Presentation on theme: "Burn Nursing Care from EMS to ICU: an overview"— Presentation transcript:
1Burn Nursing Care from EMS to ICU: an overview Amanda Richard, RN, CNS, CCRNAdrienne Costello, RN, CCRNUNM Burn CenterAdult & Pediatric Injuryfrom tragedy… hope!
2Course Objectives Identify the 3 main concerns for burn patients. Discuss interventions to prevent each of these.Address adequate pain management strategies.Resuscitation evaluation.Basic review of wound care for each stage of admission.
33 CONCERNS FOR A BURN PATIENT HypothermiaPainInfectionThese are the 3 main concerns we are going to discuss for the burn patient. Each step of the process in the health care system has a part in treating or preventing these issues.
4HYPOTHERMIA Easier to prevent than treat Increases metabolic and oxygen demandsProportional to degree of injuryTissue ischemiaWhen burn patients are allowed to chose their own environment temperatures, they opt for ambient temp of about 32/90. This minimized the metabolic expenditure. However, their CNS is trying to get them higher – increasing metabolic demand.
5AT THE SCENE Warm the rig Keep patient covered Pain medication per protocolsAvoid IV access in burn unless necessaryWe are going to assume that the ABC’s have been addressed in each of these phases as have been discussed in previous lectures.
6ER OF TRANSFERRING FACILITY Warm roomAdult – minimum of 80 degreesChildren – minimum of 85 degreesWarm IV fluids and blood productsRemove clothingPlace in dry dressing/sheetIf you have warning of the patient coming – make sure to warm the room
7ER OF TRANSFERRING FACILITY Pain is inversely proportional to burn degreePain is often severeIV route onlyMorphine/FentanylAnxiolyticsDosage
8ER OF TRANSFERRING FACILITY Debridement not necessaryDry dressing/sheetLimit flow into roomAsceptic technique with all proceduresAvoid IV access through burns unless necessaryUNM Burn Center
9PRIOR TO TRANSFER…Make sure the family sees the patient prior to transporting to the burn center!!
10ARRIVAL TO THE BURN CENTER Room warmedContinue warm fluidsMinimize exposureHot lineCool guardLightingBair Hugger
11ARRIVAL TO THE BURN CENTER Room warmedContinue warm fluidsMinimize exposureHot lineCool guardLighting
12ARRIVAL TO THE BURN CENTER Room warmedContinue warm fluidsMinimize exposureHot lineCool guardLighting
13ARRIVAL TO BURN CENTER Morphine/Fentanyl drip Ativan/Propofol drip Riker scalePlan on increasing dosage over timeDosage
14ARRIVAL TO BURN CENTER Clean lines Limit flow in room Precautions Daily tubbingDaily dressingsFamily educationNutrition
15Or…. How to give more fluid than you ever thought possible. RESUSCITATIONOr…. How to give more fluid than you ever thought possible.