Journal of burn care & research : official publication of the American Burn Association
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Comparative Study
Burn resuscitation index: a simple method for calculating fluid resuscitation in the burn patient.
The Parkland formula is the standard for calculating the initial intravenous fluid rate for resuscutation after thermal injury. However, it is cumbersome when used by those with modest burn training. We propose an easier method to calculate fluid requirements that can be initiated by first-line providers. ⋯ The BRI serves as a visual aid and provides some instruction, allowing the user to calculate fluid resuscitation with greater accuracy than with rote memorization of a formula. The BRI might be a useful tool for providers with minimal burn training. However, further investigation is warranted.
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Randomized Controlled Trial
The efficacy of music therapy protocols for decreasing pain, anxiety, and muscle tension levels during burn dressing changes: a prospective randomized crossover trial.
The purpose of this study was to explore the efficacy of two music therapy protocols on pain, anxiety, and muscle tension levels during dressing changes in burn patients. Twenty-nine inpatients participated in this prospective, crossover randomized controlled trial. On two consecutive days, patients were randomized to receive music therapy services either on the first or second day of the study. ⋯ The results showed significant decrease in pain levels before (P < .025), during (P < .05), and after (P < .025) dressing changes on days the patients received music therapy in contrast to control days. Music therapy was also associated with a decrease in anxiety and muscle tension levels during the dressing changes (P < .05) followed by a reduction in muscle tension levels after dressing changes (P < .025). Music therapy significantly decreases the acute procedural pain, anxiety, and muscle tension levels associated with daily burn care.
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High-frequency percussive ventilation (HFPV) has demonstrated a potential role as a rescue option for refractory acute respiratory distress syndrome and as a method for improving inhalation injury outcomes. Nevertheless, there is a lack of literature examining the practical application of HFPV theory toward either improving gas exchange or preventing possible ventilator-induced lung injury. This article will discuss the clinically pertinent aspects of HFPV, inclusive of high- and low-frequency ventilation.
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Return to work after burn injury: burn-injured individuals' perception of barriers and facilitators.
The aim of this study was to explore burn-injured individuals' perception of factors seen as facilitators or barriers in the process of returning to work after a severe burn injury. Semistructured interviews were prospectively conducted with 39 former burn injury patients, admitted to the Uppsala Burn Center between March 2000 and March 2007. The participants were employed or studying at the time of injury and were interviewed on average 4.6 years after the burn. ⋯ Some barriers experienced as delaying RTW were difficulties when ceasing pain medication, limited knowledge of wound care at primary health care facilities, lack of individualized rehabilitation plans, and lack of psychological support during rehabilitation. Former burn injury patients emphasized psychological resources and capabilities as facilitators in the RTW process. The need in rehabilitation for a coordinator and for assessment of work capacity, and not solely a focus on impairments, is discussed.
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Burn injuries are a significant problem with high associated morbidity and mortality. Those associated with inhalational trauma (IHT) may be associated with higher mortality, but studies on prognosis are small and underpowered. This study was designed to identify prognostic factors that increase the risk of death, to quantify this risk, and to identify existing prognostic models. ⋯ Overall, the mortality rate among burn patients in this review was 13.9% (4-28.3%), with the mortality rate among those with IHT being 27.6% (7.8-28.3%). Those studies with multivariate analyses identified increasing %TBSA, presence of IHT, and increasing age as the strongest predictors for mortality in this patient population. It seems that %TBSA, presence of IHT, and age are the best predictors of mortality among the current published literature on burn prognosis.