Publication Date: February 2018 (Volume 20, Number 2)
CME Credits: 4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. CME expires 2/1/2021
Specialty CME Credits:: Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME and 0.5 Pharmacology CME credits, subject to your state and institutional approval.
Authors
A 35-year-old chef presents to the ED after burning his right hand on a cooking surface at work. His vital signs are normal and his hand is blistered over half of the palmar surface. You place a nursing order for pain medication and a tetanus booster. As you leave the bedside, you try to recall whether he should be referred to a burn center and whether there are any evidence-based guidelines to help you select a dressing…
As you put down his chart, the nurse calls you to the resuscitation bay for a 22-year-old woman brought in by EMS from a house fire. Paramedics report that she required extrication from the collapsed house. She is minimally responsive, with soot visible in her oropharynx and extensive burns to her abdomen, back, and right upper extremity. Her vital signs are: temperature, 37.5°C (99.5°F); heart rate, 140 beats/min; blood pressure, 85/40 mm Hg; respiratory rate, 35 breaths/min; and oxygen saturation, 88% on room air. As you prepare to intubate her and start IV fluid resuscitation for her hypotension, you wonder which resuscitation fluid you should select and how to best monitor the patient’s response. You wonder whether anything other than her extensive burns may be causing her hypotension and altered mental status…