Internally Peer Reviewed At the definitive treatment facility, control of hemorrhage and airway adequacy again must be insured. Initial consideration of the burn patient includes a complete physical examination following removal of the patient's clothing Once a secure intravenous pathway has been established, one then must estimate the resuscitation fluids to be given to the burned patient.
Several formulas exist for calculation of the fluid requirement of the burn patient.
They are based upon body weight and extent of the burn. Clinical success has been reported for each such formula and, in a civilian setting with unlimited amounts of the full spectrum of intravenous fluids available, the attending physician's preference can certainly dictate the resuscitation regimen employed. In a combat situation, logistical considerations speak strongly for simplicity of resuscitation using readily available fluids in a volume sufficient to prevent renal or other organ failure, yet avoid later complications of fluid overload. The formula, which is detailed in Table 2, should be modified according to the individual patient's response in terms of urinary output, vital signs, and general condition. One should plan to administer one-half of the total fluid volume estimated for the first 24 hours postburn within the first 8 hours following injury, the time of most rapid edema formation.