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December 16, 1939

BURN SHOCK: THE QUESTION OF WATER INTOXICATION AS A COMPLICATING FACTOR: BLOOD CHEMICAL STUDIES AND REPORT OF AN EXTENSIVE BURN TREATED BY REPEATED TRANSFUSIONS OF BLOOD AND BLOOD PLASMA

JAMA. 1939;113(25):2207-2213. doi:10.1001/jama.1939.02800500013004
Abstract

It is common knowledge that cases of extensive burn are likely to terminate fatally. Seldom does recovery occur from a burn which involves half the body surface, even though the burn is superficial. There are many who die from burns involving considerably less than half the body surface. This is especially true of children.

Furthermore, it is known that patients with severe burns are liable to a variety of complications such as pneumonia, nephritis, embolism, perforating ulcer of the bowel, sepsis and various other pathologic states, any of which may be contributory causes of death. We mention these only to avoid possible confusion in the discussion which follows. Our principal theme concerns the acutely fatal shock reaction which comes a few hours or a few days after the burn.

The symptoms and course of the burn shock state are variable. Too often death comes unexpectedly in a case thought to

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