Articles: burns.
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Eur J Trauma Emerg Surg · Feb 2025
Firework injuries around New Year's Eve - epidemiology, injury patterns and risk factors.
This study aims to determine key demographic and behavioural risk factors contributing to firework-related injuries and their outcomes. ⋯ Firework-related injuries around New Year's Eve are associated with significant morbidity, particularly affecting the hands and often requiring surgical intervention. Bone injuries, male sex and multiple body region injuries were associated with higher need for surgical treatment. Despite most fireworks being purchased legally, there is widespread disregard to age restrictions and safety protocols. These findings highlight the necessity of public health initiatives to reduce the incidence and severity of such injuries, rather than stricter regulations.
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Fresh frozen plasma (FFP) as an adjunct in burn resuscitation to decrease endothelial cell permeability by restoring the glycocalyx is not yet standard of care, despite increasing evidence showing tis benefits. We hypothesize that utilizing an adjusted body weight index and starting resuscitation at a low rate of 2cc/kg/%TBSA with early plasma results in less fluid administration and superior clinical outcomes compared to traditional resuscitation methods such as Parkland formula. ⋯ Patients treated with the restrictive 2cc/kg+FFP formula received less fluid than the 3cc/kg and Parkland formula controls. With reduced fluids, patients had less mechanical ventilation, less dialysis, fewer tracheostomies, and better survival. AKI was minimal despite fluid restriction. Early experience suggests the new protocol is safe and feasible for further study.
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Burn trauma induces hypermetabolism and alters thermoregulation resulting in elevated body temperature. Because patients with burns are prone to heat loss and hypothermia, maintaining physiologic body temperature is important. However, optimal target temperature is widely unknown because thermoregulation of burn trauma has mainly been studied in the previous century, when treatment concepts differed from current era. ⋯ Classic concepts of thermal management in burn care are not universally adopted. A majority of the centers expresses the need for specific guidelines. The basis for this should be multicentre clinical trials on temperature management in burn trauma.
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Observational Study
Identification and quantification of physical activity in critically ill burn patients: A feasibility study.
Physical activity is essential in burn care to counteract the effects of severe burns and inactivity during hospitalization. However, detailed knowledge of performed physical activities is lacking. This study evaluated the feasibility of a dual accelerometer-based method to assess type, frequency, and duration of physical activity in critically ill burn patients during hospitalization. ⋯ The dual accelerometer-based method proved feasible for research purposes. For clinical application, further refinement of data processing is required.