BookJong O. Lee, editor.
Summary: Despite a decreasing number of burns and improvement in mortality of burn patients in the United States, burn injuries are still frequent. Non-burn specialists such as emergency medicine physicians and primary care physicians will inevitably treat burn patients. In many instances, the first clinicians to see burn patients are non-burn specialists in the urgent care, emergency department, or primary care clinic, yet they typically do not have any formal training or exposure to burns in residency. As a result, many clinicians feel uneasy about managing burns even if the burn is minor. If a burn center is in a reasonable proximity, one can transfer the patient, but prior to transfer, or if no burn center is available, these clinicians may have to perform the initial management. It is important that they understand the basic principles of burn care. In times of burn disasters, non-burn specialists are needed to care for burn patients as burn centers can be quickly overwhelmed. They should be able to manage burn patients including stabilization, resuscitation and wound care. The text includes all current management available today for the care of burn patients. It is organized in a stepwise manner with clear information listed in sequential chapter formats. Chapter one offers the basic epidemiology of burn care while chapters three and four discuss the initial assessment and management. The chapter five discusses inhalation injury while the next three chapters focus on burn wound management including face and hand. The majority of chapters that follow center on a specific type of burn or burn patient. The last few chapters discuss aftercare including scar management and burn rehabilitation. Written by experts in the field, Essential Burn Care for Non-Burn Specialists is a valuable guide for any physician involved in burn treatment such as emergency physicians, primary care physicians, and general and plastic surgeons.
Contents:
Intro
Contents
Chapter 1: Epidemiology
Burden of Disease
Incidence
Injuries Managed at Hospitals and Burn Centers
Mortality
Global and Local Inequities
Risk Factors for Fires and Burn Injuries
Age
Children
Elderly
Gender
Cooking and Cookstoves
Occupation
Climate and Seasonality
Comorbidities
Interpersonal and Collective Violence
Data for Burn Injury Prevention and Control
Conclusion
References
Chapter 2: Pathophysiology and Hypermetabolic Response to Burn
Introduction
What Is Hypermetabolism?
Magnitude and Duration Biomarkers and Mediators
Metabolic Consequences: Glucose, Lipids, Amino Acids
Glucose Metabolism
Lipid Metabolism
Protein Metabolism
Targeting Organ Systems: Cardiac, Renal, Gastrointestinal, and Immune Systems
Cardiac
Renal
Gastrointestinal
Immune System
Adipose Tissue
Central Nervous System
Management of Hypermetabolism: Conservative Measures
Nutrition-Calculating Energy Consumption and Nutrient Supplementation
Environment, Early Excision, and Exercise
Management of Hypermetabolism: Pharmacological Intervention
Propranolol Recombinant Human Growth Hormone
Insulin-Like Growth Factor 1/Insulin-Like Growth Factor Binding Protein-3
Insulin
Metformin
Oxandrolone
Testosterone
Conclusion
References
Chapter 3: Initial Assessment of Burn Patient
Introduction
First Aid and Prehospital Considerations
Initial Assessment
Primary Survey
Burn-Specific Secondary Survey
Obtaining a Burn-Specific History
Burn Patient Assessment
Neurologic
Ophthalmologic
Otolaryngologic
Chest and Abdomen
Genitourinary
Extremity
Evaluation of the Burn Wound Triage, Referral, and Transfer Determination
Tertiary Survey
Prehospital and Initial Assessment Considerations for Special Situations
Chemical Injury
Cold Injury
Electrical Injury
Non-accidental Injury
References
Chapter 4: Initial Management and Resuscitation
Introduction
Big Problem or Little Problem?
Airway: Who Needs to be Intubated, and How?
Fluid Resuscitation: Why and How?
Monitoring
Complicated Resuscitation
Management of the Burned Extremity
Wound Care and Pain Management
Supportive Care
Role of the Rehabilitation Team
Teamwork Final Thoughts
References
Chapter 5: Inhalation Injury
Introduction
Pathophysiology
Assessment and Grading
Management
Airway Management
Carbon Monoxide and Hydrogen Cyanide
Mechanical Ventilation
Medical Therapy
Complications
Conclusion
References
Chapter 6: Burn Wound Management
Introduction
Skin Anatomy
Care Algorithm
Minor Burns Treatment
Hospital Admission for Minor Burns
Major Burns Treatment
Escharotomy and Wound Care
Burn Surgery
Burn Excision
Skin Grafting
Autograft Skin
Skin Substitutes
Allograft Skin