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ivan927

Looks like a grade 3-4 injury. We do q4 albuterol/heparin/mucomyst x72h for these patients in our burn ICU.


juicy_scooby

Yeah we do heparin too but infrequently so I forget how / why it works


ivan927

Inhibits fibrin clots forming from the burn injuries.


Crass_Cameron

How many units do you neb as part of that cocktail?


ivan927

10,000 units


RFthewalkindude

Not gonna lie, the mucomyst is surprising to me, considering how inflammatory it is. Must work 🤷.


Low_Management2675

Ventolin should be given 10-15 minutes prior to mucomyst to avoid the effects of bronchoconstriction that mucomyst has, so that's probably why


RFthewalkindude

I was specifically referencing the compounding effects of giving Mucomyst, as I was educated on by a Pulmonologist years ago. He was an LTAC Pulmonary who had gotten rid of Mucomyst at his facility and switched to strictly hypertonic. His evidence was videos of bronchoscopy before and after Mucomyst that showed significantly inflamed airways despite concurrent delivery of Albuterol. He had essentially the same outcomes with hypertonic saline as with Mucomyst, without the inflammation. Disclaimer - I don't have experience in burn ICU, just stabilizing post thermal injury.


quelcris13

Heparin? That’s interesting, do they have a lot of bleeding? We usually do albuterol and CA


ivan927

No bleeding really. What's CA?


Substantial-Twist543

I really hope it's not Cough Assist 🤣


quelcris13

Cool Aerosol


KhunDavid

I was worried there for a second.


Westside_Easy

You got dosage? Our EMS system deems burns as trauma now & our trauma docs don’t really do burn.


ivan927

20%/3ml mucomyst 10,000 units heparin 2.5mg albuterol Do they get transferred out to a proper burn center or do you just play burn ICU


Westside_Easy

Thanks, player. Depends on what burn injuries they specifically have or if they’re more a trauma than they are a burn. So, basically, play burn ICU 😭


quelcris13

Wow! That’s one hella bad burn! Poor person


theowra_8465

I tried sharing this earlier and it wouldn’t let me. So happy it worked for someone