PubMed · 11718123
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L Santandrea. 2001. Salve.. https://doi.org/10.1097/00000446-200105000-00031
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Successful surgical and intensive care treatment of severely burned patients requires adequate prehospital management and fluid resuscitation adjusted to individual needs of the patient. Burn shock fluid resuscitation is now predominantly performed utilizing crystalloid solutions. Whenever possible, colloid solutions should not be given in the first 24 h after burn injury. The rate of administration of resuscitation fluids should maintain urine outputs between 0.5 ml/kg per h and 1 ml/kg per h and mean arterial pressures of >70 mmHg. Extended hemodynamic monitoring can provide valuable additional information, if burn resuscitation is not proceeding as planned or volume therapy guided by these typical vital signs is not attaining the desired effect. We recommend this in patients with TBSA burns of >30%. Inhalation injuries, pre-existing cardiopulmonary diseases, or TBSA burns of >50% definitely require extended hemodynamic monitoring during burn shock resuscitation. The Swan-Ganz catheter or less invasive transcardiopulmonary indicator dilution methods can be utilized to assess hemodynamic data.
The nursing shortage is widespread. The shortage of available experienced registered nurses has led to an influx of new graduate nurses (GN) into the acute care setting. This influx of inexperienced nurses into highly specialized areas has established a need to develop effective GN training programs that promote sound clinical performance,encourage professional development, and strengthen recruitment and retention efforts. This article discusses the training needs of GNs in burn units and reviews the University of Colorado Hospital (UCH) GN residency program with a discussion of its successes and future challenges.