Management of burn?
A 58-year-old female patient was activated as a Level 1 trauma alert after being involved in a house explosion with resultant fire. She was awake and alert with no loss of consciousness at the scene but sustained significant thermal injuries. She was intubated pre-hospital for “airway protection” out of concern for inhalation injury with facial burns. Initial evaluation revealed an older woman, orally intubated with bilateral breath sounds, mildly tachycardic in the 100s, moderately hypertensive in the 160s/90s, with readily apparent full-thickness burns to the face, neck, anterior torso, bilateral arms, and bilateral legs. Please recommend some management for burn.
@kuheli Care of the patient with a large body-surface area burn is complex, lengthy, and fraught with potential complications. These complications can be anticipated and minimized in burn centers accustomed to the complexities of major burn care; ultimately yielding improved survival and functional outcomes. The patient in this article, in spite of an anticipated initial mortality approaching 70% on admission, survived to discharge with only a few treatable complications, and is currently home, driving, and otherwise living independently. Her burn scars are being managed with outpatient scar exercises such as moisturization, massage, and compression. This positive outcome is the norm in burn centers, and an excellent example of why patients with major burn injuries should be cared for in these specialized centers. Any patient with a significant burn, even if not delineated on the ABA referral list, warrants discussion with a burn-trained surgical team.