The Journal of burn care & rehabilitation
-
J Burn Care Rehabil · Sep 2001
Early clinical experience with high-frequency oscillatory ventilation for ARDS in adult burn patients.
Lung protective ventilation strategies are recommended in acute respiratory distress syndrome to avoid ventilator associated lung injury, a recently characterized complication of mechanical ventilation. High-frequency oscillatory ventilation (HFOV) is an unconventional ventilation strategy which may achieve this goal. We reviewed our experience with HFOV in six severely burned patients with acute respiratory distress syndrome. ⋯ Although HFOV had no impact on mortality, it played a useful role in the supportive management of burn patients with severe oxygenation failure unresponsive to conventional ventilation. Importantly, HFOV allowed surgery to proceed in patients who may have otherwise been too unstable to go to the operating room. As far as we are aware, this is the first report of the use of intraoperative HFOV in burn patients.
-
A total of 222 burn nurses from 30 burn centers completed a questionnaire about how and when a burn patient looks at their burn wound for the first time. The registered nurse is most frequently with the patient when the patient sees the wound for the first time (n = 187; 84%). Looking at the wound is not usually a planned event, and it is not documented in the patient record. ⋯ The patient asks the nurse for an opinion about the way the wound looks (n = 181; 81.5%). The nurse uses silence, presence-of-self, and gentle encouragement with the patient while remaining positive and honest. Respondents reported that the patient wants the truth but also needs reassurance and some degree of optimism when viewing the wound for the first time.
-
J Burn Care Rehabil · Jul 2001
Randomized Controlled Trial Clinical TrialBurn wound itch control using H1 and H2 antagonists.
This study investigated the use of a combination of H1 and H2 antagonists and topical medications to control burn wound itch. Graeco-Latin square assignment provided an oral combination of 1) cetirizine and cimetidine or 2) diphenhydramine and placebo in four divided doses. ⋯ A three-way nested repeated measures interaction effect (Wilks' Lambda F = 9.85, df = 9, P <.0005) was observed representing a significantly different pattern on days 1 to 4 of the study compared with the remaining days. Controlling for the effect of topical medications, the cetirizine/cimetidine combination demonstrated a dramatic improvement at 1 and 6 hours, and a moderate improvement at 12 hours after initial medication for the day when compared with the diphenhydramine/placebo combination.
-
J Burn Care Rehabil · Jul 2001
Case ReportsThe use of TENS for pruritus relief in the burns patient: an individual case report.
The case report outlines the use of transcutaneous electrical nerve stimulation (TENS) for the relief of pruritus in a 19-year-old patient who had sustained 70% mixed-thickness flame burns. Once healed, two electrodes were applied to the region of most severe itching, which was the lumbar spine. They were applied at 10 AM and remained in place until he went to bed. ⋯ At this time the patient discontinued the use of TENS, because itching had decreased significantly. Results showed that between day 1 and day 16 there was a 50% improvement before application and a 100% improvement 4 hours after application of TENS. These results suggest that a study to investigate the effect of TENS for the relief of pruritus in the burn patient would be justified to provide an alternative, noninvasive treatment approach.
-
J Burn Care Rehabil · May 2001
An analysis of 550 hospitalized pediatric burn patients in Hong Kong.
A total of 550 acute burn patients under the age of 15 years were admitted to the Burns Unit of Prince of Wales Hospital, Hong Kong between March 1993 and February 1999. There were 337 males and 213 females with a male to female ratio of 1.58:1. The median age was 2.5 years and the median burn size was 5% total body surface area (TBSA). ⋯ The majority of patients (80.2%) had their wounds healed without any operation. Only 19 out of 550 patients (3.5%) had burns of 30% TBSA or larger, and only nine patients (1.9%) had inhalation injuries. Only one patient died in this series, which yielded a mortality rate of 0.2%.