| Burn resuscitation index: a simple method for calculating fluid resuscitation in the burn patient. | |
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MedLine Citation:
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PMID: 20489651 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The Parkland formula is the standard for calculating the initial intravenous fluid rate for resuscutation after thermal injury. However, it is cumbersome when used by those with modest burn training. We propose an easier method to calculate fluid requirements that can be initiated by first-line providers. Burn size is estimated by using the Burn Size Score (BSS), which is then crossreferenced with the patient's weight on a preprinted Burn Resuscitation Index (BRI), based on the Parkland formula, to determine initial hourly fluid rate. Seventy-two residents and faculty in the Departments of Surgery and Emergency Medicine were surveyed. Participants were shown a diagram of a burn patient and asked to calculate the initial fluid rate using the Parkland formula from memory. The study was repeated with a different diagram, and the participants were asked to calculate the initial fluid rate using the BRI (a preprinted card with written instruction pertaining to its use). Statistical analysis was performed with the McNemar test. Using the Parkland formula, 33% of surgeons and 17% of emergency medicine physicians were able to calculate the initial fluid rate. Using the BRI, 56% of surgeons and 77% of emergency medicine physicians were able to calculate the fluid rate correctly (P < .01 and P < .001, respectively). Fifty-four percent of physicians surveyed believed that the BRI was easier to use. The accuracy of determining initial fluid rate was low using the Parkland formula and "rule of nines" from memory. Accuracy increased when the BRI was used. The BRI serves as a visual aid and provides some instruction, allowing the user to calculate fluid resuscitation with greater accuracy than with rote memorization of a formula. The BRI might be a useful tool for providers with minimal burn training. However, further investigation is warranted. |
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Authors:
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Steven A Kahn; Mark Schoemann; Christopher W Lentz |
Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Journal of burn care & research : official publication of the American Burn Association Volume: 31 ISSN: 1559-0488 ISO Abbreviation: J Burn Care Res Publication Date: 2010 Jul-Aug |
Date Detail:
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Created Date: 2010-07-13 Completed Date: 2010-10-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101262774 Medline TA: J Burn Care Res Country: United States |
Other Details:
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Languages: eng Pagination: 616-23 Citation Subset: IM |
Affiliation:
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Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Algorithms* Body Surface Area Body Weight Burns / pathology, therapy* Fluid Therapy / methods* Humans Injury Severity Score Isotonic Solutions / administration & dosage Resuscitation / methods* |
| Chemical | |
Reg. No./Substance:
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0/Isotonic Solutions |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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