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.

Leclerc, Thomas, Potokar, Tom, Hughes, Amy, Norton, Ian, Alexandru, Calin, Haik, Josef, Moiemen, Naiem and Almeland, Stian Kreken (2021) 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 : journal of the International Society for Burn Injuries. ISSN 1879-1409.

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Official URL: http://www.journals.elsevier.com/burns/

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 2-4 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 20-25% and the 50-60% 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 Type: Article
Subjects: WA Patients. Primary care. Medical profession. Forensic medicine
WR Skin. Dermatology
Divisions: Emergency Services > Acute Medicine and AMU
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Depositing User: Jamie Edgar
Date Deposited: 25 Mar 2021 12:48
Last Modified: 25 Mar 2021 12:48
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4120

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