• Curr Opin Crit Care · Dec 2023

    Review

    Acute care for burn patients: fluids, surgery, and what else?

    • Tina L Palmieri.
    • Shriners Children's Northern California, University of California Davis, Sacramento, California, USA.
    • Curr Opin Crit Care. 2023 Dec 1; 29 (6): 696701696-701.

    Purpose Of ReviewRecently published initiatives spanning the burn care spectrum have substantially changed the standard of care in burn care. The purpose of this article is to describe new impactful concepts in burn first aid, triage, resuscitation, and treatment as well as their impact on future research.Recent FindingsFirst aid after burn injury traditionally consists of extinguishing the burn and applying dressings. Recent evidence suggests that applying 20 min of cool tap water to the burn wound in the first 3 h postburn mitigates burn injury extent. National burn center transfer criteria have been updated, impacting patient initial transfer and management. The adverse effects of hydroxocobalamin, a commonly used antidote for cyanide toxicity, have been delineated. Initial burn resuscitation recommendations for both volume and potentially fluid type are being reexamined. The emergence of innovative skin substitutes may improve burn survival by providing a physiologically stabilizing intermediate dressing. Finally, formal clinical practice guidelines for early mobility in the ICU after burn injury have been defined.SummaryThese changes in burn care, triage, resuscitation, and treatment have challenged traditional burn care standards, created new standards, and are the basis for future prospective randomized trials.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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