36 timestamped statements
across 1 collection
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▶Ep 2 · 3:10
I think most importantly, that if you suspect in any way, shape or form that this is part of, uh, non-accidental trauma, then that patient should definitely be transferred to a tertiary care center where they can provide the appropriate care to that patient.
The London Browder chart is probably the best chart to use because it takes into account the body shape variations in children, and it actually provides a much more accurate estimation of the, of the body surface area.
epidemiologicalBurns result in over 300 visits and 2 deaths per day in pediatric patients.↗
▶Ep 2 · 0:45
quoteBurns, one of the most common causes of pediatric injury, resulting in over 300 visits and 2 deaths per day.↗
▶Ep 2 · 1:00
quoteThe mechanism, hot liquids or steam in younger children, and fire in older children.↗
▶Ep 2 · 1:00
epidemiologicalThe mechanism of pediatric burns is hot liquids or steam in younger children, and fire in older children.↗
▶Ep 2 · 2:10
guidelineTransfer criteria to a burn center include burns of more than 5% total body surface area, particularly if they involve the face, hands, feet, genitalia, perineum, or major joints.↗
▶Ep 2 · 2:40
guidelineElectrical burns, chemical burns, and inhalational injury should be transferred to a burn center.↗
▶Ep 2 · 2:50
guidelinePatients with significant circumferential burns should be transferred to a burn center.↗
▶Ep 2 · 3:10
quoteI think most importantly, that if you suspect in any way, shape or form that this is part of, uh, non-accidental trauma, then that patient should definitely be transferred to a tertiary care center where they can provide the appropriate care to that patient.↗
▶Ep 2 · 3:40
guidelineAdmission criteria at a burn center include any infant under age 1 with a total body surface area burn greater than 8%.↗
▶Ep 2 · 4:00
guidelineAny 2nd degree burn greater than 10% or any 3rd degree burn greater than 5% are indications for admission.↗
▶Ep 2 · 4:50
clinicalBefore transfer, provide adequate pain control, apply silver sulfadiazine, and wrap wounds lightly with gauze, possibly adding Bactigras to prevent sticking.↗
▶Ep 2 · 6:00
clinicalPatients with smaller burns can be treated with oral rehydration therapy and do not necessarily require intravenous fluids.↗
▶Ep 2 · 6:20
clinicalAt the speaker's center, IV resuscitation is initiated for patients with greater than 10% total body surface area burns or teenagers with greater than 15%.↗
▶Ep 2 · 6:50
clinicalThe Lund-Browder chart is the best chart for estimating burned surface area because it takes into account body shape variations in children.↗
▶Ep 2 · 6:50
quoteThe London Browder chart is probably the best chart to use because it takes into account the body shape variations in children, and it actually provides a much more accurate estimation of the, of the body surface area.↗
▶Ep 2 · 7:10
clinicalThe palm of the patient can be used as an estimate of 1% body surface area burn.↗
▶Ep 2 · 7:20
clinicalThe Parkland formula uses Ringer's lactate solution at 3 cc per kg per percentage body surface area burn.↗
▶Ep 2 · 7:35
opinionThe Cincinnati and Galveston formulas are more pediatric-specific than the Parkland formula.↗
▶Ep 2 · 7:45
clinicalDextrose-containing solutions should be added as maintenance fluids for any patient under 30 kg.↗
▶Ep 2 · 8:10
quoteGiving colloid has been in a, actually, uh, a prospective study by Dietrich to show that there is statistically less fluid use overall, shorter lengths of stay, and a reduced incidence of fluid creep.↗
▶Ep 2 · 8:10
clinicalA prospective study by Dietrich showed that colloid use results in statistically less fluid use overall, shorter lengths of stay, and reduced incidence of fluid creep.↗
▶Ep 2 · 8:40
clinicalFluid creep is the phenomenon of giving too much fluid and not accounting for fluid already given, such as previous boluses or miscalculating total volume.↗
▶Ep 2 · 9:00
clinicalFluid overload can lead to respiratory compromise, making the patient difficult to ventilate.↗
▶Ep 2 · 9:10
clinicalIf a patient is adequately fluid resuscitated, controlled diuresis and addition of colloid can help eliminate excess fluid.↗
▶Ep 2 · 9:30
clinicalFoley catheter placement is indicated for patients with extensive burns, multiple trauma, or electrical burns where rhabdomyolysis may occur.↗
▶Ep 2 · 10:00
guidelineAll patients should receive at least a tetanus booster if their vaccination card is not available.↗
▶Ep 2 · 10:15
opinionThe speaker does not give antibiotics until there is a proven infection, as prophylactic use leads to development of resistant organisms.↗
▶Ep 2 · 10:40
clinicalCarbon monoxide levels should be checked in any patient with suspected closed space fire or inhalational injury.↗
▶Ep 2 · 11:00
clinicalPatients with carbon monoxide poisoning will have normal transcutaneous oxygen saturation but low PaO2 on blood gas because all hemoglobin is saturated with carbon monoxide rather than oxygen.↗
▶Ep 2 · 11:40
clinicalPatients with suspected inhalational injury need to be intubated very quickly because once edema sets in, intubation becomes extremely difficult.↗
▶Ep 2 · 12:00
clinicalBronchoscopy is useful in inhalational injury to assess the extent of airway injury and for pulmonary toilet, as patients often shed mucosa and develop casts in their airways.↗
▶Ep 2 · 12:25
clinicalIf a patient with chest burns is desaturating without good chest rise, an escharotomy may be needed with incisions in the anterior axillary lines bilaterally and an oblique chevron incision connecting them.↗
▶Ep 2 · 13:00
clinicalBurns evolve over time, and what initially appears as a superficial burn may progress to partial or full thickness requiring surgical debridement and grafting.↗
▶Ep 2 · 13:20
clinicalWounds should be reassessed every 24 hours for the first 48 hours.↗
▶Ep 2 · 13:40
clinicalResuscitation endpoints must be reached before considering surgical debridement, with urine output as the primary endpoint: 1 cc/kg/hr for children under 30 kg and 0.5 cc/kg/hr for those over 30 kg.↗
▶Ep 2 · 14:10
clinicalHalf of the calculated fluid should be given in the first 8 hours and the remainder over the next 16 hours according to resuscitation protocols.↗
