Erin Allman-Updike

Yeah.

So the pathophysiology of burns, severe burns especially, is divided into two phases.

The first phase is in these first 24 to 72 hours.

And that's called the hypodynamic phase.

And that is when all this inflammation is happening.

Our bodies kick into high gear.

Inflammatory markers are going everywhere.

Vascular permeability is up.

So we are at very high risk of going into shock.

And shock, as we learned in our sepsis episode, means a drop in your blood pressure, enough so that all of your other organs are not getting enough blood.

So this is incredibly dangerous.

It can result in multi-organ failure, kidney failure, liver failure.

Your heart is not pumping out enough blood.

And really it's because you're not losing blood enough.

So you're not bleeding out, but you are losing so much fluid from this process that your blood pressure just can't keep up.

We can also see really bad fluid imbalances and electrolyte imbalances as well.

So in this period, what's really important is fluid resuscitation.

As well as like management of these wounds to try and prevent all of this stuff from getting worse.

And in the case of those, like if we have circumferential burns and things, there has to be like pressure relief.

So you have to do some kind of surgical intervention, even if it's something small, to literally release that pressure so that you don't cause further damage to the tissue or the tissue downstream from that.