Advances in emergency care for burn disorders: Treatment strategies and outcomes
Keywords:
Burn care, prehospital management, fluid resuscitation, burn size estimation, ABLS updates, air transport, overtriageAbstract
Background: Effective management of burn injuries is crucial for optimizing patient outcomes, yet challenges remain in prehospital care and accurate assessment. This article reviews the advancements in emergency burn care, focusing on the prehospital management by Helicopter Emergency Medical Services (HEMS) in Switzerland and the implications for North American practices. Aim: To explore and compare burn care strategies, particularly in prehospital and initial hospital settings, and to evaluate updates in fluid resuscitation protocols and burn size estimation techniques. Methods: The study incorporates a decade-long review of HEMS data from Switzerland and examines North American practices, including referral criteria and transport strategies. Analysis of recent studies on air transport overtriage and updated fluid resuscitation formulas, such as the Parkland and Modified Brooke formulas, is also included. Results: Findings indicate a high degree of consistency in burn size assessment in Switzerland, contrasting with varying results in North America where overtriage and inaccuracies in burn size estimation are prevalent. Fluid resuscitation protocols have been refined to address these issues, with updated ABLS guidelines reflecting advancements in technology and evidence-based practices. Conclusion: Enhanced prehospital care and accurate burn size estimation are critical for effective burn management.
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Maudet L, Pasquier M, Pantet O, Albrecht R, Carron PN. Prehospital management of burns requiring specialized burn Centre evaluation: a single physician-based emergency medical service experience. Scand J Trauma Resusc Emerg Med. 2020;28(1):84 in press. DOI: https://doi.org/10.1186/s13049-020-00771-4
Committee on Trauma American College of Surgeons. Resources for Optimal Care of the Injured Patient 2014. Chicago: American College of Surgeons; 2014.
Roman J, Shank W, Demirjian J, Tang A, Vercruysse GA. Overutilization of helicopter transport in the minimally burned-a healthcare system problem that should be corrected. J Burn Care Res. 2020;41(1):15–22. https://doi.org/10.1093/jbcr/irz143. DOI: https://doi.org/10.1093/jbcr/irz143
Kashefi N, Dissanaike S. Use of air transport for minor burns: is there room for improvement? J Burn Care Res. 2016;37(5):e453–60. https://doi.org/10.1097/BCR.0000000000000276. DOI: https://doi.org/10.1097/BCR.0000000000000276
Warner P, Bailey JK, Bowers L, Hermann R, James LE, McCall JE. Aeromedical pediatric burn transportation: a six-year review. J Burn Care Res. 2016;37(2):e181–7. https://doi.org/10.1097/BCR.0000000000000198. DOI: https://doi.org/10.1097/BCR.0000000000000198
Chattopadhyay A, Sheckter CC, Long C, Karanas Y. Overuse of air ambulance Services at a Regional Burn Center. J Burn Care Res. 2018;39(4):598–603. https://doi.org/10.1093/jbcr/irx028. DOI: https://doi.org/10.1093/jbcr/irx028
Pham C, Collier Z, Gillenwater J. Changing the way we think about burn size estimation. J Burn Care Res. 2019;40(1):1–11. https://doi.org/10.1093/jbcr/iry050. DOI: https://doi.org/10.1093/jbcr/iry050
Martin NA, Lundy JB, Rickard RF. Lack of precision of burn surface area calculation by UK armed forces medical personnel. Burns. 2014;40(2):246–50. https://doi.org/10.1016/j.burns.2013.05.009. DOI: https://doi.org/10.1016/j.burns.2013.05.009
Welling L, van Harten SM, Henny CP, et al. Reliability of the primary triage process after the Volendam fire disaster. J Emerg Med. 2008;35(2):181–7. https://doi.org/10.1016/j.jemermed.2007.06.009. DOI: https://doi.org/10.1016/j.jemermed.2007.06.009
Tocco-Tussardi I, Presman B, Huss F. Want correct percentage of TBSA burned? Let a layman do the assessment. J Burn Care Res. 2018;39(2):295–301. https://doi.org/10.1097/BCR.0000000000000613. DOI: https://doi.org/10.1097/BCR.0000000000000613
Shock and fluid resuscitation. In: Advanced Burn Life Support Course, Provider Manual. Chicago: American Burn Association; 2018. p. 31–8..
Navar PD, Saffle JR, Warden GD. Effect of inhalation injury on fluid resuscitation requirements after thermal injury. Am J Surg. 1985;150(6):716–20. https://doi.org/10.1016/0002-9610(85)90415-5. DOI: https://doi.org/10.1016/0002-9610(85)90415-5
Harshman J, Roy M, Cartotto R. Emergency Care of the Burn Patient before the burn center: a systematic review and meta-analysis. J Burn Care Res. 2019;40(2):166–88. https://doi.org/10.1093/jbcr/iry060. DOI: https://doi.org/10.1093/jbcr/iry060
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