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Burns (fire/flame)

Date Last Search Run: Jan 14, 2025
Table last updated: May 02, 2021
Data last added: Mar 31, 2021

Recommendation RECOMMENDATION FOR INTERVENTION
STRENGTH OF EVIDENCE FOR INTERVENTION   SUPPORTIVE (Green) NEUTRAL (Yellow) AGAINST (Red) NOT YET GRADED (White)
1 (strong evidence exists)  
2 (fair evidence exists)  
3 (weak evidence exists)      


Interventions

Balanced crystalloids
Level Direction Primary Outcome Patient/Process Setting Reference

Crystalloid Fluid
Level Direction Primary Outcome Patient/Process Setting Reference
I Neutral (Yellow) Mortality Patient ICU Lewis SR, Pritchard MW, Evans DJ, Butler AR, Alderson P, Smith AF, et al. Colloids versus crystalloids for fluid resuscitation in critically ill people. The Cochrane database of systematic reviews 2018; 8. Medline
III Supportive (Green) Dyspnoea clinical score and on arterial blood gases Process ED-MD Bak V., et al. Hemodynamic Changes During Resus Burn Pt. Using Parkland Formula. J. Trauma 2009; 66(2):329-36. Medline
X Not Yet Graded (White) - Josuttis D, Kruse M, Plettig P, et al. Prehospital treatment of severely burned patients: a retrospective analysis of patients admitted to the Berlin burn centre. Scand J Trauma Resusc Emerg Med Aug 2024; 32(1):70. Medline

Dry Dressing
Level Direction Primary Outcome Patient/Process Setting Reference

Narcotic
Level Direction Primary Outcome Patient/Process Setting Reference
I Supportive (Green) Analgesia Patient PH-Paramedic Bounes V., Charpentier S., Houze-Cerfon CH., Bellard C., Ducassé JL. Is there an ideal morphine dose for prehospital treatment of severe acute pain? A randomized, double-blind comparison of 2 doses. Am J Emerg Med 2008; 26(2):148-54. Medline
I Supportive (Green) Pain relief using the visual analog scale score Patient PH-Paramedic Galinski M., et al. A randomized double-blind study comparing morphine with fentanyl in prehospital analgesia. Am J Emerg Med 2005; 23:114-9. Medline
II Supportive (Green) Analgesia Patient PH-Paramedic Ricard-Hibon A., et al. Compliance with a morphine protocol and effect on pain relief in out-of-hospital patients. J Emerg Med 2008; 34:305-10. Medline
X Not Yet Graded (White) - Coletta F, Pirolli R, Annunziata R, et al. Efficacy and Adverse Effects of IV Morphine for Burn Pain Management in the Emergency Department: An Observational Study. Pain Ther May 2024. Medline

Nitrous Oxide
Level Direction Primary Outcome Patient/Process Setting Reference
II Supportive (Green) Analgesia Patient PH-Paramedic McKinnon KDL. Prehospital analgesia with nitrous oxide/oxygen. CMA Journal 1981; 125:836-40. Medline
III Supportive (Green) Pain relief Patient PH-Paramedic Amey BD., Ballinger JA., Harrison EE. Prehospital Administration of Nitrous Oxide for Control of Pain. Ann Emerg Med 1981; 10(5):247-51. Medline
III Supportive (Green) Patient satisfaction Patient PH-Paramedic Johnson JC., Atherton Gl. Effectiveness of Nitrous Oxide in a rural EMS System. The Journal of Emergency Medicine 1991; 9:45-53. Medline
III Supportive (Green) Analgesia Patient PH-Paramedic Peterson TD., Kerns DE. Prehospital Pain Control: Nitrous Oxide Inhalation. Iowa Medicine 1989; 15-7. Medline

Wet/hydrogel dressing
Level Direction Primary Outcome Patient/Process Setting Reference
II Neutral (Yellow) Clinical effectiveness Patient PH-Paramedic Goodwin NS, Spinks A, Wasiak J. The efficacy of hydrogel dressings as a first aid measure for burn wound management in the pre-hospital setting: a systematic review of the literature. International wound J 2016; 13(4) 519-25. Medline


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