TCAA's Trauma University is designed to provide practitioners with cutting edge clinical education. Based on TCAA member recommendations, 2023's presentation provides a comprehensive review of a complex case covering multiple generations of trauma patients. 

Estimated completion time: 1 hour and 15 minutes
Target Audience: The Trauma healthcare team and other clinical departments

Learning Objectives

At the conclusion of this course, the learner should be better able to:

1. Describe the principles of burn disaster management. 
2. Define best practices utilized in treating the patient with burns and trauma-related injuries. 
3. Describe the diferent types of burns more unique to the pediatric population. 
4. Identify best practices for a trauma patient with inhalation-type burns. 

Faculty Presenters: Dr. Shawn Fagan

Faculty Bios:

Dr. Shawn Fagan:  Dr. Shawn P. Fagan graduated from the Baylor College of Medicine in 1994, where he also completed both his general surgery residency and a two-year basic science research fellowship in pancreatic islet cell physiology. He joined the Michael E. DeBakey Department of Surgery at Baylor College of Medicine in 2001, where he practiced at the Michael E. DeBakey Veterans’ Hospital. In 2005, Dr. Fagan sought additional subspecialty training in the field of surgical critical care under the supervision of Dr. David Herndon at the University of Texas Medical Branch at Galveston and Shriners’ Burn Hospital for Children. He was recruited to the team at Sumner Redstone Burn Center at Massachusetts General Hospital and Shriners’ Burn Hospital for Children in Boston in 2006. Shortly after, he was named the Medical Director of both burn centers. During his tenure as a surgeon, Dr. Fagan has also served as an Assistant Professor at both Baylor College of Medicine and Harvard University. A member of the American Telemedicine Association, Dr. Fagan is a proponent of telemedicine and developing the technology to improve burn and wound care. While at Sumner Redstone Burn Center in Boston, he developed a telemedicine outreach program which provided burn care across the state. He also utilized a telemedicine-based rehabilitation follow-up program that resulted in significant cost savings for the hospital – a program which received the prestigious American Business Award. In 2015, he was recruited to join the physicians at the Joseph M. Still Burn Center at Doctors Hospital in Augusta, GA. He currently serves as a burn surgeon, critical care intensivist and Chief Medical Officer for Burn & Reconstructive Centers of America. 

Abraham P, et al. Sodium nitroprusside in intensive care medicine and issues of cyanide poisoning, cyanide poisoning prophylaxis, and thiocyanate poisoning. In: Hall AH, et al, eds. Toxicology of cyanides and cyanogens: Experimental, applied and clinical aspects. West Sussex, UK:Wiley Blackwell; 2015:142-146​

American Burn Association. National Burn Repository 2017 Report: Report of Data from 2008-2016. Chicago, IL: American Burn Association;2018.

American Burn Association. Advanced Burn Life Support Course Provider Manual. 2016 Update. American Burn Association: Chicago, IL: 2016.​

American College of Surgeons, Committee on Trauma. Advanced Trauma Life Support Student Course Manual. Chicago: American College of Surgeons;2012.

American Burn Association. Advanced Burn Life Supporters Manual. Chicago, IL: American Burn Association; 2011

American Burn Association. Advanced Burn Life Support (ABLS). Excerpted from Guidelines for optimal care of the injured patient 2006, Committee on Trauma, American College of Surgeons. Chicago, IL:2017.

American Burn Association. Advanced Burn Life Support Course Provider Manual. American Burn Association: Chicago, IL: 2007.

Atiyeh BS, Costagliola M. Cultured epithelial autograft (CEA) in burn treatment: Three decades later. Burns. 2007;33:405-413

Burke JF, et al. Primary burn excision and immediate grafting: a method of shortening illness. J Trauma 1974;14:389–95.

Baud FJ, Barriot P, Toffis V, et al. Elevated blood cyanide concentrations in victims of smoke inhalation. NEJM. 1991;34:1761-1766​

Baud FJ, Haidar MK, Jouffroy R, et al. Determinants of lactic acidosis in acute cyanide poisonings. Crit Care Med. 2018;46:e523-529​

Baud FJ. Cyanide: Critical issues in diagnosis. Hum Exp Toxicol. 2007;26:191-201 Chemical Hazards Emergency Management. Hydrogen cyanide – Emergency department/Hospital management. https://chemm.nlm.nih.gov/cyanide_hospital_mmg.htm. Accessed March 12, 2019.

Culnan DM, Capek KD, Huang T, et al. Acute and reconstructive care of the burned hand. In: Herndon DN, ed. Total Burn Care. 5^th ed. Edinburgh:Elsevier;2016:589-608

Culnan DM, Craft-Coffman B, Bitz GH, et al. Carbon monoxide and cyanide poisoning in the burned pregnant patient: An indication for hyperbaric oxygen therapy. Ann Plast Surg. 2018;80:S106-S112.​

Culnan DM, Craft-Coffman B, Bitz G, Mullins RF. Rapid communication: Solution for the MEEK Glue Transfer Problem. J Burn Care Res. 2018;39:274-7

Demling RH. Smoke inhalation lung injury: An update. Eplasty. 2008;8:e27. Published 2008 May 16.​

Foncerrada G, Culnan DM, Capek KD, et al. Inhalation injury in the burned patient. Ann Plast Surg. 2018;80:S98-S105.​

Gracia R, Shepherd G. Cyanide poisoning and its treatment. Pharmacotherapy. 2004;24:1358-65

Guo HF, Ali RM, Hamid RA, et al. A new model for studying deep partial-thickness burns in rats. Int J Burns Trauma. 2017;7:107-14

Hartford CE. Care of outpatient burns. In: Herndon DN, ed. Total Burn Care. 4^th ed. Edinburgh: Elsevier; 2012:81-92.

Holmes JHIV, Molnar JA, Carter JE, et al. A comparative study of the ReCell® device and autologous split-thickness meshed skin graft in the treatment of acute burn injuries. JBCR. 2018;39:694-702

Jeng JC, Phillips B. Dead-Reckoning the distance between the national burn repository and a true population-based registry: A challenge and an opportunity. J Burn Care Res. 2009:140-141

Nelson L. Aucte cyanide toxicity: Mechanisms and manifestations. J Emerg Nurs. 2006;32:S8-11.

Sood R, Roggy DE, Zieger MJ, et al. A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries. Wounds. 2015;27:31-40

Silver et al.  Standard Operating Procedures for the Clinical Management of Patients Enrolled in a Prospective Study of Inflammation and the Host Response to Thermal Injury.  J Burn Care and Res 2007;28(2):228-230.

Stewart CL. The fire at Cocoanut Grove. J Burn Care Res. 2015;36:232-235

Subrahmanyam M. Early tangential excision and skin grafting of moderate burns is superior to honey dressing: prospective randomized trial. Burns 1999;25:729–31.

Tompkins RG, et al. Significant reductions in mortality for children with burn injuries through the use of prompt eschar excision. Ann Surg 1988;208(5):577–85.