UCSD Regional Burn Center
Jennifer Newkirk
NUTR 409
1-9-2015
1. It is common knowledge in the medical field that nutrition plays a vital role in the
recovery of individuals suffering from major burns. Patients suffering from burns often
require double the amount of calories they would normally need for healing and growth.
The dietitian working in a burn care unit has a very specialized job in helping to
determine the nutritional and calorie needs of this unique patient population. The
responsibilities of a registered dietitian employed in this field of practice are very focused
and include nutrition assessment, nutrition support to meet the excessively increased
energy needs burns require, and monitoring of feedings and recommending changes
through out the different recovery stages. Research continues to demonstrate results that
prove the importance of the dietitian’s role in critical care and in the outcome of a
patient’s health. Findings show that early implementation of enteral feeding improves
the outcomes of burn patients making the job of the dietitian critical in their recovery.1
Research also shows that enteral nutrition started safely within hours of a burn injury
reduces caloric deficit, improves nitrogen balance and reduces rates of sepsis.2 The
dietitian is part of an interdisciplinary team that works in unison to treat the varying
needs of a burn patient through each stage of the recovery process and must also spend a
great amount of time educating patients, caregivers, and family members of those who
have been injured.
2. The UCSD Regional Burn Center has an intensive care unit, a special burn care unit and
an outpatient clinic for minor burn assessment and treatment. There are over 400 patients
admitted to the Center each year ranging from all different age groups including infants
to the elderly. Patients admitted may also suffer from varying burn severities. The center
includes experts in plastic and reconstructive surgery, nutrition, social work, psychology,
pain management, child life, and physical and occupational therapy. For nearly forty
years, UC San Diego Regional Burn Center has made notable advances in burn treatment
and continues to lead burn injury research. The Center serves the San Diego and Imperial
Counties with no other specialized burn unit in close proximity. The next closes
specialized burn unit is located in Los Angeles. The UC San Diego Burn Center includes
eight separate enclosures to treat the most severely burned patients and also a full time
burn outpatient clinic. The facility also includes an operating surgical room.
3. This site visit has been my favorite of all so far. I was very intrigued when we were given
the opportunity to walk through the burn unit and see first hand the unique care setting. I
had initially assumed that most of the patients would be severe burn patients and
intubated, but am now aware that the Center treats a wide range of burns. I never realized
the difficulty of treating a patient with an inhalation burn and the accompanying
complications due to infection and illness that these patients endure. I learned the unique
role that indirect calorimetry plays in this setting and how often it is used to determine a
patient’s resting energy expenditure. I also learned how important it is working in this
field to have a tough stomach! The dietitian works with some extreme trauma patients
and anyone interested in this field cannot be squeamish in the slightest bit. There is a
unique mental health aspect to this specialty that I had never understood before. Some of
the patients admitted on the floor struggled with mental health issues that were a driving
factor in their self-inflicted burns, while other patients develop psychological stress due
to the burn recovery and healing process itself. Having worked in the field of pre-hospital
emergency response, I could see myself practicing in this area of dietetics in the future. I
know how to treat a patient and remove myself emotionally from these traumatic types of
situations. I also like the possibility of working with patients for a longer period of time
through each step of their recovery. I believe today’s take home lesson is that it takes a
unique person to work in each field of dietetics and it takes an even more special person
to work in the burn unit!
References
1) Lu G, Huang J, Yu J, et al. Influence of early post-burn enteral nutrition on clinical
outcomes of patients with extensive burns. J Clin Biochem Nutr. 2011; 48:222.
2) Saito H, Trocki O, Alexander J, et al. The effect of route of nutrient administration on the
nutritional state, catabolic hormone secretion and gut mucosal integrity after burn injury.
JPen-Parenter Enter. 1987;11:1–7.
3) UC San Diego Health System. Regional Burn Center Web site.
http://surgery.ucsd.edu/divisions/trauma-burn/about/burn-center/Pages/default.aspx.
Accessed March 8, 2015.