Care of the Critically Ill Burn Patient: An Overview from the Perspective of Optimizing Palliative Care.
Burn specialists have long recognized the need for and role modeled a comprehensive approach incorporating relief of distress as part of care during critical illness. More recently, palliative care specialists have become part of the healthcare team in many US hospitals, especially larger academic institutions that are more likely to have designated burn centers. No current literature describes the intersection of palliative care and burn care or integration of primary and specialist palliative care in this unique context. This Perspective gives an overview of burn care; focuses on pain and other symptoms in burn ICU settings; addresses special needs of critically ill burned patients, families, and clinicians for high-quality palliative care; and highlights potential benefits of integrating primary and specialist palliative care in burn critical care. Medline and Cumulative Index to Nursing and Allied Health Literature were searched, and an email survey obtained information from US burn fellowships program directors about palliative medicine training. The IPAL-ICU (Improving Palliative Care in the ICU) Project Advisory Board synthesized published evidence with their own research and clinical experience in preparing this article. Mortality and severe morbidity for critically ill burned patients remains high. American Burn Association guidelines lay the foundation for a robust system of palliative care delivery, embedding palliative care principles and processes in intensive care by burn providers. Understanding basic burn care, challenges for symptom management and communication, and culture of the particular burn unit, can optimize quality and integration of primary and specialist palliative care in this distinctive setting.
Published In/Presented At
Ray, D. E., Karlekar, M. B., Crouse, D. L., Campbell, M., Curtis, J. R., Edwards, J., & ... Nelson, J. E. (2017). Care of the Critically Ill Burn Patient. An Overview from the Perspective of Optimizing Palliative Care. Annals Of The American Thoracic Society, 14(7), 1094-1102. doi:10.1513/AnnalsATS.201607-577PS
Medicine and Health Sciences
Department of Medicine, Department of Medicine Faculty