Management of the burned trauma patient

Background and Aim : Significant thermal injuries pose a distraction to providers notfamiliar with such injuries. The trauma patient with concomitantburns challenges the emergency team in the general hospital and the trauma-burn teams in a Level 1 Trauma Center. It is generally considered that avoidable missed trauma injuries are the result ofan inadequate physical examination, inexperience, appropriate investigations not performed, or the incorrect interpretation ofimages or laboratory results, and poor or no history. Approximately 5% of multiple trauma patients sustain concomitant burns. Complicated management issues arise in these patients as burn and trauma care often conflict. This study reviews 41 consecutive burned multiple trauma patients in order to examine common management conflicts and recommend appropriate compromises in caring for these difficult patients. Methods : A retrospective study of 41 burn trauma patients admitted to Isfahan Burn Hospital from 2009 to 2017 was performed. Results : Results: In the study period, 41 patients were admitted to the Isfahan Burn Hospital with concomitant burns and trauma. Of this group, 38 (92/6%) were male. Average age was 29.5 +/- 15.0. Mechanisms included 10 electrocutions with subsequent falls, 9 motor vehicle collisions (MVC), 9 explosions, nine house fires, two pedestrian versus car accidents, two falls into fires. Average burn size was 25.4% +/- 22.4. The most common traumatic injury was fracture (41). Management of fractures in burn patients and resuscitation in head injured burn patient represented the most common conflicts in patient care. There were five deaths (9.7%) in this series. Conclusion : Burns are a rare but significant complication in the trauma patient. Outcomes are dependent on rapid trauma evaluation as well as effective resuscitation and wound management. Given the complexities of their problems, these patients necessitate a balanced multidisciplinary approach to maximize their potential for full recovery. Thoughtful compromise between trauma and burn priorities is frequently necessary.

کلیدواژه ها:

burn- trauma- management