Toussaint Jimmy, Singer Adam J
Department of Emergency Medicine, Stony Brook University, Stony Brook, NY, USA.
Clin Exp Emerg Med. 2014 Sep 30;1(1):8-18. doi: 10.15441/ceem.14.029. eCollection 2014 Sep.
Burns are among the most common injuries presenting to the emergency department. While burns, especially large ones, may be associated with significant morbidity and mortality, most are minor and can be managed by emergency practitioners and discharged home with close follow-up. In contrast, patients with large burns require aggressive management of their airway, breathing and circulation in order to reduce mortality and morbidity. While early endotracheal intubation of patients with actual or impending airway compromise and aggressive fluid resuscitation have been emphasized, it appears that the pendulum may have swung a bit too far towards the extreme. The current review will briefly cover the epidemiology, pathogenesis and diagnosis of burn injuries with greater emphasis on airway and fluid management. We will also discuss the local management of the burn wound, which is all that is required for most burn patients in the emergency department.
烧伤是急诊科最常见的损伤之一。虽然烧伤,尤其是大面积烧伤,可能会导致严重的发病率和死亡率,但大多数烧伤程度较轻,可由急诊科医生处理,并在密切随访下出院回家。相比之下,大面积烧伤患者需要积极处理气道、呼吸和循环问题,以降低死亡率和发病率。虽然已经强调了对实际或即将出现气道受损的患者进行早期气管插管以及积极的液体复苏,但现在看来可能有些矫枉过正了。本综述将简要介绍烧伤的流行病学、发病机制和诊断,重点是气道和液体管理。我们还将讨论烧伤创面的局部处理,这是急诊科大多数烧伤患者所需的全部治疗。