Overview and management strategies for the combined burn trauma patient
- Steven E Wolf, MD
Steven E Wolf, MD
- Professor and Vice-Chairman for Research, Department of Surgery
- University of Texas – Southwestern Medical Center
Burns complicate the management and outcomes of trauma patients . As with injuries sustained but not associated with burns, the initial management of a combined burn/trauma patient is stabilization and resuscitation of the patient. Management of the burn wounds is a secondary priority.
The prevalence, management strategies, and outcomes for the combined burn/trauma patient will be discussed here. The resuscitation and stabilization of multitrauma patients and the emergency management of burn patients are reviewed separately. (See "Initial management of trauma in adults" and "Trauma management: Approach to the unstable child" and "Emergency care of moderate and severe thermal burns in adults" and "Emergency care of moderate and severe thermal burns in children".)
The prevalence of combined burn/trauma ranges from 0.4 to 5.8 percent . Approximately 1 to 5 percent of patients who sustain burn injuries incur penetrating and/or blunt trauma [1-4]. Approximately 25 to 30 percent of those injured in a mass disaster or terrorist attack will sustain a moderate to severe burn injury . (See "Management principles for burns resulting from mass disasters and war casualties".)
ETIOLOGY AND TYPES OF INJURIES
Combined burn/trauma results from motor vehicle accidents with explosions, fires with structural collapse, falls while escaping a fire, electrical injuries and falls, scald burns during assaults, plane crashes, and explosions with airborne fragments and flames in civilian and combat settings [2-4,6,7].
The most common injuries associated with burns and the frequency in which they occur include [1,3,4]:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- ETIOLOGY AND TYPES OF INJURIES
- STABILIZATION AND EARLY MANAGEMENT STRATEGIES
- IMMEDIATE BURN WOUND MANAGEMENT
- Eschar management
- Transfer guidelines
- MANAGEMENT STRATEGIES FOR COMPLICATED SETTINGS
- Closed head injury
- Open and closed fractures
- Venous thromboembolism prophylaxis
- Hypermetabolism and nutrition
- SUMMARY AND RECOMMENDATIONS