The EM Educator Series: Why is my burn patient so sick?

Author: Alex Koyfman, MD (@EMHighAK) // Edited by: Brit Long, MD (@long_brit) and Manpreet Singh, MD (@MprizzleER)

Welcome to this week’s EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed.

This week has another downloadable PDF document with questions, links and answers you can share with learners as educators in #MedEd. We are working on retroactively doing this for the past posts as well. Please message us over Twitter and let us know if you have any feedback on ways to improve this for you. Enjoy!

Mini Case: Why is my burn patient so sick?

A 68-year-old female is brought in by EMS directly from a house fire with a reported 40% TBSA and concern for inhalational injury. Upon arrival, she has extensive burns to her trunk and upper and lower extremities. Her BP is 75/42 mm Hg, with HR 120 bpm and oxygen saturation 90% on RA.

 

Considerations:

  1. What are the pearls/pitfalls of fluid resuscitation?
  2. Who needs a burn center?
  3. What about the special type of trauma patient – airway; blast injury; escharotomy; pain management?
  4. What do you do with the special toxicologic case – CO, CN, etc.?
  5. What’s you approach to the Burn airway?

 

Suggested Resources:

 

The following artwork is from the talented Dr. Katy Hanson. For more, please visit https://www.hansonsanatomy.com.

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