New assignment to Burn ICU

[poppy07]

Hello, I recently joined an agency that will be placing me in assignments throughout multiple ICU's, one a Burn unit.

I've never taken care of burn patients, and am coming here to get a heads up for what I can expect of caring for these patients.

Please share what a typical day in the burn unit may be: dressings, what types of meds, etc. I saw a few formulas for fluid replacement maybe, and hope you can share what I ought to know.

Thanks so much!

[airforce07, RN]

how is your assignment going?

so I guess by now your familiar with the following:

1. Parkland formula

2. fentanyl, versed, morphine and ativan gtts for sedation... in high doses...

3. unusual vent settings to prevent barotrauma...

I was reviewing this site... thought to answer your question...

thanks

air rn:saint:

[poppy07]

Hi,

Actually still working MSICU. I am curious as to the different things you are referring to, though. Please do share.

[hdigh]

Hi. Every burn unit/center does things differently so I can only tell you what my unit does. We use primarily, narcotics for pain management (oxycodone q4h for base pain control, Dilaudid PRN for break-through pain and Fentanyl (and maybe Dilaudid) for dressing changes. We also frequently use Versed for patients with large dressing changes. Of course, there are other meds given depending on the patient, but those are out standard meds. As for burn cleaning and dressing: burns are cleaned with water and dial soap. Burns on the face receive bacitracin ointment. Ears receive sulfamylon cream if burns are partial or full thickness (otherwise bacitracin). On the body we mainly use SSD cream wrapped with Kerlix (rolled gauze) then a netting to keep the Kerlix in place. We use acticoat or aquacell on donor sites and then xeroform. We mix sulfamyon powder and amphotericin B in sterile water and wet down graft sites q4h (or PRN to keep moist). There are several other options depending on specific situations, but these are our basics dressings. Sounds like a lot and it is, but you'll sort it all out quickly. Just jump right in!!

[gambutrol]

hdigh is correct, knowledge of dressings and pain management is very important. Fluid resuscitation and rehabilitation is important as well