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A simplified fluid resuscitation formula for burns in mass casualty scenarios: Analysis of the consensus recommendation from the WHO Emergency Medical Teams Technical Working Group on Burns

Citation

Leclerc, T and Potokar, T and Hughes, A and Norton, I and Alexandru, C and Haik, J and Moiemen, N and Almeland, SK, A simplified fluid resuscitation formula for burns in mass casualty scenarios: Analysis of the consensus recommendation from the WHO Emergency Medical Teams Technical Working Group on Burns, Burns pp. 1-9. ISSN 0305-4179 (2021) [Refereed Article]


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Copyright 2021 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0) https://creativecommons.org/licenses/by/4.0/

DOI: doi:10.1016/j.burns.2021.02.022

Abstract

Background: Burn fluid resuscitation guidelines have not specifically addressed mass casualty with resource limited situations, except for oral rehydration for burns below 40% total body surface area (TBSA). The World Health Organization Technical Working Group on Burns (TWGB) recommends an initial fluid rate of 100 mL/kg/24 h, either orally or intravenously, beyond 20% TBSA burned. We aimed to compare this formula with current guidelines.

Methods: The TWGB formula was numerically compared with 24 mL/kg/%TBSA for adults and the Galveston formula for children.

Results: In adults, the TWGB formula estimated fluid volumes within the range of current guidelines for burns between 25 and 50% TBSA, and a maximal 20 mL/kg/24 h difference in the 2025% and the 5060% TBSA ranges. In children, estimated resuscitation volumes between 20 and 60% TBSA approximated estimations by the Galveston formula, but only partially compensated for maintenance fluids. Beyond 60% TBSA, the TWGB formula underestimated fluid to be given in all age groups.

Conclusion: The TWGB formula for mass burn casualties may enable appropriate fluid resuscitation for most salvageable burned patients in disasters. This simple formula is easy to implement. It should simplify patient management including transfers, reduce the risk of early complications, and thereby optimize disaster response, provided that tailored resuscitation is given whenever specialized care becomes available.

Item Details

Item Type:Refereed Article
Keywords:mass casualty, burns
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Emergency medicine
Objective Division:Health
Objective Group:Provision of health and support services
Objective Field:Urgent and critical care, and emergency medicine
UTAS Author:Haik, J (Professor Josef Haik)
ID Code:146696
Year Published:2021
Web of Science® Times Cited:4
Deposited By:Nursing
Deposited On:2021-09-22
Last Modified:2021-11-24
Downloads:1 View Download Statistics

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