Lesson 263: PreAnesthetic Assessment of the Patient with Burn Injuries (Part 2)

Course Authors:

Srinand Mandyam, MD Resident, The University of Texas Health Science Center, Houston, Texas

Amir Baluch, MD Resident, Jackson Memorial Hospital/University of Miami, Miami, Florida

Reviewed by:

Alan Kaye, MD, PhD Professor and Chairman, Department of Anesthesiology, School of Medicine at Louisiana State University Health Sciences Center, New Orleans, Louisiana

Review Date: January, 2007

Registration Fee: $15.00
2.0 AMA PRA Category 1 CreditsTM
available until
May 31, 2008

Please be sure to read registration information below.

 

Registration links are at the bottom of the page.

 

NEEDS STATEMENT

Burns destroy the skin, the largest organ in the body, which is responsible for thermal regulation, fluid and electrolyte homeostasis, and protection against infections. Burns are the only type of trauma that can be quantified as an exact percentage of damaged tissue. Burns also cause injuries to multiple organ systems that require the attention of a multidisciplinary team of specialists—including anesthesiologists—to ensure a good outcome. Patients with thermal injuries are frequently admitted to the emergency room and operating room; care of the patient with burns has been identified by committee as essential information for the anesthesiologist.

     
CASE HISTORY

A 19-year-old man weighing 84 kg is scheduled for excision and débridement of his arms, neck, chest, and shoulders after a car explosion 5 weeks earlier in which 65% of his body was burned. He has undergone 4 previous surgeries—2 for leg fractures and 2 for débridement and skin grafting—during his stay in the burn ICU. He has also had an episode of pneumonia; electrolyte abnormalities (including hypokalemia and hypophosphatemia), which have been corrected; and multiple infections.

Part 1 of this 2-part lesson, which was published last month in Anesthesiology News [33(4):53-58], dealt with the initial resuscitation and assessment of the burned patient. Part 2 outlines the management of anesthesia and pain in the patient with burn injuries.

   

LEARNING OBJECTIVES

At the end of this activity, the participant should be able to:

  1. Discuss the epidemiology of severe burns.

  2. Define the different degrees of burn injuries.

  3. Identify causative factors related to burn injuries.

  4. Explain the pathophysiology of burns.

  5. Outline the initial management of a burn injury.

  6. Discuss the anesthetic considerations in the management of the patient with burns.

  7. Identify current and novel therapies.

  8. Plan the means to establish the airway in a burned patient.

  9. Review the pharmacologic implications.

  10. Present an analgesic plan.

TARGET AUDIENCE:  Anesthesiologists

INSTRUCTIONS FOR COMPLETING THIS COURSE

The estimated time to complete this activity is 2 hours. There are two options for completing this CME activity.

Option 1: Exam Only.  This option can only be exercised by subscribers to Anesthesiology News who possess a material copy of the course.  Participants who select this option must read the article in the journal, reflect on the information presented, and then register to complete the exam and course evaluation online before May 31, 2008. (CME credit is not valid past this date.)  

To register for the exam only, click on the Register For Exam link located at the bottom of this page. DO NOT select this option if you do not possess a material copy of the CME course material.

There are ten questions in the examination and you must achieve a score of 80% or better to earn CME credit.  Following successful completion, your certificate will be immediately available online.  In addition, a historical record of  completed CME courses is maintained online in an individualized profile.  This includes copies of course certificates which can be printed at any time.

Option 2: Course Material and Exam.  All participants are eligible for this option.

You must first register for this course by clicking the "Register for Course" link located at the bottom of this page.  Course material is presented in small digestible sections followed by exam questions pertaining to the information in the segment covered.  As you read through the material on the course pages, you will occasionally be prompted to answer exam questions. 

There are several short pages of information and 10 multiple choice questions presented in this course.  You must achieve a minimum grade of 80% (8 correct answers) to receive CME credit. The exam and course evaluation must be completed before May 31, 2008. (CME credit is not valid past this date.)  

The course software does not permit you to page back from the exam questions.  You must be sure that you understand the material presented on each page before proceeding.

When you have answered the last exam question, the Course Results page will display. This page will contain your final grade and allow you to immediately view/print your Certificate if you have achieved the minimum passing score of 80%. 

Upon successful completion, your Certificate will be available at all times from your Student Control Panel.   In addition, a historical record of  completed CME courses is maintained online in an individualized profile.  This includes copies of course certificates which can be printed at any time.

The course does not need to be completed in a single online session. You can log off at any point and return to the course at your convenience.  If you wish to obtain more information regarding the features of this site, you may visit the Orientation page.  Click here to view Orientation.

REGISTRATION

The registration fee for this course is $15.00

Physicians are provided with two opportunities to complete the course presented here. 

Accreditation Statement

Mount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Credit Designation: The Mount Sinai School of Medicine designates each educational activity for a maximum of 2 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

It is the policy of Mount Sinai School of Medicine to ensure objectivity, balance, independence, and scientific rigor in all CME-sponsored educational activities. All faculty participating in the planning or implementation of a sponsored activity are expected to disclose to the audience any relevant financial relationships and to assist in resolving any conflict of interest that may arise from the relationship. Presenters must also make a meaningful disclosure to the audience of their discussions of unlabeled or unapproved drugs or devices.

Dr. Kaye has disclosed that he is a member of the speakers’ bureau of Baxter. The authors and editor have no relationships with pharmaceutical companies or manufacturers of products to disclose. This educational activity may contain discussion of published and/or investigational uses of agents for the treatment of disease. Some uses of these agents have not been approved by the FDA. Please refer to the official prescribing information for each product for approved indications, contraindications, and warnings.

CONTACT INFORMATION

Questions regarding course content may be directed to Dr. Elizabeth Frost: ElzFrost@aol.com.

If you require technical assistance with completing this course, please contact Continuing Education Online Customer Service at 718-648-8080 or send e-mail to CEO.support6@proceo.com.

All other requests for administrative assistance should be directed to Josephine Greene in the CME office at the Mount Sinai School of Medicine : 212-241-4441 or send email to Josephine.Greene@msnyuhealth.org

CALL FOR WRITERS

If you would like to write a CME lesson in Anesthesiology News, please send an e-mail to Elizabeth A.M. Frost, MD, at ElzFrost@aol.com

Click Here to REGISTER FOR
EXAM ONLY

This option is for the examination ONLY.  No course material is provided. This option is available for subscribers of Anesthesiology News who possess a material copy of the course material.  DO NOT select this option if you do not have the course material.

Click Here to REGISTER FOR COURSE AND EXAM

This option is available for all participants. This option includes a full online text version of the course material and exam.