Coloid resuscitation for burns - Forum

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Coloid resuscitation for burns - Ärzteforum

Post#1 »

However, we do not have guidelines out for burns-it is not an area anyone feels to have any major issues or controversies. Which brings me to this question-why are you still using coloid resuscitation for burns?? That was pretty much abolished over 10 years ago--all you should be using is crystalloid-Basil Pruitt's group wrote a paper admitting that their old formula using half colloid and half crystalloid should be abandoned and only crystalloid used, which is of course what the Parkland formula had stated for decades before. This is in the textbooks now.


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Re: Coloid resuscitation for burns - Ärzteforum

Post#2 »

However, the last lecture I heard Basil Pruitt give (within past 2 years) said you should still use colloid in kids, I think starting the second day. Actually, I think he may have said use colloid on everyone the second day.

Hans

Re: Coloid resuscitation for burns - Ärzteforum

Post#3 »

I am no authority on burns and therefore have tended to follow the formulas used locally in the Red Cross hospital. These use colloid from day one for kids and for day 2 only for adults. Burns in children are a bit different mainly due to the body surface to volume ratio and whilst colloid resus seems pass in most cases paediatric burns may represent a special case. Either way I am reluctant to change unless there is good support from a well worked out regime.

I would be grateful for any input from those used to managing major burns on a regular basis. I did discuss with Baragwanath but they seemed to have a horribly complicated regimen which would be totally inappropriate for my hospital.

Hans

Re: Coloid resuscitation for burns - Ärzteforum

Post#4 »

regarding CT and free fluid in post trauma patients, this study is all very well if we want radiologists to decide what we do , but in the absence of a clinical assessment on the same patients its pretty useless. What I would like to know is a) does it save unnecessary laparotomies, and b) does it spot injuries that would otherwise have been missed on clinical exam - at least for a period of time that would compromise the patients subsequent clinical progress. In addition c)how does it compare with other techniques that can be done at the bedside. We all know that in American hospitals patients enter via the CT scanner hole, but it usually takes quite a time to drag a patient down to CT scanner, heave him onto the table, monitor him while your doing all this etc etc.

It seems a nice study for remunerative radiology but useless for the surgeon As regards piles, I wasn't clear just how the haemorrhoids were excised, and what was this about skin bridge reconstruction. Could I trouble my more knowledgeable colleagues for some additional words of explanation.

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