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

AIRWAY MANAGEMENT

Goals and Objectives Goals Resident will be comfortable with basic airway evaluation and common interventions Resident will be comfortable managing patients requiring rapid sequence intubation Learning Objectives Resident will be able to define rapid sequence intubation Resident will be able to list and explain indications for rapid sequence intubation Resident will be able to list and describe airway management equipment necessary for rapid sequence intubation Suction Oxygen delivery (including BVM) Airways (adjunct and definitive) Laryngoscopes (direct and video) Monitoring equipment (including EtCO2) Resident will be able to list and describe the steps of rapid sequence intubation Planning Preparation (equipment, drugs, staff) Pre-oxygenation Positioning Pretreatment Paralysis (with sedation) Placement Proof of placement Post-intubation Management Resident will be able to list and describe the medications used for rapid sequence intubation Sedatives Paralytics Adjuncts Resident will be able to recognize and describe basic airway anatomy Resident will be able to describe the basic steps of direct and video laryngoscopy Resident will be able to list and describe common scenarios that complicate rapid sequence intubation Trauma (including c-spine precautions, elevated ICP) Hypotension Hypoxia Hypercarbia Metabolic acidosis

Recommended Resources Prior to Conference RSI Preparation Vanderbilt Checklist Part One Vanderbilt Checklist Part Two Airway Anatomy Airway Anatomy Images (AirwayCam) RSI Medications  RSI Medications (J Emerg Nurs 2003) Additional Resources RSI Overview Intro to RSI LITFL on RSI LITFL “Own the Airway” ALIEM on RSI RSI and Laryngoscopy (MDAware) Advanced Airway Management Overview (EM Updates) Long RSI Discussion (EM:RAP 2005) RSI Set-up EMCrit Airway Checklist Additional Airway Checklists (EMCrit) Preoxygenation and Prevention of Desaturation During Emergency Airway Management (Annals of EM) (pdf) Preoxygenation (EMCrit) Laryngoscopy Airway Anatomy Images (AirwayCam) Laryngoscopy Technique (EMCrit) RSI Drugs RSI Medications (J Emerg Nurs 2003) RSI Medications (EM:RAP 2007) RSI Drugs (EM-in-5) Airway Devices Airway Devices: Direct Airway Devices: Video Post-Intubation Management Post-Intubation Package (EMCrit) Post-Intubation Sedation (EMCrit) Misc RSI Topics Pediatric RSI (Annals) (pdf) RSI in Hypotension (EMCrit) RSI in Severe Acidosis (EMCrit) Walls on RSI in Head Trauma (EM:RAP 2003) Braude on “RSI” with Bagging (EM:RAP 2010) RSI with Al Sacchetti When RSI isn’t the right SI (EM Updates) Apps The Difficult Airway App PediSTAT Textbooks Rapid Sequence Intubation and Rapid Sequence Airway by Darren Braude Manual of Emergency Airway Management by Ron Walls Airway Cam Textbook by Richard Levitan

Original Post by Eric Shappell on 7/20/2014
Reviewed by James Ahn on 7/25/2014
Last Updated by Eric Shappell on 02/18/2016 Contact / Feedback