MANAGEMENT 3
Patients who have sustained a major burns injury should have a
nasogastric tube placed to decompress the dilated stomach.
During transport and resuscitation every effort should be made to
maintain body temperature.
Patients are draped in clean sheets or blankets and in the
initial phase in the emergency care area the room is armed.
Resuscitation fluid should be warmed when fluid are given at
rates of greater than 200ml/h. burn injured extremities should be
elevated above the level of the heart.
Every guideline that has been developed carries with it the
mandate that the patient's response to resuscitation be used as
the actual determinant of fluid administration, not the formula!
The goal of resuscitation is to maintain adequate tissue
perfusion and therefore preserve organ function.
The traditional assessment of adequacy of resuscitation in burn
injury has been based on observation of blood pressure, heart
rate and urine output.
In this approach the patients is "titrated" with fluid to
maintain a normal blood pressure and heart rate and a urine
output of 1 ml/kg per hours or 30 to 60 ml/h in an adult patient.
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