Burn management

Abstract

To update critical care practitioners on the recent advancements in burn care. Particular topics discussed include airway management, acute resuscitation, issues within the intensive care unit, nutrition, and wound management. This is a concise review of the recent burn literature tailored to the critical care practitioner. Criteria for extubation of burn patients are examined, as is the need for cuffed endotracheal tubes in pediatric burn patients. Strategies to avoid over-resuscitation are discussed, including use of colloid, as well as nurse-driven and computer-guided resuscitation protocols. New data regarding common ICU issues such as insulin therapy, delirium, and preferred intravenous access are reviewed. The importance of nutrition in the burn patient is emphasized, particularly early initiation of enteral nutrition, continuation of nutrition during surgical procedures, and use of adjuncts such as immunonutrition and beta blockade. Finally, both short-term and long-term wound issues are addressed via sections on laser Doppler assessment of burns and pressure garment therapy to prevent long-term scarring.