Accidental spill of Boiling Water

PDA Clinician @ Large
by Grant E. Fraser, MD

This last week, accepting 2 burn patients within a few minutes of another, from a tragedy of accidental spill of boiling water onto both mother and baby; the challenge of calculating %BSA burns on both the 6 week old and the 25 year old mother presents.

My role as part of the team was to make these calculations while others worked on IV lines, pain control and other immediate needs.

The complexity of performing a good assessment of %BSA burns is fortunately nicely addressed in the Fluid Wizard Module in ER Suite. What I found to be most convenient was the ability to select the age (as each body area makes up different % based upon age) and then simply go from head to toe marking down my estimate of what % of each particular body part was burned. I then was able to go to my medical chart and copy from my PDA, the % I designated from each body area. As body areas and percentages are selected, %BSA burned is automatically updated in the calculator results.

Performing this task manually would have been much more stressful, but also much more prone to error.

Now that I had a truly accurate assessment of the %BSA burned, I was then able to select Burn Fluids under this same section and easily get recommended initial IV fluids to be administered for both patients.

This was a great example, in my practice of how a PDA based tool allowed not only for less stress in the workplace, but also provided a more accurate assessment and documentation than would have been typical otherwise.