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Temp homeostasis in burns patients and implication of hypothermia…
Temp homeostasis in burns patients and implication of hypothermia
Initial management
Cool the burn, warm the patient
Cool running water 10-20 mins
Keep warm: large surface area burn at risk of hypothermia (compounds injury)
Cover wound: exclude air and prevent evaporative cooling
Space blanket
Heat room
Warm IV fluids
Infections
Burns patients often develop moderate pyrexia, even when all microbial cultures are negative
Bacterial infection is still the most common cause of death in burns
Depression of immune system and burn site is a favourable culture medium
Bacterial surveillance with wound swab
Isolation to prevent cross-infection, barrier nursing
Abx if infection suspected
Antibiotics
Risk of development of resistant strains
Avoid except where high suspicion or proven infection
Abx choice governed by known colonizing microorganisms