Burn Injury Treatment-Resuscitation, acute care, and rehab Flashcards
What are the 3 phases?
- Resuscitation Phase
- Acute Care
- Rehab
Resuscitation
What are the top 2 things that happen here?
Aggressive fluid replacement
Manage pain
Resuscitation-Aggressive fluid replacement
How is the body in the first 24-36 hours?
Body can’t absorb nutrients yet due to leaky capillaries
Resuscitation-Fluid replacement
What is the tx here (4)?
- Give LR or crystalloids (saline)
- Have large bore IV away from burn area (central line preferred)
- UOP needs to be 0.5-1 mg/kg/hr
- SBP needs to be over 90
Resuscitation-Fluid replacement
What fluid is given after 36 hr?
Add in colloids like albumin, plasma, and hespan
Resuscitation-Manage pain
What drug?
IV narcotics
Resuscitation-Manage pain
T/F: Giving IM and SQ injections are absorbed quick
No–Dont give IM or SQ due to fluid shifts
Resuscitation-Manage pain
Cant give IM or SQ injections except for what?
May need the tetanus vaccine; only exception to the injection rule
Resuscitation-Manage pain
Why can’t we give PO meds?
Due to delayed gastric motility
Acute care
What are the top 3 priorities here?
- Prevent infection
- Nutrition after a burn
- Pain
Acute care-Prevent infection
How do we prevent?
Monitor signs of infection
Prevent:
- Strict hand washing
- Protective isolation
- Gown, glove, mask
- Protect wound from infection
- Topical antimicrobial
- Wound care
- Good nutrition is key to lowering infection rates
Acute care-Nutrition after a burn
What is BMR like?
Increased 40-100%
Acute care-Nutrition after a burn
What is the preferred route of feeding?
Oral/enteral
- several small meals per day
- TPN if slow GI motility
Acute care-Nutrition after a burn
How much protein needed?
2-4x normal amount
Acute care-Nutrition after a burn
How many calories needed a day?
8000 kcal/d
