EM Fundamentals

BURNS AND INHALATION INJURY

Goals and Objectives Goals Resident will be comfortable with initial evaluation and basic management of patients with burns Learning Objectives Resident will be able to list and describe the different categories of burns Thermal Chemical Electrical Resident will be able to estimate the percent of body surface area (%BSA) of burn Resident will be able to describe the depths of burns Resident will be apply the modified Parkland formula to the appropriate patient population Resident will be familiar with the concept of “fluid creep” Resident will be able to recognize common indications for intubation in burn victims Shortness of breath Facial/mucosal burns/edema Singed facial/nasal hair Stridor / Wheezing (late findings) Resident will be familiar with severe complications of thermal burns and the appropriate treatment Airway edema --> Early definitive airway (as indicated) Carbon Monoxide --> Oxygen (+/- hyperbaric) Compartment syndrome --> Fasciotomy Dehydration/AKI --> IVF (Parkland Formula) Infection --> Antibiotics Rhabdomyolysis --> IVF Resident will be able to list initial and specific treatments for chemical burns Resident will be to list criteria and injury pattern associated with high-voltage electrical burns Resident will be to list the indications for referral to a burn center (from ABA Referral Criteria)

Recommended Resources Prior to Conference Burns 101: Initial Management (UW Surgery) Burns 101: Assessment (UW Surgery) Additional Resources Overview Burns in the ICU (MD CC Project) Major Burns (LITFL) Minor Burns (LITFL) Approach to Burns (CDEM) Burn Calculators/Tools Parkland Formula Calculator (MDCalc) Burn Assessment (Victoria Burn Guide) Burn PV Card (ALiEM) “Rule of 10s” (ALiEM) Burn Referral Card (ABA) Complications/Associated Injuries Inhalation Injury (EM in 5) Toxicology of Smoke Inhalation (EMCrit) Compartment syndrome review (HSSJ 2014) (pdf) Escharotomy How-to (LITFL) “Fluid Creep” (J Burn Care Res)  Textbooks Total Burn Care (Herndon)

Original Post by Eric Shappell on 7/23/2014
Reviewed by James Ahn on 7/26/2014
Last Updated by Eric Shappell on 12/09/2014 Contact / Feedback