Burns : journal of the International Society for Burn Injuries
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Observational Study
Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor.
Lactate levels to guide resuscitation in critically burned patients are controversial. The purpose of our study was to determine whether absolute lactate values or lower lactate clearance predict mortality, and whether these are useful tools in the resuscitation phase. ⋯ Initial elevated lactate levels are a factor of poor prognosis and the cut-off point that best predicts mortality should be adjusted in the patients with TBSA burned < 20%. The global clearance of lactate in the first 24 h, unlike what occurs in other injuries, does not correlate with mortality. Monitoring lactate can ensure adequate peripheral perfusion during resuscitation with lower than normal fluid preload values.
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Telemedicine technologies have a valuable potential when it comes to improving the accuracy of triage protocols in selecting severely injured patients who may benefit from transportation. The main objective of this study was to evaluate the correlation of the urgent diagnosis made by telemedicine through an App with traditional face-to-face urgent care and the final diagnosis, made by scheduled consultation. ⋯ The telemedicine system for planning referrals is a useful tool that may make significant differences in the management of burned patients although further research needs to be taken in that direction.
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Randomized Controlled Trial
The effect of foot reflexology massage on burn-specific pain anxiety and sleep quality and quantity of patients hospitalized in the burn intensive care unit (ICU).
Burn-specific pain anxiety and sleep disorders are common factors in burned patients that affect wound healing process, as well as the severity of burn pain. This study aimed to investigate the effect of foot reflexology massage on burn-specific pain anxiety and sleep condition of patients hospitalized in the burn ICU. ⋯ Based on the results, foot reflexology massage can effectively reduce pain anxiety levels and improve sleep quality and quantity of patients with burn injuries; therefore, this non- pharmacological therapeutic method is recommended to be used in the burn ICUs. (Clinical trial's registration code: IRCT20110906007494N27).
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Previous reports suggest that many factors impact recovery from burn injury. To improve our understanding of these factors, we queried adult burn survivors using a mixed method design during the first year after injury. ⋯ Several themes from responses provided insight into challenges as well as key support systems during the first year of recovery after injury. Collectively, these findings can be used to direct clinical outpatient care, patient education and psychosocial support services.