Burns Protocol
Emergency treatment guidelines for burn injuries
Initial Assessment
- • Stop the burning process
- • Ensure scene safety
- • Remove clothing and jewelry (unless stuck to skin)
- • Assess burn depth and total body surface area (TBSA)
- • Check for inhalation injury
Burn Classification
First Degree (Superficial)
Red, painful, dry, no blisters. Involves epidermis only.
Second Degree (Partial Thickness)
Red, blistered, painful, moist. Involves epidermis and dermis.
Third Degree (Full Thickness)
White/charred, painless, dry. All skin layers destroyed.
Treatment
Immediate Care
- • Cool burn with room temperature water (10-20 minutes)
- • Cover with clean, dry dressing
- • Elevate burned extremities
- • Monitor vital signs
Pain Management
- • Administer appropriate analgesia
- • Consider IV morphine for severe burns
- • Use cooling techniques cautiously
Fluid Resuscitation (Parkland Formula)
4ml × kg body weight × % TBSA burned = Total fluid in 24 hours
Give half in first 8 hours, remainder over next 16 hours
Transport Criteria
Burn Center Referral Criteria
- • Partial thickness burns >10% TBSA
- • Burns involving face, hands, feet, genitalia, or joints
- • Third degree burns in any age group
- • Electrical or chemical burns
- • Inhalation injury
- • Circumferential burns
- • Patients with pre-existing medical conditions
⚠️ Critical Considerations
- • Never apply ice directly to burns
- • Do not break blisters
- • Watch for signs of shock
- • Consider carbon monoxide poisoning in enclosed space fires
- • Document time of injury and initial treatment