MANAGEMENT (CONT)
General Principles
Because intravascularfluid loss beginstooccur immediately
after burn injury.
Peripheralvenous cannulation is preferred overcentral venous
access through noninjured sites is not available.
Patients withgreater than 20% total body surfaceareainjury
(15% inchildren) require intravenous fluidresuscitationand
should have a catheter placed in the urinary bladder.
* The treatment of the burnt area overlaps the above
measures. At any time, as soon as the condition of the
patient improves, local treatment is undertaken.
* Calculation for the record of 24 hours. 0.3-0.5 ml per kg
per% burnt area of celloid or plasma equivalent 5% dextrose
to maintain 30-50 (1 hr.) urine output.
* Invasive monitoring is for those where the response to
resusitive fluids is not adequate. SWAN-Ganz catheter will
reveal the need for improving myocardial function by the
use of dobutamine and other ionotrpic drugs.
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