[BillboSN]

I have to give a presentation to my clinical group about various diets and since we are on a burn unit the burn diet is one of them. I am at a Ped hospital and their diet is high protein, high cal, no water, no juice, no simple sugar. I have found rational for the high protein high cal but I cannot find any rational for no water or juice. If anyone could help me out I would really appreciate it.

[shandsburnrn-SRNA]

Hey BillboSN,

I have worked in a Burn ICU for 2 1/2 years with both peds and adult patients. First yes, the high protein/high calorie is spot on. This is necessary for good skin recovery/growth. The no water or juice thing is a bit of mystery to me however. The only time I have had to limit free water intake is when a patient is hyponatremic and juices, gatorade, etc if they are hypernatremic but just as a general rule, no. And the simple sugar thing is even more bizarre, for our pateints that are greater than 25% TBSA we usually place a DHT (enteral feeding tube) whether they are mechanically ventilated or not to supplement their nutritional needs. Enteral tube feeds are loaded with simple sugars, it also helps with skin regrowth. That is why alot of patients on enteral feeds are also on insulin drips or sliding scale insulin because of the high simple sugar content.

A good person to see would be the nutritionist that works with the burn patients.

Even during the initial resuscitation phase (first 24 hours) if the person is able to take PO we give to them. So if these burn patients are not allowed water or juice, how exactly are they being hydrated? Because not all burn patients require IV fluids, it depends on what stage of recovery they are in.

Make sure the no juice/water/simple sugar thing is not for something specific because it doesn't sound correct to me as a general rule to limit someone fluid intake without specific casuse. Let me know what you find out.