cimersrn

I'd say it's time to go over this doctor's head. If you're not comfortable handling this situation, turn it over to your nurse manager, but this pt needs you to continue to advocate for appropriate care. When these patients go south, they do so very rapidly and consequently need to be in a unit that's prepared and able to care for them. And the pain issue is very real!!! This pt needs better pain control and anti anxiety meds, such as fentanyl and versed gtts, as their pain is excruciating. Imagine your tissue blistering and coming off exposing the raw, tender tissue beneath. And not just on the outside of your body, but in your mouth, esophagus, nose, lady parts, and just about anywhere else you can imagine! Please, continue to be this patient's advocate and do whatever you can to get them the care that they so desperately need.

EWWWWW! We don't "re-use" silverlon. Is this recommended by the manufacturer?

We just admitted another SJS pt this past week, believed to be related to the use of a sulfa drug. Sulfa drugs seem to be a relatively common culprit

Hi There. Sorry this is off thread, but I'm looking for "Nekhismom" to see how her little brother is doing. If you're out there, I'm a burn nurse and I recently replied to your posts from last month regarding his injuries. Hope he's doing well. Thanks, cimersrn

I'm new to this BB, so I didn't read this back when you originally posted it. Please, please, please.........find the closest regional burn center and contact them!!!! Your brother needs and deserves the care that they are able to provide. My unit is in a county hospital, so we care for all, regardless of ability to pay. I don't know where you're at, but perhaps if you call a firefighters assoc or the Am Burn Assoc they could guide you in the right direction. I realize that this info is coming pretty late, but even post-op skin grafts require special care to prevent shearing, infection, etc. Your brother is also probably going to require PT and OT to maintain optimal ROM and function. Please, keep trying to get in touch with a qualified burn center. Best of luck to you and your brave little brother!

I'm so sorry that you and your brother are going through this. I wish you lived in this neck of the woods so I could come over there and help out. It sounds like this doc is not only beyond clueless but cruel as well! You can bet that if it were one of his loved ones suffering, the narcotics would be flowing like water! And yes, burn wound care is done with sterile technique.... how could he not know this!!! And his pain control is completely inadequate! Hopefully the burn doc who does his surgery will provide the appropriate care and pain control. In our unit we premedicate for drsg changes, in addition to the meds used during the change itself. Usually the premed includes something for pain, such as oxycodone, as well as something for anxiety, such as valium or versed. I think the anti anxiety aspect of this is very important, and the versed is especially good as it has a somewhat amnesia causing effect. Please let us know how your brother's surgery, and his follow up care, goes.

Just discharged a SJS pt that none of us thought could possibly make it!!! What a wonderful feeling! Anyway, in our unit we've been using acticoat or a similar product, "silverlon." These are terrific for many reasons, not the least of which is the fact that they eliminate the need for those painful daily or q shift drsg changes. Just need to moisten with sterile H2O prn. The antimicrobial properties of these products is another plus. Just make sure you don't use saline as this will neutralize the silver, thus negating the antimicrobial action. As far as pain relief is concerned, in our unit these pts are usually on Fentanyl and Versed gtts. Hope this helps!

Hi There! I took ABLS (Advanced Burn Life Support) recently, and ABLS protocol calls for copious amounts of cold H2O to cool and harden the tar. Then, removal of the tar is facilitated with a petroleum based ointment