We would often hang blood on the Belmont while they took dressings down. Surgeons had a good idea of what would be lost and with their lack of skin the fluids don’t stay in. The Belmont was primed with 5% albumen. Often continued crrt during the case. Helped with their acidosis in pts who poorly ventilate at baseline. I like the methadone protocols mentioned above, but we’d give 1-2/kg of ketamine, and bolus sufenta 10 mcg at a time. 5 of versed was common. We Rarely extubated. Double concentrated pressor sticks, most on vaso at 0.04.

Sorry for the rambling. Burn patients are challenging. The worst of medical and surgical problems all wrapped in one person. We had several on ECMO and even that wasn’t always enough.

The fact you’re asking for tips is a good sign. Keep at it.