to severe deep burns that can be life-threatening.
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
4.2K
01:20Assessment of Ventilation I: Respiratory Rate
1.9K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.9K
01:23Assessment of Respiration
1.8K
The respiratory system's basic structures and primary functions lay the foundation for nurses' comprehensive respiratory assessments. This assessment includes subjective and objective data to gauge the patient's respiratory health.
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
Subjective Assessment: Nurses interview the patient to gather information directly during the subjective assessment. It includes questions about the individual's medical history, medications, and symptoms, focusing on past respiratory conditions like...
1.8K
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
535
Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
535
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
665
Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
665