With bonfire night approaching we thought it would be a good time to have a think about burns.

However burns are a significant issue at all times of year with around 130,000 presentations to UK EDs annually, 10,000 cases are admitted to hospital, 500 of these have severe burns and 200 of these will die. But most importantly intervention that we make can make a big difference to both morbidity and mortality, really affecting outcomes. 

Throughout this episode we'll be covering the essential first responder management, all the way through to the critical care that maybe required for the sickest of burns patients. 

In the podcast we cover

• Burn type and burn severity

• The importance of history

• Assessing burn extent

• Assessing burn depth

• The A-E assessment and specifics regarding the burns patient

• NAI, antibiotics, tetanus cover, analgesia, special circumstances eyes & chemicals

• Conveyance and destination

As always we'd love to hear any thoughts or comments you have on the website and via twitter, we look forward to hearing from you.

Enjoy!

Simon, Rob & James 

References

British Burn Association First Aid Clinical Practice Guidelines

BBA Clinical Practice Guideline for Management of Burn Blisters

BBA Clinical Practice Guideline for Deroofing Burn Blisters

RCEMLearning; Major Trauma, Burns

National Burn Care Referral Guidance

WHO; fact sheet on burns

NHS Standard Contract for Specialised Burns Care (All Ages) Schedule 2- The Services A. Service Specification

LITFL; burns

Clinical review: The critical care management of the burn patient. Jane A Snell. Crit Care 2013

Fluid resuscitation in major burns. Mitra B ANZ J Surg. 2006

How well does the Parkland formula estimate actual fluid resuscitation volumes? Cartotto RC^. J Burn Care Rehabil. 2002

Fluid resuscitation management in patients with burns: update. Guilabert P. Br J Anaesth. 2016

ISBI Practice Guidelines for Burn Care 2016

Welcome back to October's Papers Podcast, this month we move airway from advanced airway management and bring you a broad array of papers.

First up we have a look at the relative success of a variety of pharmacological strategies for managing the acutely agitated patient in ED. Next up we have look at the well know CURB-65 score and it's ability to predict the need for critical care interventions. Lastly, we may all feel at times that performing a CT head on those well patients solely because they take anticoagulants may be a little on the excessive side, we review a paper that looks at the yield of positive scans in this cohort.

As ever don't just take our word for it, go and have a look at the papers yourself, we would love to hear any comments or feedback you have.

Enjoy!

Simon & Rob

References & Further Reading 

IntramuscularMidazolam, Olanzapine, Ziprasidone, or Haloperidolfor TreatingAcuteAgitationin the Emergency Department. Klein LR. Ann Emerg Med. 2018

Performanceof the CURB-65Scorein PredictingCritical CareInterventionsin PatientsAdmitted With Community-AcquiredPneumonia.Ilg A. Ann Emerg Med.2018

Incidenceof intracranial bleedingin anticoagulatedpatientswith minor head injury: a systematic review and meta-analysis of prospective studies. Minhas H. Br J Haematol.2018