Adherence to Burn Resuscitation Guidelines Reduces Resuscitation Fluids and Mortality
Bibliographic record
Abstract
In our province, regional recommendations for optimal fluid resuscitation were published in 2011 to improve the management of acute burn patients prior to transfer to a specialized burn center. The purpose of this study was to determine compliance with these provincial burn resuscitation guidelines and their subsequent impact on patient outcomes. A retrospective review of patients transferred to the provincial burn center after being initially managed at peripheral sites was performed from 2011 to 2019. Patients were included if their burn injury was greater than 20% TBSA and they were transferred within 24 hours postburn injury. Charts were reviewed for the amount of fluid patients received and resuscitation associated outcomes. A total of 72 patients met the inclusion criteria, 37 of which were treated in accordance with the 2011 guidelines. For patients that followed the 2011 provincial guidelines, they received on average 3.2 cc/kg/TBSA of fluid during the first 24 hours postburn injury. Significantly more fluids were given when guidelines were not followed with an average of 4.4 cc/kg/TBSA (P = .03). Mortality rates were found to be significantly lower during the primary admission with guidelines compliance (16.2% vs 2.7%, P = .04). No significant differences were found between the remaining evaluated complications including abdominal compartment syndrome (8.1% vs 2.7%) and need for escharotomy (35.2% vs 21.6%). The use of clinical practice guidelines decreased excess IV fluid administration in additional to decreasing mortality rates for patients initially assessed in peripheral low volume centers.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".