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Care of a severe Burn patient

Each burn patient, assessment should be started with primary survey(..).The measurement of burn surface area, by using rule of nine method is vital for initial management in order to estimate fluid requirement. Assessment of unburned skin perfusion, can be a tool for circulation status(..).Patients clothing and jewelleries are to be removed for prevention of circulatory blockage(..).
Investigations such as imaging and blood tests including drug and alcohol level,amylase,carboxy haemoglobin are to be performed for optimum treatment plan.Patients serum pottasisum should be monitored closely and to be corrected if required to prevent cardiac arrhythmia.(?).Burn patients, needs complex interdisciplinary therapeutic approach such as dietitian,speech therapist,physio therapist and OTfor optimum management.
Spinal precuations are to be maintained if they have it ,with burns. Close monitoring for rhabdomyolisis and cardiac damage from electrocution injury . Monitor for compartment syndrome at extremities and abdomen are important(..).
Using parkland and modified Brooke formula for fluid management are recommended(?).Ringer lactate is recommended fluid for burn management.The main management is to prevent multiorgan dysfuction.Tetanus vaccine is recommended as prophylaxis.
Inserting urinary indwelling catheter for accurate urine measurement for fluid management and kidney function assessment.Nasogastic tube insertion is important for meeting nutritional needs,administering medication.
Antiemetic ,antidepressants,anxiolytic to be considered for burn treatments.Photograph of burn should be considered prior dressing the wound.acticoat soaked with water normally using for dressing.Management of emotional distress and pain coping strategies are to be considered.Family support as holistic approach.
Antihistamine for pruritis.Blood sugar monitoring and tight control the same are promoting wound healing.Serum albumin level monitoring and replacement is important in management.
Wound swab must be obtained before changing dressing.passive movement,early physiotherapy and splinting and positions to be considered to prevent contracture.
References
Rowley-Conwy G,2013,Management of burn in Intensive and acute care,Nursing Standard ,vol:27945),PP:63-68
Kevin R et al,2011,Update on the Critical Care Management of Severe Burns,Journal of Intensive care Medicine,Vol:26(4),pp:223-236.

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