87 - Acute and Anesthetic Care of the Burn-Injured Patient

Abstract

Burn injury patients pose a myriad of challenges to acute and perioperative care. Major burn injury results in pathophysiologic changes affecting virtually all organs from the onset of injury until wounds are healed. Despite significant advances in therapeutic strategies, such as improving resuscitation, enhancing wound coverage, appropriate infection control, and improving treatment of inhalation injury, severe burns remain a devastating injury leading to significant morbidity and mortality. Anesthesiologists are often called on to care for burn injury patients through their hospitalization including acute airway management and resuscitation, intraoperative anesthetic care, intensive care, and management of postoperative pain. To optimally care for this challenging patient population requires understanding, appreciating, and anticipating the unique preoperative, intraoperative, and postoperative issues and problems of the burn injury patient that predispose them to increased morbidity and mortality. Perioperative concerns for the burn-injured patient include airway abnormalities, impaired lung function, vascular access, deceptively large and rapid blood loss, hypothermia, and altered pharmacology. Management of burn-related pain is extremely challenging and may change in intensity and quality over time through the multiple stages of healing. Anesthesiologists assume an essential role in developing and refining analgesic guidelines, coordinating the multidisciplinary pain management team, and aid in the education of burn unit staff and patients.