Cite this post as:
Scott Weingart, MD FCCM. EMCrit RACC Podcast 219 – Critical Burn Patients in the ED/ICU – Part I with Dennis Djogovic. EMCrit Blog. Published on March 5, 2018. Accessed on December 3rd 2022. Available at [https://emcrit.org/emcrit/critical-burn-patients-in-the-ed/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: March 5, 2018
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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Could you describe your approach to fluid resuscitation in patients with poor UOP (CKD or even ESRD)? I presume it’s based off other downstream parameters for intravascular volume repletion, but in your experience what is the best approach in this scenario?
Hi Udit, great question, unclear answers. Poor UOP is a surrogate (but not perfect) measurement for renal perfusion, which, along with cardiac ischemia, is our big concern with underresuscitation of the massive burn patient. You are correct in the need for other parameters to assess for volume status, which is very tricky with the big burn (IVC assessment, TTE, passive leg raise, CVP, cardiac outputs, are all challenging when the patient is fully wrapped in heavy dressings and 15L positive). I would consider adding albumin at the 8-12 hr mark, low dose vasopressors if fluid status adequate but MAP low.… Read more »
In need of some more information, in PC 219 it’s mentioned that ABLS calls for a fluid resus of 4ml/kg/BSA in electrocution patients. Which electrocution pts? All? What’s the definition of electrocution? Also how do you calculate BSA of an electrocution? Injuries run a huge spectrum. Thanks!