Burn units in hospitals did not make their debut until sometime in the early 1970s; before then there was no established protocol for the treatment for burns. If you were badly burned you were admitted to a hospital to be treated on a medical/surgical floor if the hospital was just a small county hospital. If you managed to live in a bigger city with a larger hospital you would have been admitted to the intensive care unit. There in the ICU or on a medical floor the doctors and nurses followed doctors orders and did the best they could to relieve the suffering of the victims.
In the 1950s lactated ringers solution was recognized to help prevent hypovolemic shock in burn patients. Lactated ringers solution is the most like the fluid in between the cells and the fluid that makes up blood plasma. This fluid contains proteins and electrolytes and is extracellular fluid that is necessary for the treatment for burns. Ringers lactate solution mimics that fluid. Lactated ringers solution is used rather than normal saline or dextrose solutions because neither of those IV fluids contains electrolytes. Burn patients are often glucose intolerant because they have abnormally high levels of adrenaline circulating in their blood. Elevated glucose in the blood stream makes the kidneys work harder to manufacture urine. Lactated ringers solution prevents the patient from dehydrating, where a 5 percent dextrose solution would dehydrate the patient. Normal saline would add chloride to the blood which could cause the patient to go into a state of acidosis, definitely not a wished treatment for burns. So much has been learned through the years through trial and error.
Techniques and philosophies have changed over the years so that treatment for burns left the patient with the least amount of scaring. The goal was to help the patient heal from the inside out; accepting the changes and getting on with life. At one time a burned patient might be left horribly scarred for the rest of his/her life. Treatment for burns involves not only the outside, but the body and mind. No one looks exactly the same after suffering severe burns; however, so much is being done to reduce scarring and improving mobility that the burned patient can begin to see the light at the end of the long tunnel. Recovering from burns takes a huge effort; the mind has to be in sync with the body to get the job done. A burn patients job is to work through the pain each day and night. The therapies are often very painful, but the outcome is definitely worth it.
Back in the days before hospitals had burn units, patients often died from the complications of their burns. Little was known about the treatment for burns; because treatment for burns was a trial and error for a long time. The techniques that worked were adopted into normal protocol for burns, and the techniques that didn’t work were discarded. The study of burns has become a specialty over the years. It is truly amazing to see a patient recover from serious burns and go on to live a normal productive life.