Document Detail


Burn resuscitation index: a simple method for calculating fluid resuscitation in the burn patient.
MedLine Citation:
PMID:  20489651     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Steven A Kahn; Mark Schoemann; Christopher W Lentz
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
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:
Created Date:  2010-07-13     Completed Date:  2010-10-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101262774     Medline TA:  J Burn Care Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  616-23     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of Rochester Medical Center, Rochester, New York, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Isotonic Solutions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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