Case of the Month #46 A Major Burn Injury: Taming the Flames

Published 13/02/2024

Take home messages

  • Major burns are a complex multisystem illness, which require comprehensive care and good multidisciplinary working to manage 

  • Anticipate difficult airway management when intubating, and leave ET tubes uncut 

  • Use the Parkland formula to guide initial fluid resuscitation, and then adjust based on clinical & biochemical endpoints 

  • Escharotomies (if required), early debridement and skin grafting are the major surgical interventions required 

  • Patients with burn injuries are at high risk of infections, which are difficult to diagnose, and extra vigilance is required 

  • The hyperinflammatory state in burns creates a catabolic state requiring high levels of nutrition, and potentially adjunctive treatment 

  • Multimodal analgesia, tailored to the individual patient, is invariably required