Fluid management in burns

ABSTRACT

A brief review of the patho-physiology of burns is presented. The main cause of shock following body burns is loss of circulating blood volume either to the exterior or into the burn area. This is best remedied by prompt replacement in accordance with the recommendations of Evans as far as volume and composition are concerned. The hourly urinary output and clinical response of the patient should be the milestones of therapy. Special care must be exercised in the management of the following categories- children with more than 10 percent body burns, all patients with more than 50 percent involvement, patients over 50 years of age, those with pre-existing cardiovascular, respiratory or renal disease, and those with respiratory burns. Significant nitrogen depletion and anaemia follow most major burns and these must be anticipated or corrected promptly if delayed convalescence and retarded wound healing are to be avoided. (AU)