| Treatment strategies for mass burn casualties. | |
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MedLine Citation:
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PMID: 19323902 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict. METHODS: Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province, were admitted 48 hours post-injury. All patients were male with a mean age of (22.4 +/- 8.7) years. The burn extent ranged from 4% to 75% ((13.6 +/- 12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition. RESULTS: These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver, kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived. CONCLUSIONS: A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of the injury and the care that the patient had received at the spot. During airlift, the stretchers should be arranged perpendicular to the longitudinal axis of the cabin. The treatment protocol in our hospital consisted mainly of prompt effective relief of all life-threatening complications, followed by early closure of burn wounds, appropriate use of anti-infection therapy, emphasis on nutritional support, correction of metabolic disorders, alleviation of immunosuppression, correction of coagulopathy, and effective support and protection of organ function. |
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Authors:
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Jia-ke Chai; Zhi-yong Sheng; Hong-ming Yang; Dai-feng Hao; Chuan-an Shen; Xiao-ming Jia; Feng Li; Sa Jing; Li-gen Li; Hui-feng Song; Chi-yu Jia; Xiao-ye Tuo; Tian-jun Sun; Quan Hu |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Chinese medical journal Volume: 122 ISSN: 0366-6999 ISO Abbreviation: Chin. Med. J. Publication Date: 2009 Mar |
Date Detail:
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Created Date: 2009-03-27 Completed Date: 2009-05-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513795 Medline TA: Chin Med J (Engl) Country: China |
Other Details:
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Languages: eng Pagination: 525-9 Citation Subset: IM |
Affiliation:
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Department of Burns and Plastic Surgery, Burns Institute, First Affiliated Hospital of General Hospital of PLA, Beijing, China. cjk304@126.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Burns / drug therapy, pathology*, surgery*, therapy Emergency Medical Services Emergency Service, Hospital Female Hospitals Humans Male Middle Aged Time Factors Transportation of Patients Treatment Outcome Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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