Management of Burns in Intensive and Acute Care

Summary of the Article

The article by Rowley-Conwy (2013) deals with the topic of providing medical care for patients with burns. The author discusses such aspects as respiratory, cardiovascular, and renal care, pain management, and the management of the wound itself at different levels of burn severity; the issues of nutrition and psychological aid are also addressed (Rowley-Conwy, 2013). Recommendations pertaining to care that are based on a review of research literature are provided for each of these separate aspects (Rowley-Conwy, 2013).

Type of Study

The article is not a report of a single study or a metastudy, but a practical guide to burn management that is based on a literature review; the author summarizes the findings of other researchers in order to provide guidelines for nurses who may face the need to supply care for patients with burns (Rowley-Conwy, 2013).

The level of evidence in this article may be stated to be D; the article is published in a peer-reviewed journal “Nursing Standard,” and uses clinical studies to support the given advice. However, it also has certain features of an integrative review, which is level C evidence.

The Target Audience of the Article

The abstract of the article mentions general nurses, and that they need to understand the needs of the patients with burns (Rowley-Conwy, 2013, p. 63); therefore, it is apparent that the intended audience of the article is general nurses, who may have to care for such patients. On the other hand, the provided recommendations are rather basic, and would not be sufficient for medics specializing in burn care. Nursing or medical students, however, may find the article useful. The audience of the article is not limited to the USA; it could be utilized by health care specialists regardless of where they are.

Easiness of Understanding

The information given by Rowley-Conwy (2013) was not difficult to understand, for the author provides explanations of and justifications for recommended methods of care and management. However, the article contains a number of medical terms, which might make its comprehension somewhat difficult for one who is a beginning student of nursing or medicine. Also, the author sometimes refers to generally accepted principles or procedures without naming them (Rowley-Conwy, 2013), which requires certain background knowledge from the readers as well.

Some Facts Learned from the Article

The article supplies numerous facts that can be useful for a nurse who needs to care for a patient with burns. For the author of this paper, it was known that lack of adequate liquid resuscitation causes a dearth of blood supply to a number of organs such as kidneys and skin; however, it was interesting to learn that excessive resuscitation of liquid may cause myocardial problems by inducing hypoxia of tissues due to oedema resulting from excessive fluid supply (Rowley-Conwy, 2013, p. 64).

Another new fact was that patients with high-voltage electrical injury can develop kidney problems (namely, tubular necrosis), for “large myoglobin molecules released after such an injury can damage the delicate renal tubules” (Rowley-Conwy, 2013, p. 64). It was also not known to the author of this paper that patients with burns often report poor pain management, which is due to the absence of corresponding universally accepted guidelines (Rowley-Conwy, 2013, p. 64).

Using the Information in the Clinical Practice

The information provided by Rowley-Conwy (2013) can be rather useful in the clinical setting, for, as was stressed, the article is a practical guide to basic burn care. For example, the fact that the issue of a general inadequacy of analgesia has been mentioned (Rowley-Conwy, 2013) makes clinicians aware of this problem, which may cause them to pay more attention to the pain. Numerous practical guidelines, such as the recommendation to provide liquid supply which allows for the minimal acceptable output of urine (0.5 mL/kg) (Rowley-Conwy, 2013, p. 64), may also be utilized in the clinical setting by following this advice.

Recommending the Article to Other Students

It is possible to recommend the article to other students, especially general nursing students, for they may have to deal with a patient with burns one day, in which case knowing the basics of burn care will be necessary. The article is suitable for such students because it provides general practical guidelines that may be adequate for a nurse who does not specialize in wound care. On the other hand, the article on its own would probably be insufficient for burn care professionals.

Possible Ways to Improve the Article

There are some ways to improve the article. For instance, it might be useful to include medication recommendations and their doses for different aspects of burn care touched upon in the article. It was noted that the author sometimes refers to certain basic, generally accepted principles of burn care; in certain cases, it might be useful to include these principles in the article, at least in order to ensure that the reader would think of the same principles that the author meant (and that what the reader thinks of, e.g., has not become obsolete).

Does the Article Encourage Exploring the Subject Further?

The article does not directly encourage further exploration of the subject. It is meant as a quick practical guide for a general nurse. Nevertheless, a practitioner who needs to care for a patient with burns may need to look for additional literature in order to gain a more comprehensive understanding of the issue.

Conclusion

Therefore, the article may prove rather useful for nurses who have to deal with patients with burns in intensive or acute care units. However, they still may need to turn to other sources of information as well to obtain a more exhaustive understanding of burn management.

Reference

Rowley-Conwy, G. (2013). Management of burns in intensive and acute care. Nursing Standard, 27(45), 63-68.