Management at the Scene
- Stop the burning process.
- Put out the fire.
- Remove the victim from the source of injury.
- Remove the clothing and cover with a clean sheet.
- Assess the burn percentage by following “Rule of Nines.”
Care of the Burn Wound
- Irrigate with copious amounts of tap water till the pain subsides (about 10–20 minutes).
- Transport the patient in clean dry sheets.
- Do not use ice.
- Do not let the core temperature drop to lower levels.
- Cover the patient with clean and dry sheet.
- Keep the patient warm.
- Inform the receiving hospital.
Referral Criteria
- Burns in very young children and elderly.
- Chemical and electrical injuries.
- Inhalational injuries.
- Burns involving more than 15% of TBSA in adults and 10% in children.
- Burns of the vital areas [face, hand, foot, genitalia].
- Burns requiring fluid resuscitation.
- Associated other trauma, medical conditions.
Assessment of Burn Depth
First Degree
- Erythema or redness
- Dry
- Painful
- Minimal or no edema
- No blisters
Second Degree
- Superficial
- Red
- Blistered
- Very painful
- Deep
- White
- Soft and resilient
- Hair follicles and sweat glands are intact.
Third Degree
- Painless
- Dry and brown
- Leathery eschar
- Thrombosed blood vessals
- Cutaneous hair can be pulled out easily.
Fourth Degree
Clinical features are similar to third degree together with exposed bone, muscle or tendon.
Fluid Resuscitation
Indications
- In adults with superficial burns of more than 15% or deeper burns of less than 15%.
Resuscitation Formula
- Evan's formula
- Brooke's formula
- Modified brooke's formula
- Parkland formula.