Guidelines for fluid resuscitation in adult burn patients were developed using ABA recommendations and literature. The study purpose was to determine if implementing guidelines would decrease burn related morbidity and mortality.

  Methods

A retrospective chart review was done including adult burn patients admitted between 08/01/02 and 04/01/03 (pre-guideline) and 05/01/03 and 08/31/04 (post-guideline) with >15% TBSA burns. There were 13 patients who met this criteria in the pre-guideline period and 36 patients in the post guideline period.  Data elements collected included: %TBSA burned, time of burn, IV fluids administered per hour, emergency department arrival time, time admitted to burn unit/floor, weight, heart rate, blood pressure, urine output, invasive monitoring, colloid use, intubation, escharotomy, decompressive laparotomy, burn conversion and mortality. Late intubation, late escharotomy, decompressive laparotomy, and mortality were used as quality control indicators for the guideline.

  Results

# >150% Parkland fluids given at 12hrs

*36 subjects met criteria, significant data was unavailable for 2 

  Conclusions

Implementation of the guidelines resulted in significant reduction in burn related morbidity and mortality. Adjustments in the burn unit compensated for variable fluid resuscitation administered in the pre-hospital and emergency department settings. Attention to the fluid resuscitation process appears to improve burn outcomes.