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Book contents
- Frontmatter
- Contents
- Foreword
- Foreword
- Preface
- Acknowledgments
- Contributors
- 1 Mechanisms and Demographics in Trauma
- 2 Trauma Airway Management
- 3 Shock Management
- 4 Establishing Vascular Access in the Trauma Patient
- 5 Monitoring the Trauma Patient
- 6 Fluid and Blood Therapy in Trauma
- 7 Massive Transfusion Protocols in Trauma Care
- 8 Blood Loss: Does It Change My Intravenous Anesthetic?
- 9 Pharmacology of Neuromuscular Blocking Agents and Their Reversal in Trauma Patients
- 10 Anesthesia Considerations for Abdominal Trauma
- 11 Head Trauma – Anesthesia Considerations and Management
- 12 Intensive Care Unit Management of Pediatric Brain Injury
- 13 Surgical Considerations for Spinal Cord Trauma
- 14 Anesthesia for Spinal Cord Trauma
- 15 Musculoskeletal Trauma
- 16 Anesthetic Considerations for Orthopedic Trauma
- 17 Cardiac and Great Vessel Trauma
- 18 Anesthesia Considerations for Cardiothoracic Trauma
- 19 Intraoperative One-Lung Ventilation for Trauma Anesthesia
- 20 Burn Injuries (Critical Care in Severe Burn Injury)
- 21 Anesthesia for Burns
- 22 Field Anesthesia and Military Injury
- 23 Eye Trauma and Anesthesia
- 24 Pediatric Trauma and Anesthesia
- 25 Trauma in the Elderly
- 26 Trauma in Pregnancy
- 27 Oral and Maxillofacial Trauma
- 28 Damage Control in Severe Trauma
- 29 Hypothermia in Trauma
- 30 ITACCS Management of Mechanical Ventilation in Critically Injured Patients
- 31 Trauma and Regional Anesthesia
- 32 Ultrasound Procedures in Trauma
- 33 Use of Echocardiography and Ultrasound in Trauma
- 34 Pharmacologic Management of Acute Pain in Trauma
- 35 Posttrauma Chronic Pain
- 36 Trauma Systems, Triage, and Transfer
- 37 Teams, Team Training, and the Role of Simulation in Trauma Training and Management
- Index
- Plate section
- References
20 - Burn Injuries (Critical Care in Severe Burn Injury)
Published online by Cambridge University Press: 18 January 2010
Edited by
Book contents
- Frontmatter
- Contents
- Foreword
- Foreword
- Preface
- Acknowledgments
- Contributors
- 1 Mechanisms and Demographics in Trauma
- 2 Trauma Airway Management
- 3 Shock Management
- 4 Establishing Vascular Access in the Trauma Patient
- 5 Monitoring the Trauma Patient
- 6 Fluid and Blood Therapy in Trauma
- 7 Massive Transfusion Protocols in Trauma Care
- 8 Blood Loss: Does It Change My Intravenous Anesthetic?
- 9 Pharmacology of Neuromuscular Blocking Agents and Their Reversal in Trauma Patients
- 10 Anesthesia Considerations for Abdominal Trauma
- 11 Head Trauma – Anesthesia Considerations and Management
- 12 Intensive Care Unit Management of Pediatric Brain Injury
- 13 Surgical Considerations for Spinal Cord Trauma
- 14 Anesthesia for Spinal Cord Trauma
- 15 Musculoskeletal Trauma
- 16 Anesthetic Considerations for Orthopedic Trauma
- 17 Cardiac and Great Vessel Trauma
- 18 Anesthesia Considerations for Cardiothoracic Trauma
- 19 Intraoperative One-Lung Ventilation for Trauma Anesthesia
- 20 Burn Injuries (Critical Care in Severe Burn Injury)
- 21 Anesthesia for Burns
- 22 Field Anesthesia and Military Injury
- 23 Eye Trauma and Anesthesia
- 24 Pediatric Trauma and Anesthesia
- 25 Trauma in the Elderly
- 26 Trauma in Pregnancy
- 27 Oral and Maxillofacial Trauma
- 28 Damage Control in Severe Trauma
- 29 Hypothermia in Trauma
- 30 ITACCS Management of Mechanical Ventilation in Critically Injured Patients
- 31 Trauma and Regional Anesthesia
- 32 Ultrasound Procedures in Trauma
- 33 Use of Echocardiography and Ultrasound in Trauma
- 34 Pharmacologic Management of Acute Pain in Trauma
- 35 Posttrauma Chronic Pain
- 36 Trauma Systems, Triage, and Transfer
- 37 Teams, Team Training, and the Role of Simulation in Trauma Training and Management
- Index
- Plate section
- References
Summary
Objectives
Describe the classification system of burn depth.
Outline the initial assessment of the severely burned patient.
Determine burn size using the Lund–Browder Diagram.
Assess the airway and the need for intubation.
Determine the fluid requirements for burn resuscitation.
Determine the requirement for escharotomy.
Describe the potential benefits and complications of early burn excision and grafting.
Modern advances in surgery, anesthesia, and critical care have had a significant impact on the treatment of severe burn injuries [1, 2]. Cohorting burn victims in specialized care burn facilities resulted in clinical research studies that led to reductions in hypovolemic shock, respiratory and renal failure, sepsis, and malnutrition. As a result, the burn size that confers a 50 percent probability of death in patients aged 15–45 years has increased from 50 percent total body surface area (TBSA) in 1950 to 80 percent TBSA in 2000 (Table 20.1). Morbidity and mortality following a major burn injury are related to age of the patient, burn size, and the presence of an inhalation injury [3–5]. The greater the burn size the greater the fluid and heat loss to the environment, both of which contribute to organ hypoperfusion and shock. The inflammatory mediator response also increases with burn size as does the degree of immunosuppression. Bacterial colonization increases with the size of the open wound and, in conjunction with the increase in immunosuppression, results in increased risk of life-threatening burn wound infection. Inhalation injury causes pulmonary dysfunction that is exacerbated by the large fluid resuscitation required following major burn injury.
Information
- Type
- Chapter
- Information
- Trauma Anesthesia , pp. 314 - 321Publisher: Cambridge University PressPrint publication year: 2008
References
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