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emDOCs Podcast – Episode 103: Thermal Burn Injury

EMDocs

Today on the emDOCs cast with Brit Long, MD ( @long_brit) , we cover the evaluation and management of the patient with a burn injury. Episode 103: Thermal Burn Injury Initial evaluation of thermal burns Range of burn severities and types: minor sunburns to full thickness burns and severe inhalation injury.

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Electrical injuries

Don't Forget the Bubbles

Up to 5% of burns occur secondary to electrical injuries, and this rises to 27% in developing countries. Significant injuries can occur even in the absence of extensive burns or other signs of external injury. Children, especially toddlers, may insert objects into outlets, leading to shocks or burns.

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Don’t Forget About the IO in the Critically Ill Patient

RebelEM

Critically ill patients requiring resuscitation often present with many challenges including the ability to secure safe, sterile, fast, and reliable intravenous (IV) access. This can often lead to significant delays in proper resuscitation. Studies reviewed landmark-based CVC compared to IO; using IJ, subclavian, and femoral CVC sites.

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Beyond the Burns: Toxic House Fire Gases

Northwestern EM Blog

More modest lactic acid elevations are less likely to be related to cyanide poisoning and should not prompt intervention, especially in an asymptomatic patient, unless the level is persistently elevated despite adequate resuscitation.

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Case Report: a High-Voltage Victim

ACEP Now

Per EMS, the patient was found at the bottom of a high voltage line with diffuse burns and amputation of his left forearm. FIGURE 1: Electrical burns of the patient’s bilateral feet. FIGURE 2: Traumatic amputation and electrical burn of the patient’s left arm. He was intubated by EMS due to the extent of his injuries.

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Therapeutics: Pacing Through Skin and Vein

Taming the SRU

Skin burns and irritation can also result from the pacing pads and cause pain. Resuscitation , Volume 181,2022,Pages 140-146,ISSN 0300-9572, [link] Scott Weingart, MD FCCM. AP placement was proven to be capture at a lower current than the AL placement in the same patients, thus more effective. [5] Bektas, Firat, and Secgin Soyuncu.

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Diagnostics and Therapeutics: Vascular Access in the Emergency Department

Taming the SRU

Establishing reliable vascular access is absolutely critical for ED patients requiring resuscitation, airway management, or medication administration. Contraindications for USGIV are the same as for any PIV: overlying skin infection, AV fistula in the extremity, previous surgery impacting vasculature, proximal trauma, or burns.