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Surgery General 04ec7a04

Which of the following is true about burn management?

A
Intravenous access fluid is done and antibiotics is not given in children
B
Escharotomy should be done for peripheral circumscribed lesion
C
Moist dressing is done
D
Parkland formula is used with 8m1/kg body wt
High-Yield Explanation
Ans. is 'b' i.e. Escharotomy should be done for peripheral circumscribed lesion Option 'd' The primary goal of fluid management is to ensure end-organ perfusion by replacing fluid that is sequestered as a result of thermal injury. A major concept in understanding burn shock is that massive fluid shift occurs even though total body water initially remains unchanged. The volume in each fluid compament changes. Intracellular & interstitial volume increases at the expense of intravascular volume due to increased vascular permeability. Multiple resuscitation formulas, employing various solutions and rate of administration are used. These formulae are used for initial management after burn. The response is monitored tthrough urine output a justments made acc or in For burned children, formulae have to be modified as a child with a comparable burn to that of an adult requires more resucitation fluid per kilogram. Another modification for burned children is addition of glucose based maintenance fluid or else profound hypoglycemia will ensue owing to minimal glycogen reserve. Option 'a' Antibiotics (Topical) are definitely helpful in burn pt. irrespective of age. Option 'b' Escharotomy is done for a circumferential eschar, on an extremity (as development of edema beneath a nonyielding eschar can produce significant vascular compromise that, if left unrecognized and untreated, will lead to permanent, serious neuromuscular & vascular deficits.) a constricting truncal eschar (a circumferential chest wall eschar can impair ventilation by limiting chest wall excursion.)

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