Emergency management of burns

ABSTRACT

1. Care of severe burns must be based on the correction of the alterations which result from the thermal trauma2. The severely burned patient should be saved from shock by adequate and prompt fluid therapy.3. A suitable formula is a great help to the physician in calculating fluid and electrolyte requirements. Certain safeguards must be observed to avoid overhydration4. The rule of nine is a good guide for determining the extent of area burned5. The burned wound can be satisfactorily treated either by dressing or exposure6. Local therapy should be secondary only to systemic therapy. Gentle cleaning of the wound under IV Demerol and analgesia may be done. Debridement under general anesthesia is contraindicated and may be done only after the patient has passed the state of shock7. ATS and Penicillin should be given prophylactically8. Restlessness in burns is usually not due to pain, but due to dehydration9. Pain should be relieved by Demerol or Morphine given intravenously10. Only deep burns need to be skin-grafted. After shock is controlled, nutrition is maintained and the areas debrided prior to elective skin grafting. (Summary)