Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications.
Burn Care| May 01 1993
Management of Acute Burns and Burn Shock Resuscitation
Lynda Faldmo, RN, BSN;
Melva Kravitz, RN, PhD, CCRN
From the Intermountain Burn Center, University of Utah Medical Center, Salt Lake City, Utah; and the Veterans Affairs Medical Center, Albuquerque, New Mexico.
Reprint requests to Melva Kravitz, RN, PhD, CCRN, Veterans Affairs Medical Center (118), 2100 Ridgecrest Drive SE, Albuquerque, NM 87108.
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AACN Adv Crit Care (1993) 4 (2): 351–366.
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Lynda Faldmo, Melva Kravitz; Management of Acute Burns and Burn Shock Resuscitation. AACN Adv Crit Care 1 May 1993; 4 (2): 351–366. doi: https://doi.org/10.4037/15597768-1993-2013
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