Which one of the following is the emergency management of burn injury in the first 24 hours?

Concept:-

• Burn injury leads to loss of fluid from the body.

Burn management includes three phases:

1. Resuscitative
2. Wound management
3. Rehabilitative or reconstructive

Resuscitative phase includes

• The management of hypovolemia.
• Capillary permeability increases in the early phase(large molecules or ions getting lost into the interstitial fluid)
• There is decreased cardiac output and increased vascular resistance.
• This leads to hypovolemia and hyperfusion (burn shock).

Explanation:

• The resuscitation fluid management uses the Parkland formula.
• Parkland formula = 4ml x TBSA (%) x body weight (kg).
  • The first half of fluid is given in the first 8 hours.
  • The remaining half is given in 16 hours.
• In pediatrics, the normal maintenance fluid is added to the Parkland formula.
• The patient's vital signs are monitored regularly along with urine output.
• Other management includes:
  • Nasal gastric tube
  • Foley catheter
  • Oxygen saturation or pulse oximetry
  • Analgesics
  • Tetanus prophylaxis
  • Wound cleaning and dressing
  • Topical antimicrobial creams
• The surgery in the burn injury is escharotomy to relieve constricting effect of a full-thickness burn.