![]() ![]() Not to be applied to children under 2 months. Local infection, in the absence of signs of systemic infection, requires topical treatment with silver sulfadiazine.Separate “new” patients ( 38.5 ☌ or 1 month: 25 mg/kg every 8 hoursĬhildren > 1 month: 15 mg/kg 2 times daily.Rigorous wound management (dressing changes, early excision).Infection is one of the most frequent and serious complications of burns: Precautions against infection are of paramount importance until healing is complete. Do not administer dopamine or furosemide. If present: induce alkaline diuresis for 48 hours (20 ml of 8.4% sodium bicarbonate per litre of RL) to obtain an output of 1 to 2 ml/kg/hour.Monitor for myoglobinuria: dark urine and urine dipstick tests.In the event of deep and extensive burns, electrical burns, crush injuries to the extremities: Reduce energy loss: occlusive dressings, warm environment (28-33 ☌), early grafting management of pain, insomnia and depression.Assess nutritional status regularly (weigh 2 times weekly).Start with small quantities on D1, then increase progressively to reach recommended energy requirements within 3 days.Enteral feeds are preferred: oral route or nasogastric tube (necessary if BSA > 20%).Provide 5-10 times the recommended daily intake of vitamins and trace elements.Nutritional requirements are administered according to the following distribution: carbohydrates 50%, lipids 30%, proteins 20%.High energy foods (NRG5, Plumpy'nut, F100 milk) are necessary if the BSA is > 20% (normal food is inadequate).No specific treatment for direct bronchopulmonary lesions. Do not administer corticosteroids (no effect on oedema predisposition to infection).Emergency surgical intervention if necessary: tracheotomy, chest escharotomy.In all cases: continuous inhalation of humidified oxygen, chest physiotherapy.Stop the infusion after 48 hours, if fluid requirements can be met by the oral route or gavage. In patients with oliguria despite adequate fluid replacement:ĭopamine IV: 5 to 15 micrograms/kg/minute by IV pumpĮpinephrine IV: 0.1 to 0.5 micrograms/kg/minute by IV pump Target endpoints for IV replacement fluids Reduce replacement fluid volumes if urine output exceeds the upper limit. This formula provides a guide only and should be adjusted according to systolic arterial pressure (SAP) and urine output. Intravenous replacement fluid to correct hypovolaemia:įluid and electrolyte requirements during the first 48 hours according to ageĬhildren 50% BSA, limit the calculation to 50% BSA. General measures during the first 48 hours Resuscitative measures Look for complications (arrhythmia, rhabdomyolysis, neurological disorders). Clinical manifestations of electrical burns vary significantly according to the type of current.In the case if altered consciousness, consider head injury, intoxication, postictal state in epileptic patients. Burns alone do not alter the level of consciousness. ![]() Burns do not bleed in the initial stage: check for haemorrhage if haemoglobin level is normal or low.Prepare the patient for the first dressing procedure in the operating room. ![]()
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