Can we make an early “do not resuscitate order” decision in severe burn patients?

Abstract

BACKGROUND: The present study was conducted to examine topic of issuing early do-not-resuscitate (DNR) order at first diagnosis of patients with severe burn injuries in light of current law in Turkey and the medical literature. DNR requires withholding cardiopulmonary resuscitation in event of respiratory or cardiac arrest and allowing natural death to occur. It is frequently enacted for terminal cancer patients and elderly patients with irreversible neurological disorders.

Perbandingan R-Baux Score dengan BOBI Score sebagai Prediktor Mortalitas Pasien Luka Bakar di RSUP Dr. M. Djamil Padang

“…2 Salah satu yang dibahas pada penelitian ini adalah sistem skoring R-Baux score dan Belgian Outcome in Burn Injury (BOBI) score karena dinilai lebih sederhana digunakan pada kejadian luka bakar akut dan juga mereka menggunakan parameter yang sama, yaitu usia total body surface area (TBSA) dan ada tidaknya trauma inhalasi, tetapi berbeda di poin skor. [2][3][4] R-Baux score diaplikasikan secara luas di Amerika Serikat, diperkenalkan oleh Osler dkk. karena penggunaannya yang sederhana dengan formula Usia + TBSA + (17XR), R=1 jika ada trauma inhalasi dan R=0 jika tanpa trauma inhalasi.…”

“…Risiko mortalitas bervariasi dari 0-100%. 2 BOBI score mulai dikembangkan pada tahun 2009 (Tabel 1). 6,7 Penelitian ini bertujuan membandingkan sistem skor mana yang paling baik yang akan digunakan pada pasien luka bakar akut di RSUP Dr. M. Djamil Padang.…”

“…Kanamisin dapat menimbulkan efek samping yang berat, yaitu ototoksik, gangguan elektrolit (hipokalemia, hipomagnesemia, hipokalsemia), dan gangguan fungsi ginjal (nefrotoksik). [1][2][3] Ototoksik oleh karena pemberian kanamisin dapat menimbulkan gangguan pendengaran (kokleotoksik) serta gangguan keseimbangan (vestibulotoksik). Kanamisin lebih dominan menyebabkan efek samping kokleotoksik berupa gangguan pendengaran dan atau tinnitus.…”

Do patients, families, and healthcare teams benefit from the integration of palliative care in burn intensive care units? Results from a systematic review with narrative synthesis

“…5 Furthermore, there is still a large proportion of patients admitted to burn intensive care units who die due to the complications associated with their acute condition and who could potentially experience more comfortable and peaceful end of life. 6,7 While making ethically challenging end-of-life decisions related to burned patients, particularly in the context of intensive care, several issues need to be taken into account, namely, the quality of life, potential complications, patients' wishes, and family knowledge of his or her choices. 8 The severity of burn injuries often unable patients to express their autonomy, creating complex situations where important decisions need to be made.…”

“…5 Furthermore, there is still a large proportion of patients admitted to burn intensive care units who die due to the complications associated with their acute condition and who could potentially experience more comfortable and peaceful end of life. 6,7…”