From Cholera to Burns: A Role for Oral Rehydration Therapy (Short Report) (Report‪)‬

INTRODUCTION Oral rehydration therapy (ORT) was formulated for treating cholera in the 1960s (1,2). It was proven as a robust treatment in a mass casualty setting of cholera in refugees fleeing a war in East Pakistan (now Bangladesh) in 1971. In this setting with limited or no intravenous (IV) fluid therapy available, ORT alone decreased deaths from about 40% to 3% and was administered by friends and families of the cholera victims without any prior training (3). Later experiences in mass outbreaks of cholera in Peru and Rwanda confirmed its efficacy (4). Burn injuries often occur as mass casualty events. The initial loss of life is due to rapid loss of fluids and electrolytes into the areas affected by the burn. The current standard of care for burns over 20% of the total body surface area (TBSA) and 10% of the TBSA in children is prompt replacement of IV fluid using standardized formulae (5). In this case series, we reduced the volume of IV fluid replacement needed in three burned patients by starting treatment in the first 24 hours. We have reviewed the relevant literature and suggest that this may be an effective way to reduce the requirements of IV fluid therapy in burns. ORT has the potential of saving many lives in the event of mass thermal casualties or in resource-poor settings where transport, intensive care, and definitive surgical care may be delayed.