FLUID RESUSCITATION

FLUID RESUSCITATION

As the understanding of ‘fluid shifts’ developed, the intro - duction of fluid resuscitation guidelines greatly improved the survival rates for patients with large burns. Standard guidelines and formulae are taught to emergency department and first - r esponder personnel. Resuscitation fluid should commence from time of burn injury and any delay in commencement must be caught up. Intravenous resuscitation is appropriate for any adult with a b urn greater than 15% TBSA and any child with a burn greater than 10% TBSA. Extremes of age require extra car e: for children, additional maintenance fluid is required; in the - elderly , judicious monitoring is necessary owing to concurrent comorbidities and the inherent physiology of ageing. Depending on resources available, the commencement of intravenous fluid resuscitation approaches 30% TBSA in some countries. If oral resuscitation is necessary then additional salt solutions (such as Dioralyte) are required as hyponatraemia and wa ter intoxication can be fatal. There are three variables in the calculation of fluid require - ments: the percentage of TBSA burned, the weight of the patient and the rate/type of fluid. Fluid loss is maximum in the first 8 hours and slows by 24–36 hours, by which stage normal fluid replacement is r equired. There are three main fluids used in the resuscitation stage: crystalloid (by far the most common), colloid and, in advantages and disadvantages. FLUID RESUSCITATION

As the understanding of ‘fluid shifts’ developed, the intro - duction of fluid resuscitation guidelines greatly improved the survival rates for patients with large burns. Standard guidelines and formulae are taught to emergency department and first - r esponder personnel. Resuscitation fluid should commence from time of burn injury and any delay in commencement must be caught up. Intravenous resuscitation is appropriate for any adult with a b urn greater than 15% TBSA and any child with a burn greater than 10% TBSA. Extremes of age require extra car e: for children, additional maintenance fluid is required; in the - elderly , judicious monitoring is necessary owing to concurrent comorbidities and the inherent physiology of ageing. Depending on resources available, the commencement of intravenous fluid resuscitation approaches 30% TBSA in some countries. If oral resuscitation is necessary then additional salt solutions (such as Dioralyte) are required as hyponatraemia and wa ter intoxication can be fatal. There are three variables in the calculation of fluid require - ments: the percentage of TBSA burned, the weight of the patient and the rate/type of fluid. Fluid loss is maximum in the first 8 hours and slows by 24–36 hours, by which stage normal fluid replacement is r equired. There are three main fluids used in the resuscitation stage: crystalloid (by far the most common), colloid and, in advantages and disadvantages. FLUID RESUSCITATION

As the understanding of ‘fluid shifts’ developed, the intro - duction of fluid resuscitation guidelines greatly improved the survival rates for patients with large burns. Standard guidelines and formulae are taught to emergency department and first - r esponder personnel. Resuscitation fluid should commence from time of burn injury and any delay in commencement must be caught up. Intravenous resuscitation is appropriate for any adult with a b urn greater than 15% TBSA and any child with a burn greater than 10% TBSA. Extremes of age require extra car e: for children, additional maintenance fluid is required; in the - elderly , judicious monitoring is necessary owing to concurrent comorbidities and the inherent physiology of ageing. Depending on resources available, the commencement of intravenous fluid resuscitation approaches 30% TBSA in some countries. If oral resuscitation is necessary then additional salt solutions (such as Dioralyte) are required as hyponatraemia and wa ter intoxication can be fatal. There are three variables in the calculation of fluid require - ments: the percentage of TBSA burned, the weight of the patient and the rate/type of fluid. Fluid loss is maximum in the first 8 hours and slows by 24–36 hours, by which stage normal fluid replacement is r equired. There are three main fluids used in the resuscitation stage: crystalloid (by far the most common), colloid and, in advantages and disadvantages.