• Burns
    • Airway may be compromised - intubation early with uncut tube
    • Breathing
      • ARDS picture
      • SIRS
      • Bronchospasm
      • Smoke inhalation
      • Cyanide toxicity
      • CO inhalation - check levels
      • May need escharotomy
    • Circulation
      • Increased permeability (PGE2, PGI2, leukotrienes, TXA2)
      • Thrombosis/destroyed vessels
      • Sepsis (late)
      • Impaired renal function
      • Fluid loss
      • Hypoalbuminaemia
      • Over resuscitation
        • Oedema
    • Disability
      • BM
      • Rule of 9's
        • >15% burn requires IVI
        • >10% in children
      • Parkland formula
        • 4ml/kg/% burn. Half over first 8hrs from injury. Remaining half in the subsequent 24hrs. CSL is the fluid used.
      • Cover burns
        • Early operative Mx is the trend
      • Catheterise
      • Muscle damage may occur which can lead to myocardial depression.
    • Referral criteria
      • Burns >10%
      • Burns of special areas
      • Full thickness burns >5%
      • Electrical and chemical burns
      • Circumferential burns
      • Burns at extremities of age
      • Burns associated with trauma
    • Hyper-metabolic state with high calorific requirements. Can be a problem with repeated fasting episodes.
    • Practical issues
      • ECG dots not sticking
      • SpO₂ probe trace/CO spurious results
      • BP cuff
      • Increased dead space may mean EtCO₂ may not reflect arterial CO₂
      • CVP access may be difficult
      • Resistance to NMBDS
      • Hyperkalaemia with sux
      • Susceptibility to sepsis
    • Opiates for pain relief
      • Background requirements
      • Procedural requirements
    • Consider ambient temp (30 ͦC) wound debridement may cause lots of bleeding so ensure blood/products available, evaporative losses, positioning
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/1/4/113.full.pdf
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/early/2012/02/23/bjaceaccp.mks001.full.pdf

    • Link:itunes.apple.com/gb/app/mersey-burns/id481808668?mt=8
    • CEACCP
      Link:ceaccp.oxfordjournals.org/content/4/2/57.full.pdf