Well if the burns are truly third degree and truly circumfrential, pulses should be assessed hourly and intra-abdominal pressures should also be monitored. Esharotomies will probably be needed to the arms, trunk, fingers. Surgical debridement would probably take place after the intial resuscitation period of 24 hrs. At my unit this patient would be intubated profilactically, especially with the expected edema of the resuscitation with a burn of that size and severity. The patient would be place on morphine and versed gtts, LR for resuscitation in addition to a continuous ascorbic acid infusion for the first 24 hrs, prevacid, albumin 25% (post resusciation). This patient could easily stay 6 months in the unit and could also easily die depending on age and comorbidities.
shandsburnRN-CRNA
188 Posts
Well if the burns are truly third degree and truly circumfrential, pulses should be assessed hourly and intra-abdominal pressures should also be monitored. Esharotomies will probably be needed to the arms, trunk, fingers. Surgical debridement would probably take place after the intial resuscitation period of 24 hrs. At my unit this patient would be intubated profilactically, especially with the expected edema of the resuscitation with a burn of that size and severity. The patient would be place on morphine and versed gtts, LR for resuscitation in addition to a continuous ascorbic acid infusion for the first 24 hrs, prevacid, albumin 25% (post resusciation). This patient could easily stay 6 months in the unit and could also easily die depending on age and comorbidities.