Wachtel T L
Trauma Services, Good Samaritan Medical Center, Phoenix, Arizona.
Crit Care Clin. 1985 Mar;1(1):3-26.
The care of major burn injuries is a critical care endeavor from the initial evaluation and admission until the patient is discharged from the burn intensive care unit. A thorough history and physical examination are essential and require expertise to classify each burn injury. The initial treatment of the burn must address stopping the burning process, insuring a patient airway, assessing inhalation injury, initiation of adequate fluid and electrolyte resuscitation, appropriate wound care, and institution of ancillary care, such as insertion of nasogastric tubes and urinary catheters, narcotic dosage, tetanus prophylaxis, laboratory studies, and environmental temperature control. Critical care units must be designed, equipped, and staffed to facilitate the safe and effective care of burned patients. A well trained and experienced multidisciplinary burn team under the direction of a surgeon who specializes in burns is essential to the ultimate outcome of the seriously burned patient. Effective communication among the burn team and with the burned patients requires formal protocols for general treatment as well as dynamic individualized care based on careful comprehensive observations and monitoring. The prognosis for these critically injured and ill patients depends on attention to every detail of their care, which can only be accomplished in a sophisticated critical care atmosphere with personnel skilled in intensive care techniques.
从最初的评估和入院到患者从烧伤重症监护病房出院，严重烧伤的护理是一项重症监护工作。全面的病史和体格检查至关重要，且需要专业知识来对每例烧伤进行分类。烧伤的初始治疗必须包括停止烧伤过程、确保患者气道通畅、评估吸入性损伤、开始充分的液体和电解质复苏、适当的伤口护理以及实施辅助护理，如插入鼻胃管和尿管、给予麻醉剂量、预防破伤风、进行实验室检查以及控制环境温度。重症监护病房的设计、设备配备和人员配置必须便于对烧伤患者进行安全有效的护理。在专门从事烧伤治疗的外科医生的指导下，一支训练有素、经验丰富的多学科烧伤团队对于严重烧伤患者的最终治疗结果至关重要。烧伤团队之间以及与烧伤患者之间的有效沟通需要通用治疗的正式方案以及基于仔细全面观察和监测的动态个性化护理。这些重伤和重病患者的预后取决于对其护理每个细节的关注，而这只有在具备熟练掌握重症监护技术人员的先进重症监护环境中才能实现。
