Burns : journal of the International Society for Burn Injuries
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A 45-month retrospective analysis of 70 geriatric burn admissions to the Welsh Regional Burns and Plastics Unit highlighted 13 (18.6 per cent) injuries that occurred whilst the patient was in residential care (six residential care homes, seven nursing homes). The mean age overall was 83 years. The residential care patients had a TBSA of 12.5 per cent with a mortality of 46 per cent, whilst the group living in the community had a TBSA of 8.63 per cent with a mortality of 14 per cent. ⋯ All 13 patients were found to have such severe dementia that they were unable to give a reliable history. In the majority of patients a lack of supervision was in part responsible. Some basic measures are presented that could reduce the incidence of accidental burn injury in this vulnerable group of the population.
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Standard murine burn models include the administration of intraperitoneal (i.p.) saline solutions which are intended to resuscitate the animals during subsequent burn shock. Prehospital administration of small volumes of concentrated salt solutions has been recommended for the early treatment of haemorrhagic shock, and have also been utilized for burn shock. We studied the effects of bolus intravenous (i.v.) hypertonic saline (HS) or hypertonic saline/dextran-40 (HS + DEX) on animal survival and acid-base balance following 25 per cent total body surface area, full-thickness burn injury in mice. ⋯ Immediate preburn i.v. administration of HS or HS + DEX did not eliminate metabolic acidosis in this murine burn model, and markedly increased the mortality when subsequent i.p. fluids were not administered. The degree of metabolic acidosis in the murine experimental burn model has not previously been clearly described. Furthermore, adequate fluid resuscitation of these animals may be difficult to achieve without indwelling vascular catheters which could deliver continuous i.v. fluids following burn injury.