title: Burn resuscitation on the African continent.
abstract: A survey of members of the International Society of Burn Injuries (ISBI) and the American Burn Association (ABA) indicated that although there was difference in burn resuscitation protocols, they all fulfilled their functions. This study presents the findings of the same survey replicated in Africa, the only continent not included in the original survey. One hundred and eight responses were received. The mean annual number of admissions per unit was ninety-eight. Fluid resuscitation was usually initiated with total body surface area burns of either more than ten or more than fifteen percent. Twenty-six respondents made use of enteral resuscitation. The preferred resuscitation formula was the Parkland formula, and Ringer's Lactate was the favoured intravenous fluid. Despite satisfaction with the formula, many respondents believed that patients received volumes that differed from that predicted. Urine output was the principle guide to adequate resuscitation, with only twenty-one using the evolving clinical picture and thirty using invasive monitoring methods. Only fifty-one respondents replied to the question relating to the method of adjusting resuscitation. While colloids are not available in many parts of the African continent on account of cost, one might infer than African burn surgeons make better use of enteral resuscitation.
authors.affiliation: Emeritus Professor of Paediatric Surgery, Division of Paediatric Surgery, Red Cross War Memorial Children's Hospitals and the University of Cape Town, Cape Town, South Africa.
authors.forename: H
authors.initials: H
authors.lastname: Rode
authors.affiliation: Registrar, Division of Plastic, Reconstructive and Maxillofacial Surgery, Groote Schuur and Red Cross War Memorial Children's Hospitals and the University of Cape Town, Cape Town, South Africa. Electronic address: rogersadr@gmail.com.
authors.forename: A D
authors.initials: AD
authors.lastname: Rogers
authors.affiliation: Consultant Paediatric Surgeon, Division of Paediatric Surgery, Red Cross War Memorial Children's Hospitals and the University of Cape Town, Cape Town, South Africa.
authors.forename: S G
authors.initials: SG
authors.lastname: Cox
authors.affiliation: Consultant General Surgeon, Departments of General Surgery and Critical Care Medicine, Nelson R. Mandela School of Medicine, University of Kwazulu Natal, Durban, South Africa.
authors.forename: N L
authors.initials: NL
authors.lastname: Allorto
authors.affiliation: Final Year Medical Student, Universitá degli studi di Milano, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Stefani
authors.affiliation: Final Year Medical Student, Universitá degli studi di Milano, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bosco
authors.affiliation: Professor and Chief of Burns, Department of Surgery, University of California at Davis, Firefighter's Burn Institute Regional Burn Center, Sacramento, California, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Greenhalgh
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000349:Africa; D001830:Body Surface Area; D002056:Burns / Q000628:therapy*; D002648:Child; D002985:Clinical Protocols; D003102:Colloids; D003906:Developing Countries; D005440:Fluid Therapy / Q000379:methods* / Q000592:standards; D006801:Humans; D006982:Hypertonic Solutions / Q000627:therapeutic use; D007262:Infusions, Intravenous; D007552:Isotonic Solutions / Q000627:therapeutic use; D010949:Plasma; D000077325:Ringer's Lactate; D012996:Solutions; D013943:Thymol / Q000627:therapeutic use
chemical_list: D003102:Colloids; C007905:Hartman's solution; D006982:Hypertonic Solutions; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D012996:Solutions; D013943:Thymol
keywords: Africa; Developing countries; Enteral resuscitation; Fluid resuscitation; Parkland formula; Resuscitation in burns