A simplified fluid resuscitation formula for burns in mass casualty scenarios: Analysis of the consensus recommendation from the WHO Emergency Medical Teams Technical Working Group on Burns
| Autor: | Thomas Leclerc, Josef Haik, Ian Norton, Amy Hughes, Naiem Moiemen, Tom Potokar, Stian Kreken Almeland, Calin Alexandru |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Resuscitation Consensus World Health Organization Critical Care and Intensive Care Medicine World health 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Age groups medicine Humans Mass Casualty Incidents Child Retrospective Studies business.industry 030208 emergency & critical care medicine Mass Casualty General Medicine Disaster response Patient management Emergency medicine Emergency Medicine Fluid Therapy Surgery Burns business Total body surface area Limited resources |
| Zdroj: | Burns |
| ISSN: | 0305-4179 |
| Popis: | Background Burn fluid resuscitation guidelines have not specifically addressed mass casualty with resource limited situations, except for oral rehydration for burns below 40% total body surface area (TBSA). The World Health Organization Technical Working Group on Burns (TWGB) recommends an initial fluid rate of 100 mL/kg/24 h, either orally or intravenously, beyond 20% TBSA burned. We aimed to compare this formula with current guidelines. Methods The TWGB formula was numerically compared with 2–4 mL/kg/%TBSA for adults and the Galveston formula for children. Results In adults, the TWGB formula estimated fluid volumes within the range of current guidelines for burns between 25 and 50% TBSA, and a maximal 20 mL/kg/24 h difference in the 20–25% and the 50–60% TBSA ranges. In children, estimated resuscitation volumes between 20 and 60% TBSA approximated estimations by the Galveston formula, but only partially compensated for maintenance fluids. Beyond 60% TBSA, the TWGB formula underestimated fluid to be given in all age groups. Conclusion The TWGB formula for mass burn casualties may enable appropriate fluid resuscitation for most salvageable burned patients in disasters. This simple formula is easy to implement. It should simplify patient management including transfers, reduce the risk of early complications, and thereby optimize disaster response, provided that tailored resuscitation is given whenever specialized care becomes available. |
| Databáze: | OpenAIRE |
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