The Journal of burn care & rehabilitation
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Burn-related pain is often severe and intermittently excruciating for months after the initial injury as the result of the multiple procedures these patients must undergo. Procedure-related pain is often undertreated, especially in children. Pain management should be integrated into the patient's overall care plan. ⋯ General anesthesia should be considered, especially in children, when patients are to undergo extremely painful procedures. Patients need not experience severe pain after burn injury. Pain management, especially during very painful procedures, should be an integrated part of patients care and high-quality pain management to improve patient outcome.
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J Burn Care Rehabil · May 1995
Comparative StudyComparative analysis of bedside and operating room tracheostomies in critically ill patients with burns.
The objective of this study was to demonstrate that bedside burn intensive care unit tracheostomy is a safe and cost-effective procedure and has advantages over operating room tracheostomy. The charts of all patients who underwent tracheostomies in the burn unit between January 1990 and September 1993 were reviewed retrospectively. All tracheostomies were performed by residents in their second to fourth postgraduate years. ⋯ No statistical difference existed in age, sex, mean total body surface area percent burned, mean inspired oxygen, mean positive end expiratory pressure, mean pretracheostomy intubated days, presence of inhalation injury, or complication rate between groups. The average combined cost for operating room and anesthesia was $1740 per tracheostomy performed in the operating room. No charge was given to the patient for a bedside tracheostomy apart from the surgeon's fee and tracheostomy tube.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Burn Care Rehabil · May 1995
Pediatric considerations in the use of Biobrane in burn wound management.
Biobrane offers a number of advantages as a wound dressing for children. It does not require the use of surgical instruments, noisy distractions, painful manipulation of the wound, or regimented daily dressing changes. Biobrane does offer the pediatric patient with burns immediate comfort and protection and enhances patient compliance and parental satisfaction.
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J Burn Care Rehabil · May 1995
The risk of pneumonia in thermally injured patients requiring ventilatory support.
The risk of pulmonary infectious complications in critically ill patients requiring ventilatory support is well established. To evaluate the impact of tracheal intubation on the risk of pneumonia, the records of three hundred seventy thermally injured patients (mean age, 37.6 years, mean total body surface area burn, 44.7%) who were admitted during a 6-year interval and required ventilatory support were reviewed. ⋯ Actuarial life table analysis considering only pneumonia acquired during ventilatory support was used to evaluate the relation between the risk of pneumonia and duration of ventilatory support. In this cohort of patients with burns, no difference in the risk of pneumonia was observed between patients with and without inhalation injury who required ventilatory support; the hazard of pneumonia was relatively constant during the first 6 weeks of intubation and was similar for all who underwent ventilation.