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

APPROACH TO ALTERED MENTAL STATUS

Goals and Objectives Goals Resident will be comfortable with initial evaluation and basic management of patients with altered mental status Learning Objectives Resident will be able to define and describe the differences between delirium, dementia and psychosis Resident will be able to outline steps in the initial assessment to the patient with altered mental status Resident will be able to produce a differential diagnosis for altered mental status Resident will be able to list rapidly reversible causes of altered mental status and appropriate interventions for each diagnosis Hypoglycemia --> Dextrose Hypoxia --> Supplemental O2 Hypercarbia --> Assisted ventilation Opioid intoxication --> Naloxone Alcohol withdrawal --> Benzodiazepines Resident will be able to describe common diagnostic studies used to determine the etiology of altered mental status Resident will be able to describe basic treatments for each disease category included in the differential diagnosis of altered mental status

Recommended Resources Prior to Conference Altered Mental Status: Evaluation and Etiology in the ED (Am J EM, 2002) Altered Mental Status (EM in 5) Additional Resources Overview Approach to AMS Part 1 (EM:RAP) Approach to AMS Part 2 (EM:RAP) Approach to AMS (Flipped EM Classroom) CDEM on AMS Consensus Statements ACEP Clinical Policy: AMS (pdf)

Original Post by Eric Shappell on 7/23/2014
Reviewed by James Ahn on 7/26/2014
Last Updated by Eric Shappell on 02/16/2016 Contact / Feedback