Lancet
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Most burn casualties will receive their primary care in an emergency department. These departments are staffed by doctors with a varying degree of supervision, and their experience of the treatment of burns is often very modest. Evidently there is a need for a simple method to calculate the fluid requirements of these patients. ⋯ It is expected that the patient will have received expert aid by the end of this time. Values for children have been predetermined using body surface area nomograms. The calculator will assist the non-specialist to determine the correct amount of fluid needed to resuscitate a burned patient, and perhaps decrease morbidity and mortality associated with this injury.
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There is disagreement on the usefulness of comprehensive geriatric assessment (CGA) due to conflicting results from individual trials. We did a meta-analysis on 28 controlled trials comprising 4959 subjects allocated to one of five CGA types and 4912 controls. Published data were supplemented with reanalysed data provided by the original investigators. ⋯ Combined odds ratio (95% confidence interval) of living at home at follow-up was 1.68 (1.17-2.41) for geriatric evaluation and management units, 1.49 (1.12-1.98) for hospital-home assessment services, and 1.20 (1.05-1.37) for home assessment services. Covariate analysis showed that programmes with control over medical recommendations and extended ambulatory follow-up were more likely to be effective. Our analysis suggests that CGA programmes linking geriatric evaluation with strong long-term management are effective for improving survival and function in older persons.