I'm an ER nurse and often send out burn patients out to a burn center. I have had multiple different instructions on how to dress the wounds. I was wondering if I could get some advice from actual wound nurses.
I recently had a 15 yo who was burnt 2nd and 3rd degree burns on face, neck, hands, wrists and upper thighs. Pt was sitting around a campfire when someone threw gasoline on it and guess what? It exploded...
We started 2 Iv's on and gave NS bolus. Saline soaked gauze and ABDs with light kurlex drsg around. She was shivering so I covered her w/ multiple warm blankets and medicated the heck out of her.
A "seasoned" er nurse told me to put xeorform and then drsg but I didn't, I was taught wet to dry. When I called report to the burn unit, they told me wet to dry was the best. The other nurse was concerned since the pt has a large area of burns that she would loose heat quickly and was why she wanted the xeoro and not wet drsg.
So, what do you all do/recommend??
Robin ER RN
Jul 27, '09
I would ask the ER attending to order Silvadene. It's pretty much the standard treatment initially for burns, at least for the first dressing. Silvadene, covered with a non-adherent dressing (adaptec non-adherent gauze) and then wrapped with kerlix (not tightly).
I hated it when I would see patients in wet dressings upon transfer, especially on children. Xeroform is the next best thing if you can't get an order for silvadene. It'll keep the wound covered without adhering to the wound itself. And wrap that with kerlix.
The nurses at the burn center are going to change the dressing upon arrival anyway to assess the burns, so it doesn't have to look pretty, it just needs to be functional.
Last edit by theatredork on Jul 27, '09