The Journal of burn care & rehabilitation
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J Burn Care Rehabil · May 1990
Post-traumatic stress disorder in hospitalized patients with burn injuries.
The degree to which patients hospitalized for a major burn displayed symptoms of post-traumatic stress disorder or met the full criteria for this disorder was assessed during the course of hospitalization. Fifty-four consecutive patients were screened weekly for symptoms of post-traumatic stress disorder. ⋯ Post-traumatic stress disorder was found to be related to patients' total body surface area burn, length of hospital stay, sex (female patients), and lack of responsibility for the injury. The results suggest that although post-traumatic stress disorder in patients with burn injuries generally resolves without interventions other than standard hospital care, it might be preventable if patients who are at risk for developing it receive appropriate psychologic treatment soon after the injury.
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A patient acuity classification is required by the Joint Commission on Accreditation of Healthcare Organizations, and this is vital in providing safe, cost-effective nursing care. The Workload Management System for Nurses (WMSN), which is based on direct and indirect nursing care research, prospectively classifies patients on the basis of direct care requirements and then establishes staffing levels on the basis of both direct care and indirect care workloads. Application of the Department of Defense WMSN to the military burn research center is feasible and has provided data for objective staffing adjustments and validated staffing requirements. In addition, several other quality assurance implications have been realized as a result of implementation of the system.
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J Burn Care Rehabil · May 1990
Case ReportsBiobrane wound dressing used in the treatment of toxic epidermal necrolysis: a case report.
Toxic epidermal necrolysis results in skin sloughing that resembles a partial-thickness thermal injury. If the exposed dermis can be protected from infection and desiccation, regeneration can occur from the skin appendages. ⋯ We report a case of a 12-year-old boy with toxic epidermal necrolysis, whose skin lesions were dressed with Biobrane temporary wound dressing. The Biobrane dressings prevented infection, decreased wound pain, and allowed uncomplicated healing in this patient.
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J Burn Care Rehabil · Mar 1990
Practice Guideline GuidelineHospital and prehospital resources for optimal care of patients with burn injury: guidelines for development and operation of burn centers. American Burn Association.
Each year in the United States burn injuries result in more than 500,000 hospital emergency department visits and approximately 70,000 acute inpatient admissions. Most burn injuries are relatively minor, and patients are discharged following outpatient treatment at the medical facility where they are first seen. Of those patients with injuries serious enough to require hospitalization, about 20,000 are admitted directly or by referral to hospitals with special capabilities in the treatment of burn injury. Hospitals with these service capabilities are normally termed "burn centers." This document defines the system, organizational structure, personnel, program, and physical facilities involved in establishing the eligibility of hospitals with the capability of being identified as burn centers.
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Pulse oximetry is a noninvasive method of measuring arterial oxygen saturation. The value of oximetry in patients with burn injuries has been questioned because of a theoretic inaccuracy in the presence of carboxyhemoglobin. We studied pulse oximetry in 27 intubated patients with burn injuries to determine the accuracy of the method and then to determine whether oximetry could replace indwelling catheters presently used for arterial blood gas analysis. ⋯ The pulse oximeter predicted "adequate" ventilation in 78% of patients with a readout of 99% or above. The arterial PO2 was greater than or equal to 90 torr in 90% of patients with oximetric readouts greater than or equal to 98% and in 10% of patients with readouts less than 95%. Pulse oximetry is an accurate adjunct in the management of patients with burn injuries and in addition provides continuous real-time data not available with arterial blood gas sampling.