(Featured image: Author: Goga312 via Wikimedia Commons)
I’m entering a few months prep for the UK and Ireland exit exam in Emergency Medicine: the FRCEM. I’ll be adding lots of little notes on pearls I’ve learned along the way. A lot of my revision is based around the Handbook of EM as a curriculum guide and review of contemporary, mainly UK guidelines. I also focus on the areas that I’m a bit sketchy on. With that in mind I hope they’re useful.
You can find more things on the FRCEM on this site here.
- Parkland = 4ml/kg/%BSA
- Give this in the first 24 hrs with half in the first 8 hours
- urine output used as your guide (you’re allowed to increase your rate of fluid if wee wee has tailed off)
- remember (at least for kids as per APLS) this is in addition to their normal maintenance fluid)
Burns Service Referral Guidelines (from British Burn Association 2012 Guidance. Note by “service” this could be as simple as refer to your local plastics team who do a bit of burns, not a mandated transfer to a centre. See the guidelines for what constitutes referral to a burns “unit” and a burns “centre”)
- Minimum Criteria
- All burns ≥2% TBSA in children or ≥3% in adults
- All full thickness burns
- All circumferential burns
- Any burn not healed in 2 weeks
- Any burn with suspicion of non-accidental injury should be referred to a Burn Unit/Centre for expert assessment within 24 hours
- Suspicion of Toxic Shock Syndrome (obviously not a burn but something they want to see)
- Discuss and consider
- All burns to hands, feet, face, perineum or genitalia
- Any chemical, electrical or friction burn
- Any cold injury
- Any unwell/febrile child with a burn
- Any concerns regarding burn injuries and co-morbidities that may affect treatment or healing of the burn