Management of acute-phase burn patients in emergency department

Abstract

In this review, we discuss the management of burn patients in the emergency room. Burn injury is characterized by a hypermetabolic response with physiological, catabolic and immune effects. The treatment of burns requires a multidisciplinary approach and a proper management able to reduce both the damage and the risk of infections. The management of a burn patient begins with a primary evaluation: i) maintaining a high index of suspicion for the presence of airway compromise following smoke inhalation and secondary to burn edema; ii) identifying and managing associated mechanical injuries; maintaining hemodynamic normality with volume resuscitation; iii) controlling temperature; iv) removing the patient from the injurious environment. Secondary evaluation holds fundamental importance and is carried out through the head-to-foot objective examination and diagnostic investigations as well as the wound dressing. Clinicians also must take measures to prevent and treat the potential complications of specific burn injuries (e.g., compartment syndromes). The role of this article is to highlight some quick and effective guidelines for the management of burn patients in the early stages, within the emergency room, before the transfer to the burn unit.