The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jan 1997
Resuscitation of thermally injured patients with oxygen transport criteria as goals of therapy.
Resuscitation from shock based on oxygen transport criteria has been widely used in trauma and surgical patients, but has not been examined in thermally injured patients. To study the possible efficacy of this type of resuscitation, the oxygen transport characteristics of burn resuscitation were studied in nine adults, of whom six had inhalation injuries, with a mean burn size of 45% total body surface area and a mean age of 33.4 years, who were resuscitated based on oxygen transport criteria. Pulmonary artery balloon flotation catheters were placed and hemodynamic and oxygen transport parameters (Fick method) were measured hourly for 6 hours. ⋯ VO2I appeared dependent on DO2I at levels of DO2I less than 800 ml/min/m2. In this study, depressed cardiovascular function in patients with burn injuries responded to volume loading and inotropic support much as it does in patients with shock of other etiologies. Whether oxygen transport-based resuscitation is effective in improving survival or the incidence of multiple organ failure is unknown and will need to be evaluated in randomized trials.
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J Burn Care Rehabil · Jan 1997
Emergency room management of minor burn injuries: a quality management evaluation.
The vast majority of acute burns are initially seen and treated in emergency departments (EDs). Most of the individuals caring for these patients have little or no specialized training in the multidisciplinary approach to the burned patient. Burns of limited severity are treated immediately and then followed on an outpatient basis; therefore reviews of documented practices in emergency departments were not found. ⋯ The data demonstrate that there was suboptimal documentation of diagnosis, treatment, and follow-up care of the thermally injured patients who were initially treated in these EDs. Burn team members should develop educational and clinical relationships with EDs in the referral area to optimize both the delivery and documentation of outpatient burn care. This is especially important in today's health care environment, in which reimbursement is based on services rendered.
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J Burn Care Rehabil · Jan 1997
The burn camp experience: variables that influence the enhancement of self-esteem.
Since 1982, there have been summer camps for children and adolescent burn survivors. Although the primary focus of camp is to have "fun," the principal goal is psychosocial readjustment through peer interactions and the resulting enhancement of self-esteem (SE). This study was initiated to test the hypothesis that the burn camp experience enhances the SE of campers. ⋯ The interval between hospital discharge and camp experience was 4 to 144 months (mean 54 months). Thirty-seven percent of the children demonstrated an increase in SE to varying degrees, whereas 30% showed no change, and 3% exhibited a decrease in SE. This study failed to support the working hypothesis.
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J Burn Care Rehabil · Nov 1996
Review Case ReportsLong thoracic nerve injury due to an electric burn.
A 19-year-old white man was burned over 7.5% of his body when he sustained an electric injury from a transformer. There was no associated fall or loss of consciousness. Debridement and grafting were required. ⋯ This has not improved. A surgical procedure suggested to improve function of the shoulder was rejected by the patient. This is only the second case reported of long thoracic nerve injury due to an electric burn of which we are aware.