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Burns


Inclusion Criteria: Patients who have thermal, chemical or electrical burns and/or those who have sustained inhalation injuries. Hypotension is not normally seen with burn patients and suggests other trauma. Refer to the Trauma guidelines, as needed.


          Basic Level

  1. Assess and support ABCs. Look closely for evidence of inhalation injury (hoarseness, stridor, sooty sputum, facial burns, or singed nasal or facial hair) and be prepared to manage the airway aggressively.
  2. Initiate spinal movement restrictions, as needed. If no suspicions of spinal injury, place the patient in a position of comfort. If evidence of shock, place the patient supine with the feet elevated and monitor airway closely. Treat shock according to the Shock guideline.
  3. Administer oxygen as needed to maintain a SpO2 of at least 96%.
  4. Remove and secure any jewelry, belts, shoes, etc. from burned areas. Remove burned or singed clothing not stuck to the skin.
  5. Control any obvious external bleeding. Prevent hypothermia and initiate care for burn wounds.
    a.    Chemical injury - Brush off chemical, flush with water to remove any residual chemical.
    b.    Thermal injury - dry sterile dressings
  6. Begin transport as soon as possible. Major and moderate burns require transport to a burn center.


    Advanced Level

  7. IV fluid resuscitation as needed to maintain adequate perfusion. Do not exceed 1 liter of IV fluids unless authorized by BioTel. Contact BioTel for fluid orders in patients with CHF, cardiac disease, or age greater than 65 years.
  8. Apply ECG and EtCO2 monitors if respiratory distress or shock is present or develops. Monitor carbon monoxide levels, if possible. ECG monitoring is mandatory if electrical injury is present.
  9. Follow Pain Management guidelines.
  10. For additional patient care considerations not covered under standing orders, consult BioTel.

Patients Requiring Transport to a Burn Center
  • Burns greater than 15% of body surface area, regardless of the degree
  • Burns of hands feet or genitalia
  • Electrical, chemical or inhalation burns (including smoke inhalation)
  • Burns associated with other injuries (e.g., fractures)
  • Burns in patients with preexisting medical conditions (elderly, diabetic cardiac history, etc.)

 

The following information is NOT part of the BioTel Treatment Guidelines. It has been made available for informational purposes only.

Adult Burn Chart             Infant Burn Chart

Lund & Browder Chart

Parkland Burn Formula

 

 
 

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