Critical Care Scenarios Lightning rounds 57: Burn critical care with Clint Leonard
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Nov 12, 2025 Dive into the complex world of burn critical care with insights from an NP specializing in the burn ICU. Discover how different burn mechanisms, from flames to electrical injuries, shape patient treatment. Learn about fluid resuscitation strategies, the timing of excisions, and innovative grafting techniques. Clint Leonard shares the challenges of hypermetabolism and nutrition needs in burn patients, highlighting the importance of a multidisciplinary approach to care. Tune in for a blend of practical advice and compelling patient stories!
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Intubate Early For Airway And Procedures
- Anticipate early intubation for inhalation injury, pain control, or repeated OR trips.
- Plan ventilation and airway control proactively because many patients need multiple operations early.
Cadaver Skin As A Biological Band‑Aid
- Cadaveric skin serves as a temporary biologic cover to reduce fluid loss and infection risk after excision.
- Donor skin delays but does not replace eventual autologous grafting, per Clint Leonard.
Stretching Limited Autologous Skin
- Strategies to extend limited autologous skin include reharvesting donor sites, meshing, and autologous spray skin.
- New spray techniques enable very high expansion ratios (up to ~80:1) to cover large defects.