Care of the critically ill burn patient: An overview from the perspective of optimizing palliative care

Daniel E. Ray, Mohana B. Karlekar, Donnelle L. Crouse, Margaret Campbell, J. Randall Curtis, Jeffrey Edwards, Dana R. Lustbader, Anne C. Mosenthal, Colleen Mulkerin, Kathleen A. Puntillo, David E. Weissman, Renee D. Boss, Karen Brasel, Judith E. Nelson

Research output: Contribution to journalReview article

Abstract

Burn specialists have long recognized the need for and have 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 U.S. 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 intensive care unit settings; addresses special needs of critically ill burned patients, their families, and clinicians for highquality palliative care; and highlights potential benefits of integrating primary and specialist palliative care in burn critical care. MEDLINE and the Cumulative Index to Nursing and Allied Health Literature were searched, and an e-mail survey was used to obtain information from U.S. Burn Fellowship Program directors about palliative medicine training. The Improving Palliative Care in the Intensive Care Unit 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 the culture of the particular burn unit, can optimize quality and integration of primary and specialist palliative care in this distinctive setting.

Original languageEnglish (US)
Pages (from-to)1094-1102
Number of pages9
JournalAnnals of the American Thoracic Society
Volume14
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Palliative Care
Critical Illness
Burn Units
Critical Care
Intensive Care Units
Patient Care Team
Postal Service
MEDLINE
Nursing
Communication
Guidelines
Morbidity
Pain
Mortality
Health
Research

Keywords

  • Burn care
  • Burn intensive care unit
  • End-of-life care
  • Palliative care

ASJC Scopus subject areas

  • Medicine(all)
  • Pulmonary and Respiratory Medicine

Cite this

Ray, D. E., Karlekar, M. B., Crouse, D. L., Campbell, M., Randall Curtis, J., 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. https://doi.org/10.1513/AnnalsATS.201607-577PS

Care of the critically ill burn patient : An overview from the perspective of optimizing palliative care. / Ray, Daniel E.; Karlekar, Mohana B.; Crouse, Donnelle L.; Campbell, Margaret; Randall Curtis, J.; Edwards, Jeffrey; Lustbader, Dana R.; Mosenthal, Anne C.; Mulkerin, Colleen; Puntillo, Kathleen A.; Weissman, David E.; Boss, Renee D.; Brasel, Karen; Nelson, Judith E.

In: Annals of the American Thoracic Society, Vol. 14, No. 7, 01.07.2017, p. 1094-1102.

Research output: Contribution to journalReview article

Ray, DE, Karlekar, MB, Crouse, DL, Campbell, M, Randall Curtis, J, Edwards, J, Lustbader, DR, Mosenthal, AC, Mulkerin, C, Puntillo, KA, Weissman, DE, Boss, RD, Brasel, K & Nelson, JE 2017, 'Care of the critically ill burn patient: An overview from the perspective of optimizing palliative care', Annals of the American Thoracic Society, vol. 14, no. 7, pp. 1094-1102. https://doi.org/10.1513/AnnalsATS.201607-577PS
Ray, Daniel E. ; Karlekar, Mohana B. ; Crouse, Donnelle L. ; Campbell, Margaret ; Randall Curtis, J. ; Edwards, Jeffrey ; Lustbader, Dana R. ; Mosenthal, Anne C. ; Mulkerin, Colleen ; Puntillo, Kathleen A. ; Weissman, David E. ; Boss, Renee D. ; Brasel, Karen ; Nelson, Judith E. / Care of the critically ill burn patient : An overview from the perspective of optimizing palliative care. In: Annals of the American Thoracic Society. 2017 ; Vol. 14, No. 7. pp. 1094-1102.
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