Burn Size Estimation and Fluid Resuscitation In the Emergency Department

ABSTRACT

PURPOSE: Assessment of the burn size in the Accident and Emergency Department is one of the most important aspects in the initial care of a burn victims. The purpose of this study was to examine in the Emergency Department the accuracy of burn size estimates and the adequacy of burn-patient fluid resuscitation in relationship to the Parkland formula. METHODS: A retrospective study was conducted of 52 adult burn patients who visited the Emergency Department of Keimyung University Dongsan Medical Center during 2003 year. A substratification of the data was undertaken to compare total burn surface area as estimated by the Emergency-Department staff with that determined by the Burn-Care-Unit staff. RESULTS: The average length of stay in the Emergency Department was 394.04 minutes (range 150~1055 minutes). The average total body surface area evaluated by the Emergency-Department staff was 33.31% compared with the Burn-Care-Unit staff's average of 29.77%, and the difference was statistically significant (p<0.05). During their stays in the Emergency Department, burn patients were underresuscitated based on the fluid volume calculated by using the Parkland formula. CONCLUSION: Early communication with the Burn-Care-Unit staff in the Emergency Department and better education of Emergency-Department physicians will markedly improve the overall care of burn patients.